Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct;7(20):537.
doi: 10.21037/atm.2019.10.10.

Development and validation of a novel nomogram for predicting distant metastasis-free survival among breast cancer patients

Yan Wang  1   2 , Yaping Yang  1   2 , Zhengbo Chen  3 , Teng Zhu  4 , Jiannan Wu  1   2 , Fengxi Su  1   2 , Heran Deng  1   2
Affiliations

Development and validation of a novel nomogram for predicting distant metastasis-free survival among breast cancer patients

Yan Wang et al. Ann Transl Med. 2019 Oct.

Abstract

Background: Distant metastasis (DM) from breast cancer has a poor prognosis. Our objective was to develop and validate a nomogram to predict individual distant metastasis-free survival (DMFS) and risk stratification in non-metastatic breast cancer patients.

Methods: A nomogram was based on an analysis of 1,201 breast cancer patients treated at Sun Yat-sen Memorial Hospital from 2001 to 2014. Using univariate and multivariate analyses to identify the predictors, this model was externally validated in an independent cohort of 538 patients from the Guangdong General Hospital between 2004 and 2012. The predictive discrimination and calibration ability of this nomogram were assessed using concordance index (C-index), risk group stratification, and calibration curve.

Results: The 5-year DMFS in the training and validation cohorts were 95.74% and 91.02%, respectively. On multivariable analysis of training cohort, the prognostic factors in the nomogram comprised age, tumor size, lymph node status, molecular subtype, and lymphovascular invasion (LVI). The C-index of our model was 0.75 [95% confidence interval (CI): 0.67-0.83] for the training cohort and 0.71 (95% CI: 0.64-0.78) for the validation cohort. The calibration curves for 5-year DMFS showed good agreement between the model prediction and actual observation. Based on the risk stratification, Kaplan-Meier curves indicated that the low-risk group had significantly better prognosis than the high-risk group (P<0.001).

Conclusions: Our nomogram can provide an individual prediction of 5-year DMFS in non-metastatic breast cancer patients. This prognostic tool may help clinicians to make appropriate treatment regimens and optimal surveillance plans.

Keywords: Breast cancer; distant metastasis-free survival (DMFS); nomogram.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Nomogram for predicting 5-year distant metastasis-free survival in breast cancer patients.
Figure 2
Figure 2
Calibration curves for 5-year distant metastasis-free survival of nomography in the training cohort (A) and validation cohort (B).
Figure 3
Figure 3
Kaplan-Meier curves for 5-year distant metastasis-free survival based on risk group stratification of the nomogram in the training cohort (A) and validation cohort (B).
See this image and copyright information in PMC

References

    1. Fan L, Strasser-Weippl K, Li JJ, et al. Breast cancer in China. Lancet Oncol 2014;15:e279-89. 10.1016/S1470-2045(13)70567-9 - DOI - PubMed
    1. Barral M, Auperin A, Hakime A, et al. Percutaneous Thermal Ablation of Breast Cancer Metastases in Oligometastatic Patients. Cardiovasc Intervent Radiol 2016;39:885-93. 10.1007/s00270-016-1301-x - DOI - PubMed
    1. Johansson ALV, Trewin CB, Hjerkind KV, et al. Breast cancer-specific survival by clinical subtype after 7 years follow-up of young and elderly women in a nationwide cohort. Int J Cancer 2019;144:1251-61. 10.1002/ijc.31950 - DOI - PubMed
    1. Poirier É, Desbiens C, Poirier B, et al. Characteristics and long-term survival of patients diagnosed with pure tubular carcinoma of the breast. J Surg Oncol 2018;117:1137-43. 10.1002/jso.24944 - DOI - PubMed
    1. Dong G, Wang D, Liang X, et al. Factors related to survival rates for breast cancer patients. Int J Clin Exp Med 2014;7:3719-24. - PMC - PubMed