Abstract:

Objective To explore the clinical variables associated with the shrinkage modes of primary breast tumor in women after neoadjuvant chemotherapy (NAC),and to develop a nomogram for predicting non-concentric shrinkage mode(NCSM).Methods Sixty-one women with pathologically proven solitary invasive ductal carcinoma(ⅡA-ⅢC) were recruited.Breast specimen was prepared with PMSS,and residual tumors were microscopically outlined,scanned and registered by Photoshop CS 5 software.The 3D model of residual tumors was reconstructed with 3D-DOCTOR 4.0 software to evaluate the shrinkage mode.17 factors such as age and body mass index and menopausal status were chosen as independent variables，and the clinic-pathologic shrinkage mode was considered as dependent variable.A Logistic regression model was used to construct the nomogram.Results Primary tumor stage,lymph node down-staging,PR and mammographic malignant calcification before NAC were independent predictors of clinic-pathologic shrinkage mode (β:1.538,OR:4.656,95%CI:1.414-15.328,P=0.011;β:1.555,OR:4.735,95%CI:1.082-20.722,P=0.039;β:-1.707,OR:0.181,95%CI:0.044-0.741,P=0.017;β:-1.405,OR:3.808,95%CI:0.06-0.998,P=0.048,respectively ).The nomogram predicting the risk of NCSM showed a good concordance index(0.869),and its conformity of mean absolute error was 0.039.Conclusion Based on the clinicopathological findings of primary breast tumor,a nomogram to predict shrinkage modes after NAC in breast carcinoma  patients is constructed.The statistical tool is helpful for individually selecting the patients who can be treated with BCT after NAC.

Key words:  , breast neoplasms, neoadjuvant chemotherapy, three-dimensional reconstruction, shrinkage modes, nomogram