Nomogram for Predicting Breast Conservation after Neoadjuvant Chemotherapy.
- Author:
Min Kyoon KIM
1
;
Wonshik HAN
;
Hyeong Gon MOON
;
Soo Kyung AHN
;
Jisun KIM
;
Jun Woo LEE
;
Ju Yeon KIM
;
Taeryung KIM
;
Kyung Hun LEE
;
Tae Yong KIM
;
Sae Won HAN
;
Seock Ah IM
;
Tae You KIM
;
In Ae PARK
;
Dong Young NOH
Author Information
- Publication Type:Original Article
- Keywords: Segmental mastectomy; Neoadjuvant therapy; Nomograms; Breast neoplasms
- MeSH: Breast Neoplasms; Breast*; Calibration; Cohort Studies; Drug Therapy*; Estrogens; Female; Humans; Logistic Models; Mammography; Mastectomy; Mastectomy, Segmental; Neoadjuvant Therapy; Neoplasm, Residual; Nipples; Nomograms*; ROC Curve
- From:Cancer Research and Treatment 2015;47(2):197-207
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The ability to accurately predict the likelihood of achieving breast conservation surgery (BCS) after neoadjuvant chemotherapy (NCT) is important in deciding whether NCT or surgery should be the first-line treatment in patients with operable breast cancers. MATERIALS AND METHODS: We reviewed the data of 513 women, who had stage II or III breast cancer and received NCT and surgery from a single institution. The ability of various clinicopathologic factors to predict the achievement of BCS and tumor size reduction to < or = 3 cm was assessed. Nomograms were built and validated in an independent cohort. RESULTS: BCS was performed in 50.1% of patients, with 42.2% of tumors reduced to < or = 3 cm after NCT. A multivariate logistic regression analysis showed that smaller initial tumor size, longer distance between the lesion and the nipple, absence of suspicious calcifications on mammography, and a single tumor were associated with BCS rather than mastectomy (p < 0.05). Negative estrogen receptor, smaller initial tumor size, higher Ki-67 level, and absence of in situ component were associated with residual tumor size < or = 3 cm (p < 0.05). Two nomograms were developed using these factors. The areas under the receiver operating characteristic curves for nomograms predicting BCS and residual tumor < or = 3 cm were 0.800 and 0.777, respectively. The calibration plots showed good agreement between the predicted and actual probabilities. CONCLUSION: We have established a model with novel factors that predicts BCS and residual tumor size after NCT. This model can help in making treatment decisions for patients who are candidates for NCT.
