期刊
ANNALS OF INTERNAL MEDICINE
卷 148, 期 5, 页码 337-W75出版社
AMER COLL PHYSICIANS
DOI: 10.7326/0003-4819-148-5-200803040-00004
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资金
- NCI NIH HHS [K24 CA125036, U01 CA070040, U01CA63731, U01 CA070013, U01 CA086082, U01CA86082, U01CA63736, K07 CA086032-01, U01CA70013, K07 CA086032, K07 CA086032-02, 01CA63740, U01CA69976, U01CA70040, U01 CA063731, U01 CA086076, U01 CA063740, U01 CA069976, U01CA86076, U01 CA063736] Funding Source: Medline
- NIAMS NIH HHS [K12 AR47659, K12 AR047659] Funding Source: Medline
Background: 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. Objective: To develop and validate an easy-to-use breast cancer risk prediction model that includes breast density. Design: Empirical model based on Surveillance, Epidemiology, and End Results incidence, and relative hazards from a prospective cohort. Setting: Screening mammography sites participating in the Breast Cancer Surveillance Consortium. Patients: 1 095 484 women undergoing mammography who had no previous diagnosis of breast cancer. Measurements: 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. Results: 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. Limitation: The model has only modest ability to discriminate between women who will develop breast cancer and those who will not. Conclusion: 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.
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