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Comparative Analysis of Proposed Strategies for Incorporating Biologic Factors into Breast Cancer Staging
- Source :
- Annals of Surgical Oncology. 27:2229-2237
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Tumor biology is an important prognostic factor in breast cancer. This study aimed to compare three staging systems incorporating both biologic factors and anatomic staging (AJCC 8th-edition pathologic prognostic staging, Bioscore, and Risk Score) in a large population-based cohort. The Surveillance, Epidemiology and End Results program was used to select patients with primary stages 1–4 breast cancer diagnosed in 2010. Patients with inflammatory carcinoma, those with missing data for biologic factors, and those with stages 1–3 disease not treated with surgery were excluded from the study. Estimates of 5-year disease-specific survival (DSS) were calculated using the Kaplan–Meier method. The Harrel concordance index (C-index) and the Akaike Information Criterion were used to compare each model in terms of predicting DSS. The study included 21,901 patients with a median age of 60 years. The median follow-up period was 52 months. All the staging models stratified DSS, with a stepwise decrease in DSS for each increase in risk category or score. The C-index of each model incorporating biologic factors was higher than the C-index for anatomic staging alone (C-index: 0.832 vs. 0.856 for AJCC pathologic prognostic staging, 0.856 for Bioscore, and 0.864 for Risk Score, all p
- Subjects :
- Oncology
medicine.medical_specialty
MEDLINE
Breast Neoplasms
Disease
Cohort Studies
Biological Factors
03 medical and health sciences
0302 clinical medicine
Breast cancer
Surgical oncology
Internal medicine
Epidemiology
medicine
Humans
Neoplasm Staging
Framingham Risk Score
business.industry
Middle Aged
Prognosis
medicine.disease
030220 oncology & carcinogenesis
Cohort
030211 gastroenterology & hepatology
Surgery
business
Cohort study
Subjects
Details
- ISSN :
- 15344681 and 10689265
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- Annals of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....131b4b76f2eef3ef69fb9379100f995e