4 research outputs found
Relationship of Predicted Risk of Developing Invasive Breast Cancer, as Assessed with Three Models, and Breast Cancer Mortality among Breast Cancer Patients
<div><p>Purpose</p><p>Breast cancer risk prediction models are used to plan clinical trials and counsel women; however, relationships of predicted risks of breast cancer incidence and prognosis after breast cancer diagnosis are unknown.</p><p>Methods</p><p>Using largely pre-diagnostic information from the Breast Cancer Surveillance Consortium (BCSC) for 37,939 invasive breast cancers (1996β2007), we estimated 5-year breast cancer risk (<1%; 1β1.66%; β₯1.67%) with three models: BCSC 1-year risk model (BCSC-1; adapted to 5-year predictions); Breast Cancer Risk Assessment Tool (BCRAT); and BCSC 5-year risk model (BCSC-5). Breast cancer-specific mortality post-diagnosis (range: 1β13 years; median: 5.4β5.6 years) was related to predicted risk of developing breast cancer using unadjusted Cox proportional hazards models, and in age-stratified (35β44; 45β54; 55β69; 70β89 years) models adjusted for continuous age, BCSC registry, calendar period, income, mode of presentation, stage and treatment. Mean age at diagnosis was 60 years.</p><p>Results</p><p>Of 6,021 deaths, 2,993 (49.7%) were ascribed to breast cancer. In unadjusted case-only analyses, predicted breast cancer risk β₯1.67% versus <1.0% was associated with lower risk of breast cancer death; BCSC-1: hazard ratio (HR) = 0.82 (95% CI = 0.75β0.90); BCRAT: HR = 0.72 (95% CI = 0.65β0.81) and BCSC-5: HR = 0.84 (95% CI = 0.75β0.94). Age-stratified, adjusted models showed similar, although mostly non-significant HRs. Among women ages 55β69 years, HRs approximated 1.0. Generally, higher predicted risk was inversely related to percentages of cancers with unfavorable prognostic characteristics, especially among women 35β44 years.</p><p>Conclusions</p><p>Among cases assessed with three models, higher predicted risk of developing breast cancer was not associated with greater risk of breast cancer death; thus, these models would have limited utility in planning studies to evaluate breast cancer mortality reduction strategies. Further, when offering women counseling, it may be useful to note that high predicted risk of developing breast cancer does not imply that if cancer develops it will behave aggressively.</p></div
Predicted risk of developing breast cancer versus risk of death (age-stratified, adjusted models).
<p>Age-stratified models, adjusted for age in single years, registry, year of diagnosis, mode of detection, AJCC stage, treatment (surgery and chemotherapy: yes/no) and income (zip code of residence)</p
Characteristics of 37,939 Women with Breast Cancer.
<p>Characteristics of 37,939 Women with Breast Cancer.</p
Predicted 5-year risk of developing breast cancer versus clinicopathologic characteristics.
<p>Predicted 5-year risk of developing breast cancer versus clinicopathologic characteristics.</p