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Nomogram for Predicting Breast Conservation after Neoadjuvant Chemotherapyopen access

Authors
Kim, Min KyoonHan, WonshikMoon, Hyeong-GonAhn, Soo KyungKim, JisunLee, Jun WooKim, Ju-YeonKim, TaeryungLee, Kyung-HunKim, Tae-YongHan, Sae-WonIm, Seock-AhKim, Tae-YouPark, In AeNoh, Dong-Young
Issue Date
Apr-2015
Publisher
KOREAN CANCER ASSOCIATION
Keywords
Segmental mastectomy; Neoadjuvant therapy; Nomograms; Breast neoplasms
Citation
CANCER RESEARCH AND TREATMENT, v.47, no.2, pp 197 - 207
Pages
11
Journal Title
CANCER RESEARCH AND TREATMENT
Volume
47
Number
2
Start Page
197
End Page
207
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/70410
DOI
10.4143/crt.2013.247
ISSN
1598-2998
2005-9256
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. 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. 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. 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. 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.
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의과대학 (의학부(임상-서울))
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