Background
Methods
Patient selection
Inclusion criteria
Exclusion criteria
Statistical analysis
Results
Clinicopathological features
Training Cohort | Validation Cohort | |||
---|---|---|---|---|
N | % | N | % | |
Year Of Diagnosis | ||||
2010 | 47,203 | 47.38 | 0 | 0.00 |
2011 | 52,415 | 52.62 | 0 | 0.00 |
2012 | 0 | 0.00 | 50,965 | 50.05 |
2013 | 0 | 0.00 | 50,869 | 49.95 |
Age Group | ||||
Age < =50Yrs | 23,231 | 23.32 | 22,203 | 21.80 |
50-60Yrs | 25,967 | 26.07 | 26,600 | 26.12 |
> 60Yrs | 50,420 | 50.61 | 53,031 | 52.08 |
Location Of Lesions | ||||
UIQ | 18,891 | 18.96 | 19,939 | 19.58 |
UOQ | 53,372 | 53.58 | 54,995 | 54.00 |
LOQ | 11,425 | 11.47 | 11,776 | 11.56 |
LIQ | 9086 | 9.12 | 8776 | 8.62 |
Central | 6844 | 6.87 | 6348 | 6.23 |
Race | ||||
White | 84,246 | 84.57 | 85,967 | 84.42 |
African American | 10,334 | 10.37 | 10,429 | 10.24 |
Others | 4184 | 4.20 | 4568 | 4.49 |
Unknown | 854 | 0.86 | 870 | 0.85 |
T-Stage | ||||
T1a
| 69,375 | 69.64 | 71,740 | 70.45 |
T2 | 27,675 | 27.78 | 27,528 | 27.03 |
T3 | 2568 | 2.58 | 2566 | 2.52 |
N-Stage | ||||
N0 | 73,662 | 73.94 | 76,954 | 75.57 |
N1 | 19,724 | 19.80 | 19,362 | 19.01 |
N2 | 4313 | 4.33 | 3829 | 3.76 |
N3 | 1919 | 1.93 | 1689 | 1.66 |
Histology | ||||
IDC | 75,974 | 76.27 | 77,806 | 76.40 |
ILC | 8582 | 8.61 | 9795 | 9.62 |
IDC & ILC | 5005 | 5.02 | 5076 | 4.98 |
IDC & Others | 3359 | 3.37 | 3390 | 3.33 |
IMC | 1849 | 1.86 | 1857 | 1.82 |
Others | 4849 | 4.87 | 3910 | 3.84 |
Grade | ||||
I | 25,663 | 25.76 | 26,780 | 26.30 |
II | 43,908 | 44.08 | 45,673 | 44.85 |
III | 29,420 | 29.53 | 28,304 | 27.79 |
Others/NA | 627 | 0.63 | 1077 | 1.06 |
Estrogen Receptor | ||||
Negative | 15,746 | 15.81 | 14,902 | 14.63 |
Positive | 83,872 | 84.19 | 86,932 | 85.37 |
Progesterone Receptor | ||||
Negative | 25,080 | 25.18 | 23,426 | 23.00 |
Positive | 74,538 | 74.82 | 78,408 | 77.00 |
Her2 | ||||
Negative | 87,670 | 88.01 | 92,043 | 90.39 |
Positive | 11,948 | 11.99 | 9791 | 9.61 |
Lymphovascular Invasion | ||||
Not Present | 80,657 | 80.97 | 83,226 | 81.73 |
Present | 18,961 | 19.03 | 18,608 | 18.27 |
Charlson-Deyo Score | ||||
0 | 83,641 | 83.96 | 84,466 | 82.94 |
1 | 13,297 | 13.35 | 14,319 | 14.06 |
2 | 2680 | 2.69 | 3049 | 2.99 |
Breast Surgery | ||||
BCS + RT | 64,552 | 64.80 | 66,480 | 65.28 |
