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Assessing breast cancer risk models in Marin County, a population with high rates of delayed childbirth
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November 22 2013
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Source: Clin Breast Cancer. 14(3):212-220.e1
[PDF-482.91 KB]
Details:
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Alternative Title:Clin Breast Cancer
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Personal Author:
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Description:Introduction
This study was designed to compare the BCRAT (Gail), IBIS (Tyrer-Cuzick), and BRCAPRO breast cancer risk assessment models using data from the Marin Women’s Study (MWS), a cohort of women within Marin County, California, with high rates of breast cancer, nulliparity, and delayed childbirth. Existing models have not been well-validated in these high risk populations.
Methods
Discrimination was assessed by AUC and calibration by estimating the ratio of expected to observed (E/O) cases. Models were assessed using data from 12,843 participants of whom 203 developed cancer in a 5-year period. All tests of statistical significance were two-sided.
Results
The IBIS model achieved an AUC of 0.65 (0.61–0.68 95% CI) compared to 0.62 (0.59–0.66 95% CI) for BCRAT and 0.60 (0.56–0.63 95% CI) for BRCAPRO. The estimated E/O ratios for the models were 1.08 (0.95–1.25 95% CI), 0.81 (0.71–0.93 95% CI), and 0.59 (0.52–0.68 95% CI) respectively. In women with age of first birth over 30, the AUC for the IBIS, BCRAT, and BRCAPRO models was 0.69 (0.62–0.75 95% CI), 0.63 (0.56–0.70 95% CI), and 0.62 (0.56–0.68 95% CI) and E/O ratios 1.15 (0.89–1.47 95% CI), 0.81 (0.63–1.05 95% CI), and 0.53 (0.41–0.68 95% CI) respectively.
Conclusions
The IBIS model was well calibrated for the high risk Marin mammography population, achieved the highest discrimination among the three models considered, and performed better in women with age first birth over 30. Both the BCRAT and BRCAPRO models had fair discriminatory ability but significantly underestimated risk for the Marin County mammography population.
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Pubmed ID:24461459
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Pubmed Central ID:PMC8040293
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Funding:
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Volume:14
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Issue:3
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