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Using SEER data (2010–2018), the work builds a Cox-regression nomogram and assigns patients to risk groups, then tests performance with discrimination, calibration, and AUC metrics. RT improves overall survival mainly in low-risk patients while high-risk benefit is not observed.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-population-based-analysis-of-a-risk-stratification-system-for-predicting-radiotherapy-benefits-in-invasive-breast-carcinoma-of-no-special-type-with-medullary-pattern/452280/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-population-based-analysis-of-a-risk-stratification-system-for-predicting-radiotherapy-benefits-in-invasive-breast-carcinoma-of-no-special-type-with-medullary-pattern/452280.png","ImageObject",300,407,{"name":92,"@type":93},"Rainbow Cat","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What patient subgroup does the study focus on?","Question",{"text":112,"@type":113},"The study focuses on invasive breast carcinoma of no special type (IBC-NST) with medullary pattern, described as a rare histologic subtype accounting for about 3–5% of breast malignancies.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the prognostic risk stratification model developed?",{"text":117,"@type":113},"Using SEER data from 2010–2018, the authors performed univariate and multivariate Cox regression to build a prognostic nomogram and stratify patients into low- and high-risk groups.",{"name":119,"@type":110,"acceptedAnswer":120},"In which risk group did radiotherapy improve overall survival?",{"text":121,"@type":113},"Radiotherapy significantly improved overall survival in low-risk patients compared with no RT, while no significant improvement was reported for high-risk patients.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},452280,1790817659,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":41,"preview_page_count":4},962090769181,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Zhang et al. European Journal  \nEuropean Journal of Medical Research (2026) 31:34  \n[https://doi.org/10.1186/s40001-025-03558-4](https://doi.org/10.1186/s40001-025-03558-4 of Medical Research)[ of Medical Research](https://doi.org/10.1186/s40001-025-03558-4 of Medical Research)  \n RESEARCH Open Access  \nA population-based analysis of a risk  \nstratification system for predicting radiotherapy benefits in invasive breast carcinoma  \nof no special type with medullary pattern  \nJian Zhang1†, Lizhao Wang1†, Heyan Chen1†, Yu Yan1, Guanqun Ge1, Ke Wang1* and Jianjun He 1*  \nAbstract  \nBackground Invasive breast carcinoma of no special type (IBC-NST) with medullary pattern is a rare histological subtype, accounting for 3–5% of breast malignancies. Its distinct clinicopathological features and uncertain benefit from radiotherapy (RT) pose unique therapeutic challenges. Current guidelines extrapolate treatment protocols from invasive ductal carcinoma, yet prognostic heterogeneity and the absence of validated biomarkers underscore the need for precision stratification tools to guide RT decisions.  \nMethods Using data from the SEER database (2010–2018), we conducted univariate and multivariate Cox regression analyses to develop a prognostic stratification model and stratified the whole cohort into different risk groups to determine the optimal candidates to benefit from radiotherapy. The accuracy of the nomogram was evaluated by discrimination and calibration evaluation.  \nResults Among 667 eligible patients, 535 were allocated to the training set and 132 to the validation set (8:2 ratio) . Five independent prognostic factors were identified: age, T stage, N stage, molecular subtype, and chemotherapy status. These were incorporated into a nomogram predicting 3-and 5-year overall survival (OS) . Using an optimal cutoff, patients were stratified into low-and high-risk groups. Radiotherapy significantly improved OS in low-risk patients compared to those not receiving RT (P = 0 . 017), but not in high-risk patients (P = 0 .47) . The model demonstrated strong predictive performance, with 3-and 5-year AUC values of 0.777 and 0.775 in the training set, and 0.747 and 0.712 in the validation set. Calibration curves indicated close agreement between predicted and observed outcomes.  \nConclusion We developed and validated a prognostic nomogram for IBC-NST with medullary pattern that accurately stratifies patients by risk. Our findings indicate that radiotherapy is associated with a survival benefit primarily in lowrisk patients, offering a practical tool to optimize RT personalization and avoid overtreatment in high-risk individuals. Keywords Invasive breast carcinoma, Medullary pattern, Radiotherapy, Overall survival, Risk stratification, Nomogram  \n†Jian Zhang, Lizhao Wang and Heyan Chen have contributed equally to this work.  \n*Correspondence: Ke Wang [xjtu_wet@163.com](xjtu_wet@163.com)[ ](xjtu_wet@163.com)Jianjun He [chinahjj09@126.com](chinahjj09@126.com)  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://cre","cbCaic4DDrzwJFwq","https://ap.wps.com/l/cbCaic4DDrzwJFwq","pdf",2401208,12,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction\n## Breast cancer heterogeneity and medullary carcinoma subtype\n## WHO classification and immunophenotype\n## Prognosis and evidence gaps for treatment","[{\"question\":\"What patient subgroup does the study focus on?\",\"answer\":\"The study focuses on invasive breast carcinoma of no special type (IBC-NST) with medullary pattern, described as a rare histologic subtype accounting for about 3–5% of breast malignancies.\"},{\"question\":\"How was the prognostic risk stratification model developed?\",\"answer\":\"Using SEER data from 2010–2018, the authors performed univariate and multivariate Cox regression to build a prognostic nomogram and stratify patients into low- and high-risk groups.\"},{\"question\":\"In which risk group did radiotherapy improve overall survival?\",\"answer\":\"Radiotherapy significantly improved overall survival in low-risk patients compared with no RT, while no significant improvement was reported for high-risk patients.\"}]","A population-based analysis of a risk stratification system for predicting radiotherapy benefits in invasive breast carcinoma of no special type with medullary pattern | PDF",1790736839]