Breast Cancer Research and Treatment

, Volume 128, Issue 3, pp 827–835 | Cite as

Improved web-based calculators for predicting breast carcinoma outcomes

  • James S. Michaelson
  • L. Leon Chen
  • Devon Bush
  • Allan Fong
  • Barbara Smith
  • Jerry Younger


We describe a set of web-based calculators, available at, which estimate the risk of breast carcinoma death, the reduction in life expectancy, and the impact of various adjuvant treatment choices. The published SNAP method of the binary biological model of cancer metastasis uses information on tumor size, nodal status, and other prognostic factors to accurately estimate of breast cancer lethality at 15 years after diagnosis. By combining these 15-year lethality estimates with data on the breast cancer hazard function, breast cancer lethality can be estimated at each of the 15 years after diagnosis. A web-based calculator was then created to visualize the estimated lethality with and without a range of adjuvant therapy options at any of the 15 years after diagnosis, and enable conditional survival calculations. NIH population data was used to estimate non-breast-cancer chance of death. The accuracy of the calculators was tested against two large breast carcinoma datasets: 7,907 patients seen at two academic hospitals and 362,491 patients from the SEER national dataset. The calculators were found to be highly accurate and specific, as seen by their capacity for stratifying patients into groups differing by as little as a 2% risk of death, and accurately accounting for nodal status, histology, grade, age, and hormone receptor status. Our breast carcinoma calculators provide accurate and useful estimates of the risk of death, which can aid in analysis of the various adjuvant therapy options available to each patient.


Breast cancer Survival Outcome Calculator Epidemiology Conditional survival Hazard function 



Work in this article was supported through funds from the Department of Surgical Oncology at Massachusetts General Hospital.

Conflicts of interest

None reported.


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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • James S. Michaelson
    • 1
    • 2
    • 6
    • 7
  • L. Leon Chen
    • 1
  • Devon Bush
    • 1
  • Allan Fong
    • 1
  • Barbara Smith
    • 1
    • 4
  • Jerry Younger
    • 3
    • 5
  1. 1.Department of SurgeryMassachusetts General HospitalBostonUSA
  2. 2.Department of PathologyMassachusetts General HospitalBostonUSA
  3. 3.Department of MedicineMassachusetts General HospitalBostonUSA
  4. 4.Department of SurgeryHarvard Medical SchoolBostonUSA
  5. 5.Department of MedicineHarvard Medical SchoolBostonUSA
  6. 6.Department of PathologyHarvard Medical SchoolBostonUSA
  7. 7.Laboratory of Quantitative Medicine, Division of Surgical OncologyMassachusetts General HospitalCambridgeUSA

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