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. 2023 Nov 20;9:e46474. doi: 10.2196/46474

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©Malin Hjärtström, Looket Dihge, Pär-Ola Bendahl, Ida Skarping, Julia Ellbrant, Mattias Ohlsson, Lisa Rydén. Originally published in JMIR Cancer (https://cancer.jmir.org), 20.11.2023.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cancer, is properly cited. The complete bibliographic information, a link to the original publication on https://cancer.jmir.org/, as well as this copyright and license information must be included.

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Models developed and evaluated in the study. Three nodal (N) models were developed to account for the lack of data on lymphovascular invasion (LVI) status in cohort II. The external validation was made in cohort II (Swedish National Quality Register for Breast Cancer; n=18,633). A new N model was developed in the training cohort (n=14,906) of cohort II, and its performance was compared with that of the 3 other N models in the test cohort (n=3727) of cohort II. An LVI model was developed to predict the LVI status for patients without documented LVI status in cohort I, and the LVI model was externally validated in cohort III. In addition, different alternatives for LVI imputation were tested in the model N-LVI_present^I in cohort III.