Risk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis

BackgroundLymph node negative (N0) breast cancer can be found coexisting with distant metastasis (DM), which might consequently make clinicians underestimate the risk of relapse and insufficient treatment for this subpopulation.MethodsThe clinicopathological characteristics of N0 breast cancer patie...

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Autores principales:	Yu Min, Xiaoman Liu, Daixing Hu, Hang Chen, Jialin Chen, Ke Xiang, Guobing Yin, Yuling Han, Yang Feng, Haojun Luo
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	N0 breast cancer distant metastasis risk factor nomogram cancer-specific survival Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/d7c7263f44da4a359a8adc02d710f244
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spelling	oai:doaj.org-article:d7c7263f44da4a359a8adc02d710f2442021-11-30T20:00:04ZRisk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis1664-239210.3389/fendo.2021.771226https://doaj.org/article/d7c7263f44da4a359a8adc02d710f2442021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.771226/fullhttps://doaj.org/toc/1664-2392BackgroundLymph node negative (N0) breast cancer can be found coexisting with distant metastasis (DM), which might consequently make clinicians underestimate the risk of relapse and insufficient treatment for this subpopulation.MethodsThe clinicopathological characteristics of N0 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database between January 2010 and December 2015 were retrospectively reviewed. Multivariate logistic and Cox analyses were used to identify independent risk factors in promoting DM and the 1-, 3-, and 5- year cancer-specific survival (CSS) in this subpopulation.ResultSeven factors including age (<40 years), tumor size (>10 mm), race (Black), location (central), grade (poor differentiation), histology (invasive lobular carcinoma), and subtype (luminal B and Her-2 enriched) were associated with DM, and the area under curve (AUC) was 0.776 (95% CI: 0.763–0.790). Moreover, T1-3N0M1 patients with age >60 years at diagnosis, Black race, triple-negative breast cancer subtype, no surgery performed, and multiple DMs presented a worse 1-, 3-, and 5-year CSS. The areas under the ROC for 1-, 3-, and 5- year CSS in the training cohort were 0.772, 0.741, and 0.762, respectively, and 0.725, 0.695, and 0.699 in the validation cohort.ConclusionThe clinicopathological characteristics associated with the risk of DM and the prognosis of female breast cancer patients without lymph node metastasis but with DM are determined. A novel nomogram for predicting 1-, 3-, 5- year CSS in T1-3N0M1 patients is also well established and validated, which could help clinicians better stratify patients who are at a high-risk level for receiving relatively aggressive management.Yu MinXiaoman LiuDaixing HuHang ChenJialin ChenKe XiangGuobing YinYuling HanYang FengHaojun LuoFrontiers Media S.A.articleN0 breast cancerdistant metastasisrisk factornomogramcancer-specific survivalDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	N0 breast cancer distant metastasis risk factor nomogram cancer-specific survival Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	N0 breast cancer distant metastasis risk factor nomogram cancer-specific survival Diseases of the endocrine glands. Clinical endocrinology RC648-665 Yu Min Xiaoman Liu Daixing Hu Hang Chen Jialin Chen Ke Xiang Guobing Yin Yuling Han Yang Feng Haojun Luo Risk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis
description	BackgroundLymph node negative (N0) breast cancer can be found coexisting with distant metastasis (DM), which might consequently make clinicians underestimate the risk of relapse and insufficient treatment for this subpopulation.MethodsThe clinicopathological characteristics of N0 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database between January 2010 and December 2015 were retrospectively reviewed. Multivariate logistic and Cox analyses were used to identify independent risk factors in promoting DM and the 1-, 3-, and 5- year cancer-specific survival (CSS) in this subpopulation.ResultSeven factors including age (<40 years), tumor size (>10 mm), race (Black), location (central), grade (poor differentiation), histology (invasive lobular carcinoma), and subtype (luminal B and Her-2 enriched) were associated with DM, and the area under curve (AUC) was 0.776 (95% CI: 0.763–0.790). Moreover, T1-3N0M1 patients with age >60 years at diagnosis, Black race, triple-negative breast cancer subtype, no surgery performed, and multiple DMs presented a worse 1-, 3-, and 5-year CSS. The areas under the ROC for 1-, 3-, and 5- year CSS in the training cohort were 0.772, 0.741, and 0.762, respectively, and 0.725, 0.695, and 0.699 in the validation cohort.ConclusionThe clinicopathological characteristics associated with the risk of DM and the prognosis of female breast cancer patients without lymph node metastasis but with DM are determined. A novel nomogram for predicting 1-, 3-, 5- year CSS in T1-3N0M1 patients is also well established and validated, which could help clinicians better stratify patients who are at a high-risk level for receiving relatively aggressive management.
format	article
author	Yu Min Xiaoman Liu Daixing Hu Hang Chen Jialin Chen Ke Xiang Guobing Yin Yuling Han Yang Feng Haojun Luo
author_facet	Yu Min Xiaoman Liu Daixing Hu Hang Chen Jialin Chen Ke Xiang Guobing Yin Yuling Han Yang Feng Haojun Luo
author_sort	Yu Min
title	Risk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis
title_short	Risk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis
title_full	Risk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis
title_fullStr	Risk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis
title_full_unstemmed	Risk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis
title_sort	risk factors, prognostic factors, and nomogram for distant metastasis in breast cancer patients without lymph node metastasis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/d7c7263f44da4a359a8adc02d710f244
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Risk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis

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