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. 2022 Aug 19:12:838787.
doi: 10.3389/fonc.2022.838787. eCollection 2022.

Predicting the molecular subtypes of breast cancer using nomograms based on three-dimensional ultrasonography characteristics

Xiaojing Xu  1 , Liren Lu  1 , Luoxi Zhu  1 , Yanjuan Tan  1 , Lifang Yu  1 , Lingyun Bao  1
Affiliations

Predicting the molecular subtypes of breast cancer using nomograms based on three-dimensional ultrasonography characteristics

Xiaojing Xu et al. Front Oncol. .

Abstract

Background: Molecular subtyping of breast cancer is commonly doneforindividualzed cancer management because it may determines prognosis and treatment. Therefore, preoperativelyidentifying different molecular subtypes of breast cancery can be significant in clinical practice.Thisretrospective study aimed to investigate characteristic three-dimensional ultrasonographic imaging parameters of breast cancer that are associated with the molecular subtypes and establish nomograms to predict the molecular subtypes of breast cancers.

Methods: A total of 309 patients diagnosed with breast cancer between January 2017and December 2019 were enrolled. Sonographic features were compared between the different molecular subtypes. A multinomial logistic regression model was developed, and nomograms were constructed based on this model.

Results: The performance of the nomograms was evaluated in terms of discrimination and calibration.Variables such as maximum diameter, irregular shape, non-parallel growth, heterogeneous internal echo, enhanced posterior echo, lymph node metastasis, retraction phenomenon, calcification, and elasticity score were entered into the multinomial model.Three nomograms were constructed to visualize the final model. The probabilities of the different molecular subtypes could be calculated based on these nomograms. Based on the receiver operating characteristic curves of the model, the macro-and micro-areaunder the curve (AUC) were0.744, and 0.787. The AUC was 0.759, 0.683, 0.747 and 0.785 for luminal A(LA), luminal B(LB), human epidermal growth factor receptor 2-positive(HER2), and triple-negative(TN), respectively.The nomograms for the LA, HER2, and TN subtypes provided good calibration.

Conclusions: Sonographic features such as calcification and posterior acoustic features were significantly associated with the molecular subtype of breast cancer. The presence of the retraction phenomenon was the most important predictor for the LA subtype. Nomograms to predict the molecular subtype were established, and the calibration curves and receiver operating characteristic curves proved that the models had good performance.

Keywords: breast cancer; molecular subtypes; nomogram; relevance of three-dimensional ultrasonography; ultrasonography.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
LB prediction nomogram. Nomograms were constructed based on the results of the multivariate logistic regression mode factors.
Figure 2
Figure 2
HER2 prediction nomogram. Nomograms were constructed based on the results of the multivariate logistic regression mode factors.
Figure 3
Figure 3
TN prediction nomogram. Nomograms were constructed based on the results of the multivariate logistic regression mode factors.
Figure 4
Figure 4
ROC curve. The macro- and micro-AUC were 0.744 and 0.787, respectively. The AUC was 0.759for predicting LA, 0.683 for predicting LB,0.747 for predicting HER2-positive, and 0.785 for predicting TN.
Figure 5
Figure 5
Calibration curve of the nomogram. The diagonal line indicates the ideal nomogram reference.
See this image and copyright information in PMC

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