A nomogram for predicting probability of low risk of MammaPrint results in women with clinically high-risk breast cancer.

Abstract

We aimed to develop a prediction MammaPrint (MMP) genomic risk assessment nomogram model for hormone-receptor positive (HR+) and human epidermal growth factor receptor-2 negative (HER2-) breast cancer and minimal axillary burden (N0-1) tumors using clinicopathological factors of patients who underwent an MMP test for decision making regarding adjuvant chemotherapy. A total of 409 T1-3 N0-1 M0 HR + and HER2- breast cancer patients whose MMP genomic risk results and clinicopathological factors were available from 2017 to 2020 were analyzed. With randomly selected 306 patients, we developed a nomogram for predicting a low-risk subgroup of MMP results and externally validated with remaining patients (n = 103). Multivariate analysis revealed that the age at diagnosis, progesterone receptor (PR) score, nuclear grade, and Ki-67 were significantly associated with MMP risk results. We developed an MMP low-risk predictive nomogram. With a cut off value at 5% and 95% probability of low-risk MMP, the nomogram accurately predicted the results with 100% positive predictive value (PPV) and negative predictive value respectively. When applied to cut-off value at 35%, the specificity and PPV was 95% and 86% respectively. The area under the receiver operating characteristic curve was 0.82 (95% confidence interval [CI] 0.77 to 0.87). When applied to the validation group, the nomogram was accurate with an area under the curve of 0.77 (95% CI 0.68 to 0.86). Our nomogram, which incorporates four traditional prognostic factors, i.e., age, PR, nuclear grade, and Ki-67, could predict the probability of obtaining a low MMP risk in a cohort of high clinical risk patients. This nomogram can aid the prompt selection of patients who does not need additional MMP testing.

• Authors: Young Joo Lee, Young Sol Hwang, Junetae Kim, Sei-Hyun Ahn, Byung Ho Son, Hee Jeong Kim, Beom Seok Ko, Jisun Kim, Il Yong Chung, Jong Won Lee, Sae Byul Lee
• Journal: Scientific reports (Sci Rep) Vol. 11 Issue 1 Pg. 23509 (12 06 2021) ISSN: 2045-2322 [Electronic] England
• PMID: 34873249 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2021. The Author(s).

Chemical References

• Receptors, Progesterone
• Receptor, ErbB-2

Topics

• Axilla (pathology)
• Breast (pathology)
• Breast Neoplasms (diagnosis, genetics, pathology)
• Female
• Humans
• Lymphatic Metastasis (genetics, pathology)
• Middle Aged
• Nomograms
• Probability
• ROC Curve
• Receptor, ErbB-2 (genetics)
• Receptors, Progesterone
• Retrospective Studies
• Risk