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Improved web-based calculators for predicting breast carcinoma outcomes

  • Epidemiology
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Abstract

We describe a set of web-based calculators, available at http://www.CancerMath.net, 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.

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Acknowledgements

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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Authors and Affiliations

  1. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

    James S. Michaelson, L. Leon Chen, Devon Bush, Allan Fong & Barbara Smith

  2. Department of Pathology, Massachusetts General Hospital, Boston, MA, USA

    James S. Michaelson

  3. Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Jerry Younger

  4. Department of Surgery, Harvard Medical School, Boston, MA, USA

    Barbara Smith

  5. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Jerry Younger

  6. Department of Pathology, Harvard Medical School, Boston, MA, USA

    James S. Michaelson

  7. Laboratory of Quantitative Medicine, Division of Surgical Oncology, Massachusetts General Hospital, Partners Research Building, 65 Landsdowne Street, Suite 205 A, Cambridge, MA, 02139, USA

    James S. Michaelson

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  1. James S. Michaelson
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  2. L. Leon Chen
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  3. Devon Bush
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  4. Allan Fong
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  5. Barbara Smith
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  6. Jerry Younger
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Correspondence to James S. Michaelson.

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Michaelson, J.S., Chen, L.L., Bush, D. et al. Improved web-based calculators for predicting breast carcinoma outcomes. Breast Cancer Res Treat 128, 827–835 (2011). https://doi.org/10.1007/s10549-011-1366-9

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  • DOI: https://doi.org/10.1007/s10549-011-1366-9

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