지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.96 No.4
- 발행연도
- 2019.4
- 수록면
- 169 - 176 (8page)
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초록· 키워드
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Purpose: Many patients with cytology proven node-positive breast cancer receive a neoadjuvant chemotherapy (NAC) treatment. We developed a nomogram to predict the breast and axillary pathologic complete responses (pCR) in patients with a cytologically proven axillary node positive breast cancer with NAC.
Methods: We selected 995 patients who were diagnosed with an invasive breast cancer and axillary lymph nodes metastasis, and who were treated with NAC followed by a curative surgery at the Samsung Medical Center between January 2007 and December 2014. The baseline patient and tumor characteristics, chemotherapy regimen, and tumor and nodal responses were thoroughly analyzed and reviewed. A nomogram was developed using a binary logistic regression model with a cross validation.
Results: Axillary pCR was achieved in 47.3% and breast pCR was achieved in 24.3% of the patients after NAC. In this case, the both pCR was associated with an initial clinical tumor stage, negative progesterone receptor status, positive human epidermal growth factor receptor 2 status, and clinical radiologic nodal responses. A nomogram was developed based on the clinical and statistically significant predictors. It had good discrimination performance (area under the curve [AUC], 0.868; 95% confidence interval, 0.84–0.89) and calibration fit as noted in that case. The cross validation had an average AUC 0.853 (0.837–0.869).
Conclusion: Our nomogram might help to predict breast and axillary pCRs after NAC in patients with an initially nodepositive breast cancer. Minimal surgery might be acceptable in patients for whom the nomogram indicates a high probability of achieving pCRs.
Methods: We selected 995 patients who were diagnosed with an invasive breast cancer and axillary lymph nodes metastasis, and who were treated with NAC followed by a curative surgery at the Samsung Medical Center between January 2007 and December 2014. The baseline patient and tumor characteristics, chemotherapy regimen, and tumor and nodal responses were thoroughly analyzed and reviewed. A nomogram was developed using a binary logistic regression model with a cross validation.
Results: Axillary pCR was achieved in 47.3% and breast pCR was achieved in 24.3% of the patients after NAC. In this case, the both pCR was associated with an initial clinical tumor stage, negative progesterone receptor status, positive human epidermal growth factor receptor 2 status, and clinical radiologic nodal responses. A nomogram was developed based on the clinical and statistically significant predictors. It had good discrimination performance (area under the curve [AUC], 0.868; 95% confidence interval, 0.84–0.89) and calibration fit as noted in that case. The cross validation had an average AUC 0.853 (0.837–0.869).
Conclusion: Our nomogram might help to predict breast and axillary pCRs after NAC in patients with an initially nodepositive breast cancer. Minimal surgery might be acceptable in patients for whom the nomogram indicates a high probability of achieving pCRs.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (20)
참고문헌 신청
Fisher B / 1997 / Effect of preoperative chemotherapy on localregional disease in women with operable breast cancer : findings from National Surgical Adjuvant Breast and Bowel Project B-18 / J Clin Oncol 15:2483~2493
Bear HD / 2006 / Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer : National Surgical Adjuvant Breast and Bowel Project Protocol B-27 / J Clin Oncol 24:2019~2027
Boughey JC / 2013 / Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer : the ACOSOG Z1071(Alliance)clinical trial / JAMA 310:1455~1461
Mittendorf EA / 2014 / Implementation of the american college of surgeons oncology group z1071 trial data in clinical practice : is there a way forward for sentinel lymph node dissection in clinically node-positive breast cancer patients treated with neoadjuvant chemotherapy / Ann Surg Oncol 21:2468~2473
김구상 / 2015 / The reality in the follow-up of breast cancer survivors: survey of Korean Breast Cancer Society / 대한외과학회지 88(3):133~139
Bear HD / 2006 / Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer : National Surgical Adjuvant Breast and Bowel Project Protocol B-27 / J Clin Oncol 24:2019~2027
Boughey JC / 2013 / Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer : the ACOSOG Z1071(Alliance)clinical trial / JAMA 310:1455~1461
Mittendorf EA / 2014 / Implementation of the american college of surgeons oncology group z1071 trial data in clinical practice : is there a way forward for sentinel lymph node dissection in clinically node-positive breast cancer patients treated with neoadjuvant chemotherapy / Ann Surg Oncol 21:2468~2473
김구상 / 2015 / The reality in the follow-up of breast cancer survivors: survey of Korean Breast Cancer Society / 대한외과학회지 88(3):133~139
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UCI(KEPA) : I410-ECN-0101-2019-514-000759702