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Predicting five-year interval second breast cancer risk in women with prior breast cancer
Rebecca A Hubbard1, Yu-Ru Su2, Erin J A Bowles2
1Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Journal of the National Cancer Institute
|March 11, 2024
Summary
A new risk model accurately predicts the likelihood of developing a second breast cancer after a negative mammogram. This tool can help personalize breast cancer surveillance for women with a history of the disease.
Area of Science:
- Oncology
- Radiology
- Biostatistics
Background:
- Annual mammography is standard for breast cancer survivors.
- Predicting mammography failures like interval cancers can personalize surveillance.
- Current risk models may not fully capture individual risk profiles.
Purpose of the Study:
- To develop and validate a risk prediction model for interval second breast cancers in women with a history of breast cancer.
- To estimate one-year and five-year cumulative risks of interval second cancers.
- To assess model performance across different racial and ethnic groups.
Main Methods:
- Used data from the Breast Cancer Surveillance Consortium (1996-2019).
- Employed Least Absolute Shrinkage and Selection Operator (LASSO)-penalized regression.
- Validated model performance using cross-validation.
Main Results:
- The model demonstrated good calibration (expected/observed ratio=1.00) and accuracy (AUC=0.64).
- Performance was consistent across racial and ethnic groups.
- Median five-year cumulative risk was 1.20%; higher in younger, pre/perimenopausal women, and those with ER-negative primaries.
Conclusions:
- The developed risk model identifies women at higher risk for interval second breast cancers.
- This model may guide the use of additional surveillance imaging modalities.
- Further evaluation is needed to confirm if risk-guided surveillance improves early detection and reduces failures.
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