Discussion
tumor, breast cancer
TUMOR, BREAST CANCER
The global incidence of breast cancer is increasing rapidly, and it is of great clinical significance to study the diagnostic prediction of breast cancer [Most previous research on ALNM in breast cancer patients has only focused on single independent risk factors for ALNM, such as tumor size and grade [Unlike previous studies that predicted ALNM, our study cohort included clinical lymph node staging of patients and other information to predict ALN status, resulting in a more accurate preoperative assessment of ALN status [Admittedly, this study has several limitations. First, our models were built based on data collected from a single center, and because this is a retrospective study, its clinical applicability may be reduced. Multicenter evidence will be needed to validate the models in the future before they can be put into clinical use. Second, we did not conduct subgroup analyses due to the small sample size. The possibility of ALNM may differ among breast cancer patients with different molecular subtyping. In future study, we will assess the ability of the predictive models to predict ALNM in each molecular subtype. Additionally, the cN relies heavily on the ultrasound results and the expertise of the doctors, which is subjective and little is known about the reproducibility of those methods. Fourth, due to medical limitations at the time of the patient’s diagnosis approximately 10 years ago and the lack of genetic testing data, we focused only on the potential impact of clinical and pathological features on ALNM and did not consider the genetic features. For future prospective studies, researchers may combine transcriptome and gene mutation data for predicting ALNM. Finally, we have validated the effects of our nomograms by using the validation set which may overestimate the value of our model, and prospective external validation is lacking.