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A Model for Individualized Risk Prediction of Contralateral Breast Cancer
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1 2017
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Source: Breast Cancer Res Treat. 161(1):153-160
[PDF-191.52 KB]
Details:
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Alternative Title:Breast Cancer Res Treat
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Personal Author:
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Description:Purpose
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.
Methods
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.
Results
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.
Conclusions
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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Pubmed ID:27815748
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Pubmed Central ID:PMC5224985
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Volume:161
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Issue:1
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