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Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
Published on: January 12, 2017
Ultrasound-Derived Nomogram for Differentiating HER2+/HER2- Subtypes in Luminal B-Type Breast cancer: Principal
Shiqi Zhang1,2, Tiantian Ren1, Yanyan Tong2
1Department of Ultrasound, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China.
Objective:
To identify ultrasound predictors of HER2 status in Luminal B-type breast cancer and develop an interpretable preoperative nomogram.
Methods:
This retrospective study included 159 patients divided into training (n = 111) and validation (n = 48) cohorts. Candidate predictors were screened by univariable logistic regression (p < 0.20), followed by multivariable logistic regression with backward AIC-based selection. LASSO regression, bootstrap internal validation, ROC analysis, calibration, and DCA were performed.
Results:
Luminal B (HER2+) and Luminal B (HER2-) tumors differed in orientation, spiculation, hyperechoic halo, microcalcification, Adler grade blood flow, and posterior echo patterns. The final model retained orientation, spiculation, hyperechoic halo, Adler grade blood flow, and posterior echo attenuation; LASSO selected the same predictors. The nomogram showed good discrimination (training AUC, 0.827; validation AUC, 0.800). Bootstrap validation yielded optimism-corrected AUC and calibration slope values of 0.801 and 0.728, respectively. Calibration showed acceptable agreement, and DCA suggested potential clinical utility.
Conclusion:
The ultrasound-based nomogram may provide a noninvasive, interpretable aid to preoperative HER2 risk stratification in Luminal B-type breast cancer, but prospective multicenter validation is required before broader clinical application.
