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External validation of a multivariable prediction model for positive resection margins in breast-conserving surgery

Manhoobi, Irina Palimaru ; Ellbrant, Julia LU ; Bendahl, Pär Ola LU ; Redsted, Søren ; Bodilsen, Anne ; Tramm, Trine ; Christiansen, Peer and Rydén, Lisa LU orcid (2025) In BMC Research Notes 18(1).
Abstract

Objectives: Positive resection margins after breast-conserving surgery (BCS) most often demands a repeat surgery. To preoperatively identify patients at risk of positive margins, a multivariable model has been developed that predicts positive margins after BCS with a high accuracy. This study aimed to externally validate this prediction model to explore its generalizability and assess if additional preoperatively available variables can further improve its predictive accuracy. The validation cohort included 225 patients with invasive breast cancer who underwent BCS at Aarhus University Hospital, Aarhus, Denmark during 2020–2022. Receiver operating characteristic (ROC) and calibration analysis were used to validate the prediction model.... (More)

Objectives: Positive resection margins after breast-conserving surgery (BCS) most often demands a repeat surgery. To preoperatively identify patients at risk of positive margins, a multivariable model has been developed that predicts positive margins after BCS with a high accuracy. This study aimed to externally validate this prediction model to explore its generalizability and assess if additional preoperatively available variables can further improve its predictive accuracy. The validation cohort included 225 patients with invasive breast cancer who underwent BCS at Aarhus University Hospital, Aarhus, Denmark during 2020–2022. Receiver operating characteristic (ROC) and calibration analysis were used to validate the prediction model. Univariable logistic regression was used to evaluate if additional variables available in the validation cohort were associated with positive margins and backward elimination to explore if these variables could further improve the model´s predictive accuracy. Results: The AUC of the model was 0.60 (95% CI: 0.50–0.70) indicating a lower discriminative capacity in the external cohort. We found weak evidence for an association between increased preoperative breast density on mammography and positive resection margins after BCS (p = 0.027), but the AUC of the model did not improve, when mammographic breast density was included as an additional variable in the model.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast-conserving surgery, External validation, Invasive breast cancer, Positive resection margins, Prediction model
in
BMC Research Notes
volume
18
issue
1
article number
36
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85217141678
  • pmid:39865247
ISSN
1756-0500
DOI
10.1186/s13104-025-07103-8
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2025.
id
1634218f-0fd7-41ff-a9e4-7089b50438d1
date added to LUP
2025-04-09 11:06:45
date last changed
2025-07-02 18:06:13
@article{1634218f-0fd7-41ff-a9e4-7089b50438d1,
  abstract     = {{<p>Objectives: Positive resection margins after breast-conserving surgery (BCS) most often demands a repeat surgery. To preoperatively identify patients at risk of positive margins, a multivariable model has been developed that predicts positive margins after BCS with a high accuracy. This study aimed to externally validate this prediction model to explore its generalizability and assess if additional preoperatively available variables can further improve its predictive accuracy. The validation cohort included 225 patients with invasive breast cancer who underwent BCS at Aarhus University Hospital, Aarhus, Denmark during 2020–2022. Receiver operating characteristic (ROC) and calibration analysis were used to validate the prediction model. Univariable logistic regression was used to evaluate if additional variables available in the validation cohort were associated with positive margins and backward elimination to explore if these variables could further improve the model´s predictive accuracy. Results: The AUC of the model was 0.60 (95% CI: 0.50–0.70) indicating a lower discriminative capacity in the external cohort. We found weak evidence for an association between increased preoperative breast density on mammography and positive resection margins after BCS (p = 0.027), but the AUC of the model did not improve, when mammographic breast density was included as an additional variable in the model.</p>}},
  author       = {{Manhoobi, Irina Palimaru and Ellbrant, Julia and Bendahl, Pär Ola and Redsted, Søren and Bodilsen, Anne and Tramm, Trine and Christiansen, Peer and Rydén, Lisa}},
  issn         = {{1756-0500}},
  keywords     = {{Breast-conserving surgery; External validation; Invasive breast cancer; Positive resection margins; Prediction model}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Research Notes}},
  title        = {{External validation of a multivariable prediction model for positive resection margins in breast-conserving surgery}},
  url          = {{http://dx.doi.org/10.1186/s13104-025-07103-8}},
  doi          = {{10.1186/s13104-025-07103-8}},
  volume       = {{18}},
  year         = {{2025}},
}