Abstract:
BACKGROUND:Three tools are currently available to predict the risk of contralateral breast cancer (CBC). We aimed to compare the performance of the Manchester formula, CBCrisk, and PredictCBC in patients with invasive breast cancer (BC). METHODS:We analyzed data of 132,756 patients (4682 CBC) from 20 international studies with a median follow-up of 8.8 years. Prediction performance included discrimination, quantified as a time-dependent Area-Under-the-Curve (AUC) at 5 and 10 years after diagnosis of primary BC, and calibration, quantified as the expected-observed (E/O) ratio at 5 and 10 years and the calibration slope. RESULTS:The AUC at 10 years was: 0.58 (95% confidence intervals [CI] 0.57-0.59) for CBCrisk; 0.60 (95% CI 0.59-0.61) for the Manchester formula; 0.63 (95% CI 0.59-0.66) and 0.59 (95% CI 0.56-0.62) for PredictCBC-1A (for settings where BRCA1/2 mutation status is available) and PredictCBC-1B (for the general population), respectively. The E/O at 10 years: 0.82 (95% CI 0.51-1.32) for CBCrisk; 1.53 (95% CI 0.63-3.73) for the Manchester formula; 1.28 (95% CI 0.63-2.58) for PredictCBC-1A and 1.35 (95% CI 0.65-2.77) for PredictCBC-1B. The calibration slope was 1.26 (95% CI 1.01-1.50) for CBCrisk; 0.90 (95% CI 0.79-1.02) for PredictCBC-1A; 0.81 (95% CI 0.63-0.99) for PredictCBC-1B, and 0.39 (95% CI 0.34-0.43) for the Manchester formula. CONCLUSIONS:Current CBC risk prediction tools provide only moderate discrimination and the Manchester formula was poorly calibrated. Better predictors and re-calibration are needed to improve CBC prediction and to identify low- and high-CBC risk patients for clinical decision-making.
journal_name
Breast Cancer Res Treatjournal_title
Breast cancer research and treatmentauthors
Giardiello D,Hauptmann M,Steyerberg EW,Adank MA,Akdeniz D,Blom JC,Blomqvist C,Bojesen SE,Bolla MK,Brinkhuis M,Chang-Claude J,Czene K,Devilee P,Dunning AM,Easton DF,Eccles DM,Fasching PA,Figueroa J,Flyger H,García-Cldoi
10.1007/s10549-020-05611-8subject
Has Abstractpub_date
2020-06-01 00:00:00pages
423-434issue
2eissn
0167-6806issn
1573-7217pii
10.1007/s10549-020-05611-8journal_volume
181pub_type
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journal_title:Breast cancer research and treatment
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