Risk-predicted dual nomograms consisting of clinical and ultrasound factors for downgrading BI-RADS category 4a breast lesions - A multiple centre study
机构：[1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China[2]Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China[3]Department of Ultrasound, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China，Chongqing Key Laboratory of UltrasoundMolecular Imaging, Chongqing 400010, China[4]Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, China中国医科大学附属盛京医院中国医科大学盛京医院[5]Department of Medical Ultrasound, Fudan University Shanghai Cancer Center & Department of Oncology, Shanghai Medical College, Fudan University, Shanghai200032, China[6]Department of Ultrasonography, Henan Provincial People′s Hospital, Zhengzhou 450003, China[7]Department of Ultrasound, Shanxi Academy of Medical Science, Dayi Hospital of Shanxi Medical University, Taiyuan 030032, China[8]Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China华中科技大学同济医学院附属同济医院[9]Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun 130033, China吉林大学中日联谊医院[10]Department of Ultrasound, the Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China中山大学附属第二医院[11]Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China[12]Department of Medical Ultrasound, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, China[13]Department of Ultrasound, Union Hospital of Fujian Medical University, Fujian Institute of Ultrasound Medicine, Fuzhou 350001, China[14]Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200025, China[15]Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan 430060, China[16]Department of Ultrasound, Qilu Hospital, Shandong University, Jinan 250012, China[17]Department of Ultrasound, the Third Xiangya Hospital of Central South University, Changsha 410013, China[18]Department of Ultrasound, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China[19]Department of Ultrasound Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China[20]Department of Ultrasonography, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China[21]Department of Ultrasound, Shenzhen People’s Hospital, the Second Clinical Medical College of Jinan University, Shenzhen 518020, China深圳市康宁医院深圳市人民医院深圳医学信息中心[22]Department of Ultrasound, the First Hospital of Shanxi Medical University, Taiyuan 030001, China[23]Department of Ultrasound, the Second Hospital of Dalian Medical University, Dalian 116027, China[24]Department of Ultrasound, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Purpose: To develop and to validate a risk-predicted nomogram for downgrading Breast Imaging Reporting and Data System (BI-RADS) category 4a breast lesions. Patients and Methods: We enrolled 680 patients with breast lesions that were diagnosed as BI-RADS category 4a by conventional ultrasound from December 2018 to June 2019. All 4a lesions were randomly divided into development and validation groups at the ratio of 3:1. In the development group consisting of 499 cases, the multiple clinical and ultrasound predicted factors were extracted, and dual-predicted nomograms were constructed by multivariable logistic regression analysis, named clinical nomogram and ultrasound nomogram, respectively. Patients were twice classified as either "high risk" or "low risk" in the two nomograms. The performance of these dual nomograms was assessed by an independent validation group of 181 cases. Receiver Operating Characteristic (ROC) curve and diagnostic value were calculated to evaluate the applicability of the new model. Results: After multiple logistic regression analysis, the clinical nomogram included 2 predictors: age and the first-degree family members with breast cancer. The area under the curve (AUC) value for the clinical nomogram was 0.661 and 0.712 for the development and validation groups, respectively. The ultrasound nomogram included 3 independent predictors (margins, calcification and strain ratio), and the AUC value in this nomogram was 0.782 and 0.747 in the development and validation groups, respectively. In the development group of 499 patients, approximately 50.90% (254/499) of patients were twice classified "low risk", with a malignancy rate of 1.18%. In the validation group of 181 patients, approximately 47.51% (86/181) of patients had been twice classified as "low risk", with a malignancy rate of 1.16%. Conclusions: A dual-predicted nomogram incorporating clinical factors and imaging characteristics is an applicable model for downgrading the low-risk lesions in BI-RADS category 4a and shows good stability and accuracy, which is useful for decreasing the rate of invasive examinations and surgery.
基金：
Natural Science Foundation of BeijingBeijing Natural Science Foundation [7202156]; Foundation of ihecc [2018C0032-2]; Peking Union Medical College Reform in Education Project [10023201900113]
第一作者机构：[1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
通讯机构：[*1]Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China
推荐引用方式(GB/T 7714)：
Zihan Niu,Jia-Wei Tian,Hai-Tao Ran,et al.Risk-predicted dual nomograms consisting of clinical and ultrasound factors for downgrading BI-RADS category 4a breast lesions - A multiple centre study[J].JOURNAL OF CANCER.2021,12(1):292-304.doi:10.7150/jca.51302.
APA：
Zihan Niu,Jia-Wei Tian,Hai-Tao Ran,Wei-Dong Ren,Cai Chang...&Yu-Xin Jiang.(2021).Risk-predicted dual nomograms consisting of clinical and ultrasound factors for downgrading BI-RADS category 4a breast lesions - A multiple centre study.JOURNAL OF CANCER,12,(1)
MLA：
Zihan Niu,et al."Risk-predicted dual nomograms consisting of clinical and ultrasound factors for downgrading BI-RADS category 4a breast lesions - A multiple centre study".JOURNAL OF CANCER 12..1(2021):292-304
