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. 2022 Sep:173:178-193.
doi: 10.1016/j.ejca.2022.06.011. Epub 2022 Aug 4.

Incorporating progesterone receptor expression into the PREDICT breast prognostic model

Isabelle Grootes  1 Renske Keeman  2 Fiona M Blows  3 Roger L Milne  4 Graham G Giles  4 Anthony J Swerdlow  5 Peter A Fasching  6 Mustapha Abubakar  7 Irene L Andrulis  8 Hoda Anton-Culver  9 Matthias W Beckmann  10 Carl Blomqvist  11 Stig E Bojesen  12 Manjeet K Bolla  13 Bernardo Bonanni  14 Ignacio Briceno  15 Barbara Burwinkel  16 Nicola J Camp  17 Jose E Castelao  18 Ji-Yeob Choi  19 Christine L Clarke  20 Fergus J Couch  21 Angela Cox  22 Simon S Cross  23 Kamila Czene  24 Peter Devilee  25 Thilo Dörk  26 Alison M Dunning  3 Miriam Dwek  27 Douglas F Easton  28 Diana M Eccles  29 Mikael Eriksson  24 Kristina Ernst  30 D Gareth Evans  31 Jonine D Figueroa  32 Visnja Fink  30 Giuseppe Floris  33 Stephen Fox  34 Marike Gabrielson  24 Manuela Gago-Dominguez  35 José A García-Sáenz  36 Anna González-Neira  37 Lothar Haeberle  10 Christopher A Haiman  38 Per Hall  39 Ute Hamann  40 Elaine F Harkness  41 Mikael Hartman  42 Alexander Hein  10 Maartje J Hooning  43 Ming-Feng Hou  44 Sacha J Howell  45 ABCTB Investigators  46 kConFab Investigators  47 Hidemi Ito  48 Anna Jakubowska  49 Wolfgang Janni  30 Esther M John  50 Audrey Jung  51 Daehee Kang  52 Vessela N Kristensen  53 Ava Kwong  54 Diether Lambrechts  55 Jingmei Li  56 Jan Lubiński  57 Mehdi Manoochehri  40 Sara Margolin  58 Keitaro Matsuo  59 Nur Aishah Mohd Taib  60 Anna Marie Mulligan  61 Heli Nevanlinna  62 William G Newman  31 Kenneth Offit  63 Ana Osorio  64 Sue K Park  65 Tjoung-Won Park-Simon  26 Alpa V Patel  66 Nadege Presneau  27 Katri Pylkäs  67 Brigitte Rack  30 Paolo Radice  68 Gad Rennert  69 Atocha Romero  70 Emmanouil Saloustros  71 Elinor J Sawyer  72 Andreas Schneeweiss  73 Fabienne Schochter  30 Minouk J Schoemaker  74 Chen-Yang Shen  75 Rana Shibli  69 Peter Sinn  76 William J Tapper  29 Essa Tawfiq  77 Soo Hwang Teo  78 Lauren R Teras  66 Diana Torres  79 Celine M Vachon  80 Carolien H M van Deurzen  81 Camilla Wendt  82 Justin A Williams  17 Robert Winqvist  67 Mark Elwood  77 Marjanka K Schmidt  83 Montserrat García-Closas  7 Paul D P Pharoah  28
Affiliations

Incorporating progesterone receptor expression into the PREDICT breast prognostic model

Isabelle Grootes et al. Eur J Cancer. 2022 Sep.

Abstract

Background: Predict Breast (www.predict.nhs.uk) is an online prognostication and treatment benefit tool for early invasive breast cancer. The aim of this study was to incorporate the prognostic effect of progesterone receptor (PR) status into a new version of PREDICT and to compare its performance to the current version (2.2).

Method: The prognostic effect of PR status was based on the analysis of data from 45,088 European patients with breast cancer from 49 studies in the Breast Cancer Association Consortium. Cox proportional hazard models were used to estimate the hazard ratio for PR status. Data from a New Zealand study of 11,365 patients with early invasive breast cancer were used for external validation. Model calibration and discrimination were used to test the model performance.

Results: Having a PR-positive tumour was associated with a 23% and 28% lower risk of dying from breast cancer for women with oestrogen receptor (ER)-negative and ER-positive breast cancer, respectively. The area under the ROC curve increased with the addition of PR status from 0.807 to 0.809 for patients with ER-negative tumours (p = 0.023) and from 0.898 to 0.902 for patients with ER-positive tumours (p = 2.3 × 10-6) in the New Zealand cohort. Model calibration was modest with 940 observed deaths compared to 1151 predicted.

Conclusion: The inclusion of the prognostic effect of PR status to PREDICT Breast has led to an improvement of model performance and more accurate absolute treatment benefit predictions for individual patients. Further studies should determine whether the baseline hazard function requires recalibration.

Keywords: PREDICT Breast; Progesterone receptor; Prognosis; breast cancer.

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Figures

Fig. 1
Fig. 1
Calibration plot of observed outcomes at 15 years after diagnosis with 95% confidence intervals against 15-year predicted outcomes at by quintiles of the predicted value in the New Zealand cohort.

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