Using Clinical Factors and Mammographic Breast Density to Estimate Breast Cancer Risk: Development and Validation of a New Predictive Model
Top Cited Papers
- 4 March 2008
- journal article
- Published by American College of Physicians in Annals of Internal Medicine
- Vol. 148 (5), 337-47
- https://doi.org/10.7326/0003-4819-148-5-200803040-00004
Abstract
Current models for assessing breast cancer risk are complex and do not include breast density, a strong risk factor for breast cancer that is routinely reported with mammography. To develop and validate an easy-to-use breast cancer risk prediction model that includes breast density. Empirical model based on Surveillance, Epidemiology, and End Results incidence, and relative hazards from a prospective cohort. Screening mammography sites participating in the Breast Cancer Surveillance Consortium. 1,095,484 women undergoing mammography who had no previous diagnosis of breast cancer. Self-reported age, race or ethnicity, family history of breast cancer, and history of breast biopsy. Community radiologists rated breast density by using 4 Breast Imaging Reporting and Data System categories. During 5.3 years of follow-up, invasive breast cancer was diagnosed in 14,766 women. The breast density model was well calibrated overall (expected-observed ratio, 1.03 [95% CI, 0.99 to 1.06]) and in racial and ethnic subgroups. It had modest discriminatory accuracy (concordance index, 0.66 [CI, 0.65 to 0.67]). Women with low-density mammograms had 5-year risks less than 1.67% unless they had a family history of breast cancer and were older than age 65 years. The model has only modest ability to discriminate between women who will develop breast cancer and those who will not. A breast cancer prediction model that incorporates routinely reported measures of breast density can estimate 5-year risk for invasive breast cancer. Its accuracy needs to be further evaluated in independent populations before it can be recommended for clinical use.Keywords
This publication has 51 references indexed in Scilit:
- MULTIVARIABLE PROGNOSTIC MODELS: ISSUES IN DEVELOPING MODELS, EVALUATING ASSUMPTIONS AND ADEQUACY, AND MEASURING AND REDUCING ERRORSStatistics in Medicine, 1996
- Mammographic Features and Breast Cancer Risk: Effects With Time, Age, and Menopause StatusJNCI Journal of the National Cancer Institute, 1995
- Quantitative Classification of Mammographic Densities and Breast Cancer Risk: Results From the Canadian National Breast Screening StudyJNCI Journal of the National Cancer Institute, 1995
- Mammographic Parenchymal Patterns: A Marker of Breast Cancer RiskEpidemiologic Reviews, 1993
- The calculation of breast cancer risk for women with a first degree family history of ovarian cancerBreast Cancer Research and Treatment, 1993
- The risk of breast cancer associated with mammographic parenchymal patterns: a meta-analysis of the published literature to examine the effect of method of classification.1992
- Projecting Individualized Probabilities of Developing Breast Cancer for White Females Who Are Being Examined AnnuallyJNCI Journal of the National Cancer Institute, 1989
- MAMMOGRAPHIC PARENCHYMAL PATTERNS AS INDICATORS OF BREAST CANCER RISKAmerican Journal of Epidemiology, 1989
- Comparing the Areas under Two or More Correlated Receiver Operating Characteristic Curves: A Nonparametric ApproachBiometrics, 1988
- Mammographic parenchymal patterns and quantitative evaluation of mammographic densities: a case-control studyAmerican Journal of Roentgenology, 1987