Prediction and clinical utility of a contralateral breast cancer risk model

Research output: Contribution to journalJournal articleResearchpeer-review

Standard

Prediction and clinical utility of a contralateral breast cancer risk model. / Giardiello, Daniele; Steyerberg, Ewout W.; Hauptmann, Michael; Adank, Muriel A.; Akdeniz, Delal; Blomqvist, Carl; Bojesen, Stig E.; Bolla, Manjeet K.; Brinkhuis, Mariël; Chang-Claude, Jenny; Czene, Kamila; Devilee, Peter; Dunning, Alison M.; Easton, Douglas F.; Eccles, Diana M.; Fasching, Peter A.; Figueroa, Jonine; Flyger, Henrik; Garciá-Closas, Montserrat; Haeberle, Lothar; Haiman, Christopher A.; Hall, Per; Hamann, Ute; Hopper, John L.; Jager, Agnes; Jakubowska, Anna; Jung, Audrey; Keeman, Renske; Kramer, Iris; Lambrechts, Diether; Le Marchand, Loic; Lindblom, Annika; Lubiński, Jan; Manoochehri, Mehdi; Mariani, Luigi; Nevanlinna, Heli; Oldenburg, Hester S.A.; Pelders, Saskia; Pharoah, Paul D.P.; Shah, Mitul; Siesling, Sabine; Smit, Vincent T.H.B.M.; Southey, Melissa C.; Tapper, William J.; Tollenaar, Rob A.E.M.; Van Den Broek, Alexandra J.; Van Deurzen, Carolien H.M.; Van Leeuwen, Flora E.; Van Ongeval, Chantal; Van't Veer, Laura J.; Wang, Qin; Wendt, Camilla; Westenend, Pieter J.; Hooning, Maartje J.; Schmidt, Marjanka K.

In: Breast Cancer Research, Vol. 21, 144, 12.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Giardiello, D, Steyerberg, EW, Hauptmann, M, Adank, MA, Akdeniz, D, Blomqvist, C, Bojesen, SE, Bolla, MK, Brinkhuis, M, Chang-Claude, J, Czene, K, Devilee, P, Dunning, AM, Easton, DF, Eccles, DM, Fasching, PA, Figueroa, J, Flyger, H, Garciá-Closas, M, Haeberle, L, Haiman, CA, Hall, P, Hamann, U, Hopper, JL, Jager, A, Jakubowska, A, Jung, A, Keeman, R, Kramer, I, Lambrechts, D, Le Marchand, L, Lindblom, A, Lubiński, J, Manoochehri, M, Mariani, L, Nevanlinna, H, Oldenburg, HSA, Pelders, S, Pharoah, PDP, Shah, M, Siesling, S, Smit, VTHBM, Southey, MC, Tapper, WJ, Tollenaar, RAEM, Van Den Broek, AJ, Van Deurzen, CHM, Van Leeuwen, FE, Van Ongeval, C, Van't Veer, LJ, Wang, Q, Wendt, C, Westenend, PJ, Hooning, MJ & Schmidt, MK 2019, 'Prediction and clinical utility of a contralateral breast cancer risk model', Breast Cancer Research, vol. 21, 144. https://doi.org/10.1186/s13058-019-1221-1

APA

Giardiello, D., Steyerberg, E. W., Hauptmann, M., Adank, M. A., Akdeniz, D., Blomqvist, C., ... Schmidt, M. K. (2019). Prediction and clinical utility of a contralateral breast cancer risk model. Breast Cancer Research, 21, [144]. https://doi.org/10.1186/s13058-019-1221-1

Vancouver

Giardiello D, Steyerberg EW, Hauptmann M, Adank MA, Akdeniz D, Blomqvist C et al. Prediction and clinical utility of a contralateral breast cancer risk model. Breast Cancer Research. 2019 Dec;21. 144. https://doi.org/10.1186/s13058-019-1221-1

