A scoring system to predict recurrence in breast cancer patients

Surg Oncol. 2018 Dec;27(4):681-687. doi: 10.1016/j.suronc.2018.09.005. Epub 2018 Sep 18.

Abstract

Objective: Current breast cancer recurrence prediction models have limitations for clinical practice (statistical methodology, simplicity and specific populations). We therefore developed a new model that overcomes these limitations.

Methods: This cohort study comprised 272 patients with breast cancer followed between 2003 and 2016. The main variable was time-to-recurrence (locoregional and/or metastasis) and secondary variables were its risk factors: age, postmenopause, grade, oestrogen receptor, progesterone receptor, c-erbB2 status, stage, multicentricity, diagnosis and treatment. A Cox model to predict recurrence was estimated with the secondary variables, and this was adapted to a points system to predict risk at 5 and 10 years from diagnosis. The model was validated internally by bootstrapping, calculating the C statistic and smooth calibration (splines). The system was integrated into a mobile application for Android.

Results: Of the 272 patients with breast cancer, 47 (17.3%) developed recurrence in a mean time of 8.6 ± 3.5 years. The system variables were: age, grade, multicentricity and stage. Validation by bootstrapping showed good discrimination and calibration.

Conclusions: A points system has been developed to predict breast cancer recurrence at 5 and 10 years.

Keywords: Breast neoplasms; Mobile applications; Models; Recurrence; Statistical.

MeSH terms

  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Carcinoma, Ductal, Breast / secondary
  • Carcinoma, Ductal, Breast / therapy*
  • Carcinoma, Lobular / secondary
  • Carcinoma, Lobular / therapy*
  • Cohort Studies
  • Combined Modality Therapy / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphatic Metastasis
  • Middle Aged
  • Models, Statistical*
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / etiology
  • Prognosis