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. 2022 Sep 1;95(1138):20220305.
doi: 10.1259/bjr.20220305. Epub 2022 Aug 2.

Nomograms predicting recurrence in patients with triple negative breast cancer based on ultrasound and clinicopathological features

Lei Zhang  1 , Xudong Zhang  1 , Peng Han  1 , Dantong Zhao  1 , Nana Hu  1 , Wei Fan  1 , Panting Wang  1 , Xiaoxuan Zuo  1 , Hanqing Kong  1 , Fuhui Peng  1 , Jiawei Tian  1 , Hao Cui  1
Affiliations

Nomograms predicting recurrence in patients with triple negative breast cancer based on ultrasound and clinicopathological features

Lei Zhang et al. Br J Radiol. .

Abstract

Objectives: The clinicopathological and ultrasound features associated with recurrence in patients with triple negative breast cancer (TNBC) were used to develop a nomogram to predict the prognosis of TNBC.

Methods: Clinicopathological data of 300 patients with TNBC treated between July 2012 and September 2014 were retrospectively reviewed. The endpoint was progression-free survival (PFS). Prognostic factors were screened by multivariate COX regression to develop nomograms. The C-index and calibration curves were used to evaluate the predictive accuracy and discriminatory ability of nomograms.

Results: Of 300 patients with TNBC followed-up for 5 years, 80 (26.7%) had PFS events. Five informative prognostic factors (large size, vertical orientation, posterior acoustic enhancement, lymph node involvement, and high pathological stage) were screened and used to construct a nomogram for PFS. The C-index of the PFS nomogram was 0.88 (p < 0.01, 95% confidence interval, 0.85-0.90), indicating good predictive accuracy.

Conclusions: We developed and validated a nomogram for predicting PFS in TNBC. Vertical orientation and posterior acoustic enhancement in ultrasound images of TNBC were associated with worse outcomes.

Advances in knowledge: Patients with TNBC have a very poor prognosis and patients have a high risk of recurrence, and our study developed a nomogram based on ultrasound and clinicopathological features for TNBC patients to improve the accuracy of individualized prediction of recurrence and provide help for clinical treatment.

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Conflict of interest statement

Competing interests: The authors declare no competing financial interests

Figures

Figure 1.
Figure 1.
The degree of distribution of expression for U-score in high-risk patients and low-risk patients according to the five informative features. (a) The middle bar represents the median, and the box represents the interquartile range. (b) In the Kaplan-Meier curve, the difference between high- and low-risk patients is statistically significant.
Figure 2.
Figure 2.
Stratified analyses were performed to estimate progression-free survival in various subgroups, comparing large and small size (a), high and low pathological stages (b), lymph node involvement and non-involvement (c), vertical and parallel orientations (d), posterior acoustic enhancement and non-enhancement (e).
Figure 3.
Figure 3.
(a) Nomogram integrating the five informative factors from ultrasound and clinicopathological features. (b) calibration curve of the nomogram. The diagonal line represents an ideal evaluation, whereas the light-colored lines represent the performance of the nomogram. A closer fit to the diagonal line indicates a better evaluation.
Figure 4.
Figure 4.
Example of one triple-negative breast cancer. (a) B-mode ultrasound: the yellow arrow refers to the posterior acoustic enhancement, and the two-dotted line indicates the vertical orientation. (b) Color Doppler ultrasound: blood flow is abundant. (c) Elastic ultrasound: the lesion was hard with rendered blue. (d) HE-stained pathological image reveals the high pathological stage.
See this image and copyright information in PMC

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