Author

Giardiello, Daniele ; Steyerberg, Ewout W. ; Hauptmann, Michael ; Adank, Muriel A. ; Akdeniz, Delal ; Blomqvist, Carl ; Bojesen, Stig E. ; Bolla, Manjeet K. ; Brinkhuis, Mariël ; Chang-Claude, Jenny ; Czene, Kamila ; Devilee, Peter ; Dunning, Alison M. ; Easton, Douglas F. ; Eccles, Diana M. ; Fasching, Peter A. ; Figueroa, Jonine ; Flyger, Henrik ; Garciá-Closas, Montserrat ; Haeberle, Lothar ; Haiman, Christopher A. ; Hall, Per ; Hamann, Ute ; Hopper, John L. ; Jager, Agnes ; Jakubowska, Anna ; Jung, Audrey ; Keeman, Renske ; Kramer, Iris ; Lambrechts, Diether ; Le Marchand, Loic ; Lindblom, Annika ; Lubiński, Jan ; Manoochehri, Mehdi ; Mariani, Luigi ; Nevanlinna, Heli ; Oldenburg, Hester S.A. ; Pelders, Saskia ; Pharoah, Paul D.P. ; Shah, Mitul ; Siesling, Sabine ; Smit, Vincent T.H.B.M. ; Southey, Melissa C. ; Tapper, William J. ; Tollenaar, Rob A.E.M. ; Van Den Broek, Alexandra J. ; Van Deurzen, Carolien H.M. ; Van Leeuwen, Flora E. ; Van Ongeval, Chantal ; Van't Veer, Laura J. ; Wang, Qin ; Wendt, Camilla ; Westenend, Pieter J. ; Hooning, Maartje J. ; Schmidt, Marjanka K. / Prediction and clinical utility of a contralateral breast cancer risk model. In: Breast Cancer Research. 2019 ; Vol. 21.

Bibtex

@article{7fe708d6bc0843b39d041163c0b94e14,
title = "Prediction and clinical utility of a contralateral breast cancer risk model",
abstract = "Background: Breast cancer survivors are at risk for contralateral breast cancer (CBC), with the consequent burden of further treatment and potentially less favorable prognosis. We aimed to develop and validate a CBC risk prediction model and evaluate its applicability for clinical decision-making. Methods: We included data of 132,756 invasive non-metastatic breast cancer patients from 20 studies with 4682 CBC events and a median follow-up of 8.8 years. We developed a multivariable Fine and Gray prediction model (PredictCBC-1A) including patient, primary tumor, and treatment characteristics and BRCA1/2 germline mutation status, accounting for the competing risks of death and distant metastasis. We also developed a model without BRCA1/2 mutation status (PredictCBC-1B) since this information was available for only 6{\%} of patients and is routinely unavailable in the general breast cancer population. Prediction performance was evaluated using calibration and discrimination, calculated by a time-dependent area under the curve (AUC) at 5 and 10 years after diagnosis of primary breast cancer, and an internal-external cross-validation procedure. Decision curve analysis was performed to evaluate the net benefit of the model to quantify clinical utility. Results: In the multivariable model, BRCA1/2 germline mutation status, family history, and systemic adjuvant treatment showed the strongest associations with CBC risk. The AUC of PredictCBC-1A was 0.63 (95{\%} prediction interval (PI) at 5 years, 0.52-0.74; at 10 years, 0.53-0.72). Calibration-in-the-large was-0.13 (95{\%} PI:-1.62-1.37), and the calibration slope was 0.90 (95{\%} PI: 0.73-1.08). The AUC of Predict-1B at 10 years was 0.59 (95{\%} PI: 0.52-0.66); calibration was slightly lower. Decision curve analysis for preventive contralateral mastectomy showed potential clinical utility of PredictCBC-1A between thresholds of 4-10{\%} 10-year CBC risk for BRCA1/2 mutation carriers and non-carriers. Conclusions: We developed a reasonably calibrated model to predict the risk of CBC in women of European-descent; however, prediction accuracy was moderate. Our model shows potential for improved risk counseling, but decision-making regarding contralateral preventive mastectomy, especially in the general breast cancer population where limited information of the mutation status in BRCA1/2 is available, remains challenging.",
keywords = "BRCA mutation carriers, Clinical decision-making, Contralateral breast cancer, Risk prediction model",
author = "Daniele Giardiello and Steyerberg, {Ewout W.} and Michael Hauptmann and Adank, {Muriel A.} and Delal Akdeniz and Carl Blomqvist and Bojesen, {Stig E.} and Bolla, {Manjeet K.} and Mari{\"e}l Brinkhuis and Jenny Chang-Claude and Kamila Czene and Peter Devilee and Dunning, {Alison M.} and Easton, {Douglas F.} and Eccles, {Diana M.} and Fasching, {Peter A.} and Jonine Figueroa and Henrik Flyger and Montserrat Garci{\'a}-Closas and Lothar Haeberle and Haiman, {Christopher A.} and Per Hall and Ute Hamann and Hopper, {John L.} and Agnes Jager and Anna Jakubowska and Audrey Jung and Renske Keeman and Iris Kramer and Diether Lambrechts and {Le Marchand}, Loic and Annika Lindblom and Jan Lubiński and Mehdi Manoochehri and Luigi Mariani and Heli Nevanlinna and Oldenburg, {Hester S.A.} and Saskia Pelders and Pharoah, {Paul D.P.} and Mitul Shah and Sabine Siesling and Smit, {Vincent T.H.B.M.} and Southey, {Melissa C.} and Tapper, {William J.} and Tollenaar, {Rob A.E.M.} and {Van Den Broek}, {Alexandra J.} and {Van Deurzen}, {Carolien H.M.} and {Van Leeuwen}, {Flora E.} and {Van Ongeval}, Chantal and {Van't Veer}, {Laura J.} and Qin Wang and Camilla Wendt and Westenend, {Pieter J.} and Hooning, {Maartje J.} and Schmidt, {Marjanka K.}",
year = "2019",
month = "12",
doi = "10.1186/s13058-019-1221-1",
language = "English",
volume = "21",
journal = "Breast Cancer Research (Online Edition)",
issn = "1465-5411",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Prediction and clinical utility of a contralateral breast cancer risk model

