Development and validation of a nomogram for predicting internal mammary sentinel node metastasis in breast cancer patients

• Published in: European journal of surgical oncology 2023-10, Vol.49 (10), p.107040-107040, Article 107040
• Main Authors: Qiu, Peng-Fei, Lv, Qing, Zhao, Wen-He, Huang, Yuan-Xi, Zhu, Shi-Guang, Zhong, Hong, Yang, Guang-Lun, Bell, Steven, Wang, Li-Yang, Xu, Ying-Ying, Sun, Xiao, Chen, Yu-Guang, Ding, Qiang, Wang, Yong-Sheng
• Format: Article
• Language: English
• Subjects: Breast cancer; Internal mammary node; Nomogram; Sentinel node biopsy
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2023.107040

Internal mammary nodes are important in breast cancer prognosis, but their diagnosis is often missed in clinical practice, leading to inaccurate staging and treatment. We developed a validated nomogram to predict the presence of internal mammary sentinel nodes (IMSN) metastasis. A total of 864 sequential IMSN biopsy procedures from a prospective studies database of 1505 cases were used for model development and validation. Multivariable logistic regression was performed on 519 sequential IMSN biopsy procedures from multi-center data between August 2018 and July 2022 to predict the presence of IMSN metastasis. A nomogram was developed based on the logistic regression model and subsequently applied to 345 sequential IMSN biopsy procedures from single-center data between November 2011 and July 2018. The model's discrimination was assessed using the area under the receiver operating characteristic curve. The overall frequency of IMSN metastasis was 17.0% in our study. A predictive model for IMSN metastasis was constructed using tumor size, tumor location, lymphovascular invasion, the number of positive axillary nodes (P