{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T15:02:04Z","timestamp":1781103724523,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T00:00:00Z","timestamp":1610496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009330","name":"Medical Science and Technology Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["A2018348"],"award-info":[{"award-number":["A2018348"]}],"id":[{"id":"10.13039\/501100009330","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000691","name":"Academy of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Nodular sclerosing adenoses (NSAs) and malignant tumors (MTs) may coexist and are often classified into the same Breast Imaging Reporting and Data System (BI\u2010RADS) category. We aimed to build and validate an ultrasound\u2010based nomogram to distinguish MT from NSA for building a precise sequence of biopsies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>The training cohort included 156 patients (156 masses) with NSA or MT at one study institution. We used best subset regression to determine the predictors for building a nomogram from ultrasonic characteristics and patients' age. Model performance and clinical utility were evaluated using Brier score, concordance (C)\u2010index, calibration curve, and decision curve analysis. The independent validation cohort consisted of 162 patients (162 masses) from a separate institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Through best subset regression, we selected 6 predictors to develop nomogram: age, calcification, echogenic rim, vascularity distribution, tumor size, and thickness of breast parenchyma. Brier score and C\u2010index of the nomogram in the training cohort were 0.068 and 0.967 (95% confidence interval [CI]: 0.941\u20130.993), respectively. In addition, calibration curve demonstrated good agreement between prediction and pathological result. In the validation cohort, the nomogram still obtained a favorable C\u2010index score of 0.951 (95% CI: 0.919\u20130.983) and fine calibration. Decision curve analysis showed that the model was clinically useful.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>If multiple NSA and MT masses are present in the same patient and are classified into the same BI\u2010RADS category, our nomogram can be used as a supplement to the BI\u2010RADS category for accurate biopsy of the mass most likely to be MT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.15612","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T12:49:24Z","timestamp":1610714964000},"page":"2189-2200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["<scp>Ultrasound\u2010Based<\/scp> Nomogram for Distinguishing Malignant Tumors from Nodular Sclerosing Adenoses in Solid Breast Lesions"],"prefix":"10.1002","volume":"40","author":[{"given":"Ting","family":"Liang","sequence":"first","affiliation":[{"name":"The Second School of Clinical Medicine 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