AU - Giardiello, Daniele

AU - Steyerberg, Ewout W.

AU - Hauptmann, Michael

AU - Adank, Muriel A.

AU - Akdeniz, Delal

AU - Blomqvist, Carl

AU - Bojesen, Stig E.

AU - Bolla, Manjeet K.

AU - Brinkhuis, Mariël

AU - Chang-Claude, Jenny

AU - Czene, Kamila

AU - Devilee, Peter

AU - Dunning, Alison M.

AU - Easton, Douglas F.

AU - Eccles, Diana M.

AU - Fasching, Peter A.

AU - Figueroa, Jonine

AU - Flyger, Henrik

AU - Garciá-Closas, Montserrat

AU - Haeberle, Lothar

AU - Haiman, Christopher A.

AU - Hall, Per

AU - Hamann, Ute

AU - Hopper, John L.

AU - Jager, Agnes

AU - Jakubowska, Anna

AU - Jung, Audrey

AU - Keeman, Renske

AU - Kramer, Iris

AU - Lambrechts, Diether

AU - Le Marchand, Loic

AU - Lindblom, Annika

AU - Lubiński, Jan

AU - Manoochehri, Mehdi

AU - Mariani, Luigi

AU - Nevanlinna, Heli

AU - Oldenburg, Hester S.A.

AU - Pelders, Saskia

AU - Pharoah, Paul D.P.

AU - Shah, Mitul

AU - Siesling, Sabine

AU - Smit, Vincent T.H.B.M.

AU - Southey, Melissa C.

AU - Tapper, William J.

AU - Tollenaar, Rob A.E.M.

AU - Van Den Broek, Alexandra J.

AU - Van Deurzen, Carolien H.M.

AU - Van Leeuwen, Flora E.

AU - Van Ongeval, Chantal

AU - Van't Veer, Laura J.

AU - Wang, Qin

AU - Wendt, Camilla

AU - Westenend, Pieter J.

AU - Hooning, Maartje J.

AU - Schmidt, Marjanka K.

