A Model for Individualized Risk Prediction of Contralateral Breast Cancer
Published Date:Nov 04 2016
Source:Breast Cancer Res Treat. 161(1):153-160.
Pubmed Central ID:PMC5224985
HHSN261201000140C/CA/NCI NIH HHS/United States
P30 CA118100/CA/NCI NIH HHS/United States
N01PC35138/CA/NCI NIH HHS/United States
N01 CN067009/CN/NCI NIH HHS/United States
HHSN261201300012I/CA/NCI NIH HHS/United States
N01PC35142/CA/NCI NIH HHS/United States
R21 CA186086/CA/NCI NIH HHS/United States
HHSN261201000035I/CA/NCI NIH HHS/United States
HHSN261201000034C/CA/NCI NIH HHS/United States
U58 DP003862/DP/NCCDPHP CDC HHS/United States
HHSN261201000029C/CA/NCI NIH HHS/United States
N01 CN005230/CN/NCI NIH HHS/United States
HHSN261201100031C/CA/NCI NIH HHS/United States
Patients diagnosed with invasive breast cancer (BC) or ductal carcinoma in situ are increasingly choosing to undergo contralateral prophylactic mastectomy (CPM) to reduce their risk of contralateral breast cancer (CBC). This is a particularly disturbing trend as a large proportion of these CPMs are believed to be medically unnecessary. Many BC patients tend to substantially overestimate their CBC risk. Thus, there is a pressing need to educate patients effectively on their CBC risk. We develop a CBC risk prediction model to aid physicians in this task.
We used data from two sources: Breast Cancer Surveillance Consortium and Surveillance, Epidemiology, and End Results to build the model. The model building steps are similar to those used in developing the Breast Cancer Risk Assessment Tool (popularly known as Gail model) for counseling women on their BC risk. Our model, named Contralateral Breast Cancer Risk (CBCRisk) is exclusively designed for counseling women diagnosed with unilateral BC on the risk of developing CBC.
We identified eight factors to be significantly associated with CBC–age at first BC diagnosis, anti-estrogen therapy, family history of BC, high risk pre-neoplasia, estrogen receptor status, breast density, type of first BC, and age at first birth. Combining the relative risk estimates with the relevant hazard rates, CBCRisk projects absolute risk of developing CBC over a given period.
By providing individualized CBC risk, CBCRisk may help in counseling of BC patients. In turn, this may potentially help alleviate the rate of medically unnecessary CPMs.
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