Determinants of Breast Nodules in Perimenopausal Women: A Prospective Cohort Study

Background: Perimenopausal women often require hormone replacement therapy (HRT), which is associated with an increased risk of developing breast nodules compared to women in other age groups. Consequently, this study aimed to identify risk factors for breast nodule development in...

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Main Authors: Xue Lei, Jing Mu, Guiyue Lei, Ke Liu, Dian Wang, Laigang Zhao, Lin Yang
Format: Article
Language:English
Published: IMR Press 2025-02-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/52/2/10.31083/CEOG25938
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author Xue Lei
Jing Mu
Guiyue Lei
Ke Liu
Dian Wang
Laigang Zhao
Lin Yang
author_facet Xue Lei
Jing Mu
Guiyue Lei
Ke Liu
Dian Wang
Laigang Zhao
Lin Yang
author_sort Xue Lei
collection DOAJ
description Background: Perimenopausal women often require hormone replacement therapy (HRT), which is associated with an increased risk of developing breast nodules compared to women in other age groups. Consequently, this study aimed to identify risk factors for breast nodule development in perimenopausal women and to develop a predictive model to mitigate these risks. Methods: This prospective cohort study included 436 perimenopausal women who underwent breast ultrasound examinations at the Affiliated Hospital of Guizhou Medical University, China. Clinical data were collected, with 304 cases (70%) assigned to the modeling group, while the remaining 132 cases (30%) were allocated to the validation group using a computerized randomization method. Subsequently, participants in each group were categorized into either the control group or the disease group based on the presence or absence of breast nodules. Risk factors associated with the occurrence of breast nodules in perimenopausal women from the modeling group were analyzed using univariate analysis and multivariate logistic regression. A nomogram predictive model was subsequently constructed using R software. The predictive accuracy and discriminative ability of the model for perimenopausal breast nodules were evaluated in both the modeling and validation groups using goodness-of-fit curves and receiver operating characteristic (ROC) analysis. Results: Factors exhibiting significant differences in the univariate analysis were included in the multivariate logistic regression model. The results revealed that family relationships, the modified Kupperman score, depression, dietary status, estradiol (E2), triglycerides (TG), and total cholesterol (TC) were independent risk factors for the development of breast nodules during perimenopause. In contrast, elevated high follicle-stimulating hormone (FSH) levels were identified as a protective factor against perimenopausal breast nodules. A nomogram predictive model was developed to assess the predictive validity of breast nodules occurrence during perimenopause, using goodness-of-fit curves. The results showed χ2 = 4.936, p = 0.764 for the training group, and χ2 = 8.642, p = 0.071 for the testing group. The model’s discrimination was evaluated by the ROC curve, with the results showing an area under the curve (AUC) of 0.941 for the training model, along with a specificity of 91.7%, and sensitivity of 96.4%. In the testing model, the AUC was also 0.941, with a sensitivity of 90.2% and specificity of 98.4%. Conclusions: Poor family relationships, unhealthy dietary habits, severe menopausal symptoms, severe depression, elevated estrogen levels, and elevated blood lipid levels were identified as independent risk factors for the development of breast nodules during perimenopause. In contrast, high FSH levels serve as a protective factor against perimenopausal breast nodules. The predictive model developed using this approach demonstrates strong predictive accuracy and discriminative power.