PY - 2019/12

Y1 - 2019/12

N2 - Background: Breast cancer survivors are at risk for contralateral breast cancer (CBC), with the consequent burden of further treatment and potentially less favorable prognosis. We aimed to develop and validate a CBC risk prediction model and evaluate its applicability for clinical decision-making. Methods: We included data of 132,756 invasive non-metastatic breast cancer patients from 20 studies with 4682 CBC events and a median follow-up of 8.8 years. We developed a multivariable Fine and Gray prediction model (PredictCBC-1A) including patient, primary tumor, and treatment characteristics and BRCA1/2 germline mutation status, accounting for the competing risks of death and distant metastasis. We also developed a model without BRCA1/2 mutation status (PredictCBC-1B) since this information was available for only 6% of patients and is routinely unavailable in the general breast cancer population. Prediction performance was evaluated using calibration and discrimination, calculated by a time-dependent area under the curve (AUC) at 5 and 10 years after diagnosis of primary breast cancer, and an internal-external cross-validation procedure. Decision curve analysis was performed to evaluate the net benefit of the model to quantify clinical utility. Results: In the multivariable model, BRCA1/2 germline mutation status, family history, and systemic adjuvant treatment showed the strongest associations with CBC risk. The AUC of PredictCBC-1A was 0.63 (95% prediction interval (PI) at 5 years, 0.52-0.74; at 10 years, 0.53-0.72). Calibration-in-the-large was-0.13 (95% PI:-1.62-1.37), and the calibration slope was 0.90 (95% PI: 0.73-1.08). The AUC of Predict-1B at 10 years was 0.59 (95% PI: 0.52-0.66); calibration was slightly lower. Decision curve analysis for preventive contralateral mastectomy showed potential clinical utility of PredictCBC-1A between thresholds of 4-10% 10-year CBC risk for BRCA1/2 mutation carriers and non-carriers. Conclusions: We developed a reasonably calibrated model to predict the risk of CBC in women of European-descent; however, prediction accuracy was moderate. Our model shows potential for improved risk counseling, but decision-making regarding contralateral preventive mastectomy, especially in the general breast cancer population where limited information of the mutation status in BRCA1/2 is available, remains challenging.

AB - Background: Breast cancer survivors are at risk for contralateral breast cancer (CBC), with the consequent burden of further treatment and potentially less favorable prognosis. We aimed to develop and validate a CBC risk prediction model and evaluate its applicability for clinical decision-making. Methods: We included data of 132,756 invasive non-metastatic breast cancer patients from 20 studies with 4682 CBC events and a median follow-up of 8.8 years. We developed a multivariable Fine and Gray prediction model (PredictCBC-1A) including patient, primary tumor, and treatment characteristics and BRCA1/2 germline mutation status, accounting for the competing risks of death and distant metastasis. We also developed a model without BRCA1/2 mutation status (PredictCBC-1B) since this information was available for only 6% of patients and is routinely unavailable in the general breast cancer population. Prediction performance was evaluated using calibration and discrimination, calculated by a time-dependent area under the curve (AUC) at 5 and 10 years after diagnosis of primary breast cancer, and an internal-external cross-validation procedure. Decision curve analysis was performed to evaluate the net benefit of the model to quantify clinical utility. Results: In the multivariable model, BRCA1/2 germline mutation status, family history, and systemic adjuvant treatment showed the strongest associations with CBC risk. The AUC of PredictCBC-1A was 0.63 (95% prediction interval (PI) at 5 years, 0.52-0.74; at 10 years, 0.53-0.72). Calibration-in-the-large was-0.13 (95% PI:-1.62-1.37), and the calibration slope was 0.90 (95% PI: 0.73-1.08). The AUC of Predict-1B at 10 years was 0.59 (95% PI: 0.52-0.66); calibration was slightly lower. Decision curve analysis for preventive contralateral mastectomy showed potential clinical utility of PredictCBC-1A between thresholds of 4-10% 10-year CBC risk for BRCA1/2 mutation carriers and non-carriers. Conclusions: We developed a reasonably calibrated model to predict the risk of CBC in women of European-descent; however, prediction accuracy was moderate. Our model shows potential for improved risk counseling, but decision-making regarding contralateral preventive mastectomy, especially in the general breast cancer population where limited information of the mutation status in BRCA1/2 is available, remains challenging.

KW - BRCA mutation carriers

KW - Clinical decision-making

KW - Contralateral breast cancer

KW - Risk prediction model

U2 - 10.1186/s13058-019-1221-1

DO - 10.1186/s13058-019-1221-1

M3 - Journal article

C2 - 31847907

AN - SCOPUS:85076826918

VL - 21

JO - Breast Cancer Research (Online Edition)

JF - Breast Cancer Research (Online Edition)

SN - 1465-5411

M1 - 144

ER -

ID: 241365034