Mastectomyb
| 35,066 | 35.20 | 35,354 | 34.72 |
Nomogram for predicting risk of any positive ALNs
Univariate analysis | Multivariate analysis | ||||||
---|---|---|---|---|---|---|---|
N0 | N1–3 |
P
b
| OR(95%) |
P
| |||
n | %a
| n | %a
| ||||
Age Group | |||||||
Age < =50Yrs | 15,652 | 67.38 | 7579 | 32.62 | <0.001 | 1 | |
50-60Yrs | 18,757 | 72.23 | 7210 | 27.77 | 0.91(0.87–0.95) | <0.001 | |
> 60Yrs | 39,253 | 77.85 | 11,167 | 22.15 | 0.70(0.67–0.73) | <0.001 | |
Location Of Lesions | |||||||
UIQ | 15,519 | 82.15 | 3372 | 17.85 | <0.001 | 1 | |
UOQ | 38,406 | 71.96 | 14,966 | 28.04 | 1.84(1.75–1.93) | <0.001 | |
LOQ | 8149 | 71.33 | 3276 | 28.67 | 1.91(1.79–2.03) | <0.001 | |
LIQ | 7089 | 78.02 | 1997 | 21.98 | 1.46(1.36–1.56) | <0.001 | |
Central | 4499 | 65.74 | 2345 | 34.26 | 2.19(2.03–2.35) | <0.001 | |
T-Stage | |||||||
T1 | 57,744 | 83.23 | 11,631 | 16.77 | <0.001 | 1 | |
T2 | 15,160 | 54.78 | 12,515 | 45.22 | 3.05(2.95–3.16) | <0.001 | |
T3 | 758 | 29.52 | 1810 | 70.48 | 7.85(7.12–8.65) | <0.001 | |
Histology | |||||||
IDC | 55,824 | 73.48 | 20,150 | 26.52 | <0.001 | 1 | |
ILC | 6174 | 71.94 | 2408 | 28.06 | 1.08(1.02–1.15) | 0.009 | |
IDC & ILC | 3437 | 68.67 | 1568 | 31.33 | 1.19(1.11–1.28) | <0.001 | |
IDC & Others | 2688 | 80.02 | 671 | 19.98 | 0.74(0.67–0.82) | <0.001 | |
IMC | 1731 | 93.62 | 118 | 6.38 | 0.24(0.19–0.29) | <0.001 | |
Others | 3808 | 78.53 | 1041 | 21.47 | 0.79(0.73–0.86) | <0.001 | |
Grade | |||||||
I | 21,746 | 84.74 | 3917 | 15.26 | <0.001 | 1 | |
II | 32,129 | 73.17 | 11,779 | 26.83 | 1.29(1.23–1.35) | <0.001 | |
III | 19,337 | 65.73 | 10,083 | 34.27 | 1.31(1.24–1.38) | <0.001 | |
Others/NA | 450 | 71.77 | 177 | 28.23 | 1.27(1.04–1.56) | 0.022 | |
Estrogen Receptor | |||||||
Negative | 11,326 | 71.93 | 4420 | 28.07 | <0.001 | 1 | |
Positive | 62,336 | 74.32 | 21,536 | 25.68 | 1.20(1.12–1.28) | <0.001 | |
Progesterone Receptor | |||||||
Negative | 18,233 | 72.70 | 6847 | 27.30 | <0.001 | 1 | |
Positive | 55,429 | 74.36 | 19,109 | 25.64 | 1.16(1.10–1.23) | <0.001 | |
Her2 | |||||||
Negative | 65,656 | 74.89 | 22,014 | 25.11 | <0.001 | 1 | |
Positive | 8006 | 67.01 | 3942 | 32.99 | 1.11(1.05–1.16) | <0.001 | |
Lymphovascular Invasion | |||||||
Not Present | 66,799 | 82.82 | 13,858 | 17.18 | <0.001 | 1 | |
