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Developing and validating an individualized breast cancer risk prediction model for women attending breast cancer screening

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dc.contributor.author Louro, Javier
dc.contributor.author Román, Marta
dc.contributor.author Posso, Margarita
dc.contributor.author Vázquez‐de las Heras, Ivonne
dc.contributor.author Saladié, Francina
dc.contributor.author Rodríguez Arana, Ana Maria
dc.contributor.author Quintana, María Jesús
dc.contributor.author Domingo Torrell, Laia
dc.contributor.author Baré, Marisa
dc.contributor.author Marcos-Gragera, Rafael
dc.contributor.author Vernet-Tomás, Maria
dc.contributor.author Sala, Maria
dc.contributor.author Castells, Xavier
dc.contributor.author BELE Study Group
dc.contributor.author IRIS Study Group
dc.contributor.author IRIS Study Group
dc.date.accessioned 2021-07-12T06:09:02Z
dc.date.available 2021-07-12T06:09:02Z
dc.date.issued 2021
dc.identifier.citation Louro J, Román M, Posso M, Vázquez I, Saladié F, Rodriguez-Arana A, Quintana MJ, Domingo L, Baré M, Marcos-Gragera R, Vernet-Tomas M, Sala M, Castells X; BELE and IRIS Study Groups. Developing and validating an individualized breast cancer risk prediction model for women attending breast cancer screening. PLoS One. 2021;16(3):e0248930. DOI: 10.1371/journal.pone.0248930
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10230/48151
dc.description.abstract Background: Several studies have proposed personalized strategies based on women's individual breast cancer risk to improve the effectiveness of breast cancer screening. We designed and internally validated an individualized risk prediction model for women eligible for mammography screening. Methods: Retrospective cohort study of 121,969 women aged 50 to 69 years, screened at the long-standing population-based screening program in Spain between 1995 and 2015 and followed up until 2017. We used partly conditional Cox proportional hazards regression to estimate the adjusted hazard ratios (aHR) and individual risks for age, family history of breast cancer, previous benign breast disease, and previous mammographic features. We internally validated our model with the expected-to-observed ratio and the area under the receiver operating characteristic curve. Results: During a mean follow-up of 7.5 years, 2,058 women were diagnosed with breast cancer. All three risk factors were strongly associated with breast cancer risk, with the highest risk being found among women with family history of breast cancer (aHR: 1.67), a proliferative benign breast disease (aHR: 3.02) and previous calcifications (aHR: 2.52). The model was well calibrated overall (expected-to-observed ratio ranging from 0.99 at 2 years to 1.02 at 20 years) but slightly overestimated the risk in women with proliferative benign breast disease. The area under the receiver operating characteristic curve ranged from 58.7% to 64.7%, depending of the time horizon selected. Conclusions: We developed a risk prediction model to estimate the short- and long-term risk of breast cancer in women eligible for mammography screening using information routinely reported at screening participation. The model could help to guiding individualized screening strategies aimed at improving the risk-benefit balance of mammography screening programs.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Public Library of Science (PLoS)
dc.relation.ispartof PLoS One. 2021;16(3):e0248930
dc.rights © 2021 Louro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Developing and validating an individualized breast cancer risk prediction model for women attending breast cancer screening
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0248930
dc.subject.keyword Breast cancer
dc.subject.keyword Mammography
dc.subject.keyword Cancer risk factors
dc.subject.keyword Forecasting
dc.subject.keyword Biopsy
dc.subject.keyword Calcification
dc.subject.keyword Medical risk factors
dc.subject.keyword Cancer detection and diagnosis
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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