title: Development of a prediction model for lymph node metastasis in luminal A subtype breast cancer: the possibility to omit sentinel lymph node biopsy.
abstract: The present study aimed to construct a prediction model for axillary lymph node metastasis (ALNM) using a DNA microarray assay for gene expression in breast tumor tissues. Luminal A breast cancers, diagnosed by PAM50 testing, were analyzed, and a prediction model (genomic nodal index (GNI)) consisting of 292 probe sets for ALNM was constructed in a training set of patients (n=388), and was validated in the first (n=59) and the second (n=103) validation sets. AUCs of ROC were 0.820, 0.717, and 0.749 in the training, first, and second validation sets, respectively. GNI was most significantly associated with ALNM, independently of the other conventional clinicopathological parameters in all cohorts. It is suggested that GNI can be used to identify the patients with a low risk for ALNM so that sentinel lymph node biopsy can be spared safely.
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Nakauchi
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Naoi
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Shimazu
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Tsunashima
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Nishio
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Maruyama
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shimomura
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Naofumi
authors.initials: N
authors.lastname: Kagara
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Shimoda
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Breast and Endocrine Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan. Electronic address: noguchi@onsurg.med.osaka-u.ac.jp.
authors.forename: Shinzaburo
authors.initials: S
authors.lastname: Noguchi
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D001943:Breast Neoplasms / Q000145:classification / Q000235:genetics* / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D003661:Decision Support Techniques; D018572:Disease-Free Survival; D005260:Female; D020869:Gene Expression Profiling / Q000379:methods*; D015972:Gene Expression Regulation, Neoplastic; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D049451:Nomograms; D020411:Oligonucleotide Array Sequence Analysis; D010641:Phenotype; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome; D019564:Unnecessary Procedures
chemical_list: D014408:Biomarkers, Tumor
keywords: Breast cancer; DNA microarray; Intrinsic subtype; Luminal A; Lymph node metastasis