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A nomogram for predicting locoregional recurrence in primary breast cancer patients who received breast‐conserving surgery after neoadjuvant chemotherapy
Author(s) -
Matsuda Naoko,
Hayashi Naoki,
Ohde Sachiko,
Yagata Hiroshi,
Kajiura Yuka,
Yoshida Atsushi,
Suzuki Koyu,
Nakamura Seigo,
Tsunoda Hiroko,
Yamauchi Hideko
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23586
Subject(s) - medicine , nomogram , lymphovascular invasion , breast cancer , concordance , oncology , proportional hazards model , stage (stratigraphy) , multivariate analysis , neoadjuvant therapy , chemotherapy , breast conserving surgery , cancer , metastasis , mastectomy , paleontology , biology
Background We sought to develop and validate a predictive model of locoregional recurrence (LRR) in patients who underwent breast‐conserving therapy (BCT) after neoadjuvant chemotherapy (NAC). Patients and methods The clinicopathological characteristics of 520 consecutive primary breast cancer patients with residual tumor who underwent BCT after NAC between 2001 and 2008 were evaluated. Predictive variables of LRR were determined using a multivariate Cox proportional hazards model. The model was validated for discrimination and calibration by bootstrap re‐sampling. Results At a median follow‐up period of 51 months, 64 patients (12%) had developed LRR. Clinical stage T3 or T4, lymphovascular invasion, nuclear grade >3, and ≥4 positive lymph nodes metastasis were positively correlated with LRR. The nomogram for predicting LRR developed by using these four‐clinicopathologic variables demonstrated high concordance. Patients with score 0–1 derived by the prediction model had significantly low LRR rate compared with patients with score 2 or higher ( P < 0.001). Conclusions This nomogram may be useful to predict LRR in primary breast cancer patients who underwent BCT after NAC with high reproducibility. This model is useful to conduct a study‐identifying patients who may need an additional treatment to standard adjuvant therapy because of a high probability of LRR. J. Surg. Oncol. 2014 109:764–769 . © 2014 Wiley Periodicals, Inc.