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spelling doaj-art-5ed0656348f64cdaababc09e2eefc7cf2025-08-20T02:11:05ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632025-02-015222593810.31083/CEOG25938S0390-6663(24)02550-8Determinants of Breast Nodules in Perimenopausal Women: A Prospective Cohort StudyXue Lei0Jing Mu1Guiyue Lei2Ke Liu3Dian Wang4Laigang Zhao5Lin Yang6Department of Clinical Medical, Guizhou Medical University, 550004 Guiyang, Guizhou, ChinaDepartment of Clinical Medical, Guizhou Medical University, 550004 Guiyang, Guizhou, ChinaDepartment of Clinical Medical, Guizhou Medical University, 550004 Guiyang, Guizhou, ChinaDepartment of Clinical Medical, Guizhou Medical University, 550004 Guiyang, Guizhou, ChinaSchool of Basic Medical Sciences, Capital Medical University, 100015 Beijing, ChinaDepartment of Gynecological, The Affiliated Hospital of Guizhou Medical University, 550001 Guiyang, Guizhou, ChinaDepartment of Clinical Medical, Guizhou Medical University, 550004 Guiyang, Guizhou, ChinaBackground: Perimenopausal women often require hormone replacement therapy (HRT), which is associated with an increased risk of developing breast nodules compared to women in other age groups. Consequently, this study aimed to identify risk factors for breast nodule development in perimenopausal women and to develop a predictive model to mitigate these risks. Methods: This prospective cohort study included 436 perimenopausal women who underwent breast ultrasound examinations at the Affiliated Hospital of Guizhou Medical University, China. Clinical data were collected, with 304 cases (70%) assigned to the modeling group, while the remaining 132 cases (30%) were allocated to the validation group using a computerized randomization method. Subsequently, participants in each group were categorized into either the control group or the disease group based on the presence or absence of breast nodules. Risk factors associated with the occurrence of breast nodules in perimenopausal women from the modeling group were analyzed using univariate analysis and multivariate logistic regression. A nomogram predictive model was subsequently constructed using R software. The predictive accuracy and discriminative ability of the model for perimenopausal breast nodules were evaluated in both the modeling and validation groups using goodness-of-fit curves and receiver operating characteristic (ROC) analysis. Results: Factors exhibiting significant differences in the univariate analysis were included in the multivariate logistic regression model. The results revealed that family relationships, the modified Kupperman score, depression, dietary status, estradiol (E2), triglycerides (TG), and total cholesterol (TC) were independent risk factors for the development of breast nodules during perimenopause. In contrast, elevated high follicle-stimulating hormone (FSH) levels were identified as a protective factor against perimenopausal breast nodules. A nomogram predictive model was developed to assess the predictive validity of breast nodules occurrence during perimenopause, using goodness-of-fit curves. The results showed χ2 = 4.936, p = 0.764 for the training group, and χ2 = 8.642, p = 0.071 for the testing group. The model’s discrimination was evaluated by the ROC curve, with the results showing an area under the curve (AUC) of 0.941 for the training model, along with a specificity of 91.7%, and sensitivity of 96.4%. In the testing model, the AUC was also 0.941, with a sensitivity of 90.2% and specificity of 98.4%. Conclusions: Poor family relationships, unhealthy dietary habits, severe menopausal symptoms, severe depression, elevated estrogen levels, and elevated blood lipid levels were identified as independent risk factors for the development of breast nodules during perimenopause. In contrast, high FSH levels serve as a protective factor against perimenopausal breast nodules. The predictive model developed using this approach demonstrates strong predictive accuracy and discriminative power.https://www.imrpress.com/journal/CEOG/52/2/10.31083/CEOG25938perimenopausebreast nodulesrisk factorsnomogram prediction model
spellingShingle Xue Lei
Jing Mu
Guiyue Lei
Ke Liu
Dian Wang
Laigang Zhao
Lin Yang
Determinants of Breast Nodules in Perimenopausal Women: A Prospective Cohort Study
Clinical and Experimental Obstetrics & Gynecology
perimenopause
breast nodules
risk factors
nomogram prediction model
title Determinants of Breast Nodules in Perimenopausal Women: A Prospective Cohort Study
title_full Determinants of Breast Nodules in Perimenopausal Women: A Prospective Cohort Study
title_fullStr Determinants of Breast Nodules in Perimenopausal Women: A Prospective Cohort Study
title_full_unstemmed Determinants of Breast Nodules in Perimenopausal Women: A Prospective Cohort Study
title_short Determinants of Breast Nodules in Perimenopausal Women: A Prospective Cohort Study
title_sort determinants of breast nodules in perimenopausal women a prospective cohort study
topic perimenopause
breast nodules
risk factors
nomogram prediction model
url https://www.imrpress.com/journal/CEOG/52/2/10.31083/CEOG25938
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