Evidence map›Paper›PMID 41372507›Full record

ArticleScientific reports2025

Development and validation of a nomogram incorporating YpT stage for predicting ypN0 using multicenter data in clinically node-positive breast cancer.

Hideo Shigematsu, Shinsuke Sasada, Junji Hashizume, Tatsunari Sasada, Shinji Ozaki, Midori Noma, Tomoyuki Yoshiyama, Goda Noriko, Ayumi Kawamata, Akiko Emi and 4 more

Abstract readMulticenter StudyValidation Study
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Hideo ShigematsuDepartment of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3-Kasumi, Minami-ku, Hiroshima City, 734-8551, Japan. shigematu1330@hiroshima-u.ac.jp.
Shinsuke SasadaDepartment of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3-Kasumi, Minami-ku, Hiroshima City, 734-8551, Japan.
Junji HashizumeDepartment of Breast Surgery, JA Onomichi General Hospital, Hiroshima, 722-8508, Japan.
Tatsunari SasadaDepartment of Breast and Endocrine Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, 739-0041, Japan.
Shinji OzakiDepartment of Gastroenterological, Breast and Transplant Surgery, Hiroshima Prefectural Hospital, Hiroshima, 734-8530, Japan.
Midori NomaDepartment of Gastroenterological, Breast and Transplant Surgery, Hiroshima Prefectural Hospital, Hiroshima, 734-8530, Japan.
Tomoyuki YoshiyamaDepartment of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, 737-0023, Japan.
Goda NorikoDepartment of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, 737-0023, Japan.
Ayumi KawamataDepartment of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, 737-0023, Japan.
Akiko EmiDepartment of Breast Surgery, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, 731-0293, Japan.
Yuki KanekoDepartment of Breast Surgery, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, 731-0293, Japan.
Keiko KajitaniDepartment of Breast Surgery, JA Hiroshima General Hospital, Hiroshima, 738-8503, Japan.
Tomoko ItagakiDepartment of Breast Surgery, JA Hiroshima General Hospital, Hiroshima, 738-8503, Japan.
Morihito OkadaDepartment of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3-Kasumi, Minami-ku, Hiroshima City, 734-8551, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recent studies have demonstrated that breast pathological complete response (pCR) can be accurately diagnosed preoperatively using image-guided needle biopsy after neoadjuvant chemotherapy (NAC), underscoring the value of incorporating ypT stage into prediction models for axillary response (ypN0). Based on this evidence, we developed and externally validated a nomogram to predict ypN0 in patients with clinically node-positive (cN+) breast cancer treated with NAC. This retrospective, multicenter study included 609 patients with cN + breast cancer who underwent NAC followed by surgery. A nomogram was developed using a training cohort (n = 330) and validated in an independent cohort (n = 279). Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, decision curve analysis (DCA), and positive predictive value (PPV). The nomogram incorporated five predictors: ypT stage, cN stage, hormone receptor status, HER2 status, and post-NAC cN stage. It showed strong discriminative ability, with bias-corrected AUCs of 0.858 in the training cohort and 0.855 in the validation cohort. Calibration and DCA confirmed good model performance. PPV exceeded 0.90 when the nomogram-predicted probability was ≥ 0.7 in both cohorts. This nomogram demonstrated high diagnostic accuracy for predicting ypN0 and may support the selection of candidates for axillary surgery de-escalation based on post-NAC biopsy findings. Prospective validation using biopsy-confirmed pCR is warranted.

Indexed as

Breast NeoplasmsNomogramsAdultAgedFemaleHumansLymphatic MetastasisLymph NodesMiddle AgedNeoadjuvant TherapyNeoplasm StagingRetrospective StudiesROC CurveBreast cancerNeoadjuvant chemotherapyNomogramYpN0YpT stage

Identifiers

PMID41372507
PMCPMC12816637

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.