Present | 6863 | 36.20 | 12,098 | 63.80 | 6.36(6.12–6.60) | <0.001 |
Nomogram for predicting pN2–3 disease in patients with any positive ALNs
Univariate analysis | Multivariate analysis | ||||||
---|---|---|---|---|---|---|---|
N0 | N1–3 |
P
b
| OR(95%) |
P
| |||
n | %a
| n | %+ | ||||
Age Group | |||||||
Age < =50Yrs | 3229 | 66.30 | 1641 | 33.70 | <0.001 | 1 | |
50-60Yrs | 2958 | 66.20 | 1510 | 33.80 | 1.06(0.97–1.16) | 0.202 | |
> 60Yrs | 3917 | 62.49 | 2351 | 37.51 | 1.23(1.14–1.34) | <0.001 | |
Location Of Lesions | |||||||
UIQ | 1374 | 69.39 | 606 | 30.61 | <0.001 | 1 | |
UOQ | 5753 | 64.16 | 3213 | 35.84 | 1.30(1.17–1.45) | <0.001 | |
LOQ | 1300 | 63.82 | 737 | 36.18 | 1.38(1.20–1.59) | <0.001 | |
LIQ | 788 | 69.31 | 349 | 30.69 | 1.15(0.98–1.36) | 0.095 | |
Central | 889 | 59.83 | 597 | 40.17 | 1.36(1.17–1.58) | <0.001 | |
T-Stage | |||||||
T1 | 4589 | 76.36 | 1421 | 23.64 | <0.001 | 1 | |
T2 | 4993 | 60.53 | 3256 | 39.47 | 1.83(1.69–1.97) | <0.001 | |
T3 | 522 | 38.75 | 825 | 61.25 | 3.97(3.48–4.52) | <0.001 | |
Histology | |||||||
IDC | 8027 | 66.32 | 4076 | 33.68 | <0.001 | 1 | |
ILC | 761 | 52.02 | 702 | 47.98 | 1.96(1.73–2.22) | <0.001 | |
IDC & ILC | 570 | 61.16 | 362 | 38.84 | 1.27(1.10–1.47) | 0.001 | |
IDC & Others | 272 | 67.83 | 129 | 32.17 | 0.91(0.73–1.13) | 0.396 | |
IMC | 59 | 81.94 | 13 | 18.06 | 0.44(0.24–0.82) | 0.01 | |
Others | 415 | 65.35 | 220 | 34.65 | 1.02(0.85–1.21) | 0.848 | |
Grade | |||||||
I | 1482 | 75.88 | 471 | 24.12 | <0.001 | 1 | |
II | 4433 | 65.51 | 2334 | 34.49 | 1.30(1.15–1.47) | <0.001 | |
III | 4140 | 60.98 | 2649 | 39.02 | 1.44(1.26–1.64) | <0.001 | |
Others/NA | 49 | 50.52 | 48 | 49.48 | 1.48(0.95–2.30) | 0.08 | |
Estrogen Receptor | |||||||
Negative | 1892 | 62.18 | 1151 | 37.82 | <0.001 | 1 | |
Positive | 8212 | 65.37 | 4351 | 34.63 | 1.05(0.92–1.19) | 0.467 | |
Progesterone Receptor | |||||||
Negative | 2809 | 61.93 | 1727 | 38.07 | <0.001 | 1 | |
Positive | 7295 | 65.90 | 3775 | 34.10 | 0.93(0.84–1.04) | 0.219 | |
Her2 | |||||||
Negative | 8541 | 65.96 | 4408 | 34.04 | <0.001 | 1 | |
Positive | 1563 | 58.83 | 1094 | 41.17 | 1.30(1.18–1.42) | <0.001 | |
Lymphovascular Invasion | |||||||
Not Present | 5632 | 74.12 | 1966 | 25.88 | <0.001 | 1 | |
Present | 4472 | 55.84 | 3536 | 44.16 | 2.11(1.96–2.26) | <0.001 |