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One versus Two Breast Density Measures to Predict 5- and 10-Year Breast Cancer Risk.


ABSTRACT: One measure of Breast Imaging Reporting and Data System (BI-RADS) breast density improves 5-year breast cancer risk prediction, but the value of sequential measures is unknown. We determined whether two BI-RADS density measures improve the predictive accuracy of the Breast Cancer Surveillance Consortium 5-year risk model compared with one measure.We included 722,654 women of ages 35 to 74 years with two mammograms with BI-RADS density measures on average 1.8 years apart; 13,715 developed invasive breast cancer. We used Cox regression to estimate the relative hazards of breast cancer for age, race/ethnicity, family history of breast cancer, history of breast biopsy, and one or two density measures. We developed a risk prediction model by combining these estimates with 2000-2010 Surveillance, Epidemiology, and End Results incidence and 2010 vital statistics for competing risk of death.The two-measure density model had marginally greater discriminatory accuracy than the one-measure model (AUC, 0.640 vs. 0.635). Of 18.6% of women (134,404 of 722,654) who decreased density categories, 15.4% (20,741 of 134,404) of women whose density decreased from heterogeneously or extremely dense to a lower density category with one other risk factor had a clinically meaningful increase in 5-year risk from <1.67% with the one-density model to ?1.67% with the two-density model.The two-density model has similar overall discrimination to the one-density model for predicting 5-year breast cancer risk and improves risk classification for women with risk factors and a decrease in density.A two-density model should be considered for women whose density decreases when calculating breast cancer risk.

SUBMITTER: Kerlikowske K 

PROVIDER: S-EPMC4452451 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

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One versus Two Breast Density Measures to Predict 5- and 10-Year Breast Cancer Risk.

Kerlikowske Karla K   Gard Charlotte C CC   Sprague Brian L BL   Tice Jeffrey A JA   Miglioretti Diana L DL  

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20150330 6


<h4>Background</h4>One measure of Breast Imaging Reporting and Data System (BI-RADS) breast density improves 5-year breast cancer risk prediction, but the value of sequential measures is unknown. We determined whether two BI-RADS density measures improve the predictive accuracy of the Breast Cancer Surveillance Consortium 5-year risk model compared with one measure.<h4>Methods</h4>We included 722,654 women of ages 35 to 74 years with two mammograms with BI-RADS density measures on average 1.8 ye  ...[more]

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