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Breast cancer risk prediction: an update to the Rosner-Colditz breast cancer incidence model.

Authors :
Rice, Megan
Tworoger, Shelley
Hankinson, Susan
Tamimi, Rulla
Eliassen, A.
Willett, Walter
Colditz, Graham
Rosner, Bernard
Source :
Breast Cancer Research & Treatment; Nov2017, Vol. 166 Issue 1, p227-240, 14p
Publication Year :
2017

Abstract

Purpose: To update and expand the Rosner-Colditz breast cancer incidence model by evaluating the contributions of more recently identified risk factors as well as predicted percent mammographic density (MD) to breast cancer risk. Methods: Using data from the Nurses' Health Study (NHS) and NHSII, we added adolescent somatotype (9 unit scale), vegetable intake (servings/day), breastfeeding (months), physical activity (MET-h/week), and predicted percent MD to the Rosner-Colditz model to determine whether these variables improved model discrimination. We evaluated all invasive as well as ER+/PR+, ER+/PR−, and ER−/PR− breast cancer. Results: In the NHS/NHSII, we accrued over 5200 cases of invasive breast cancer over more than 20 years of follow-up with complete data on the risk factors. Adolescent somatotype and predicted percent MD significantly improved the original Rosner-Colditz model for all invasive breast cancer (change in age-adjusted AUC = 0.020, p < 0.001). The relative risk (RR) of invasive breast cancer for a 4-unit increase in adolescent somatotype was 0.62 (95% CI 0.56, 0.70), whereas the RR for a 20-unit increase in predicted percent MD was 1.32 (95% CI 1.28, 1.36). Adolescent somatotype and predicted percent MD also significantly improved the ER+/PR+model (change in age-adjusted AUC = 0.020, p < 0.001) as well as the ER+/PR− model (change in age-adjusted AUC = 0.012, p = 0.007). Adolescent somatotype, predicted percent MD, breastfeeding, and vegetable intake improved the ER−/PR− model (change in AUC = 0.031, p < 0.0001). The RR of ER−/PR− disease for 5 vegetable servings/day increase was 0.83 (95% CI 0.70, 0.99), while the RR for every 12 months of breastfeeding was 0.88 (95% CI 0.77, 1.01). Physical activity did not improve risk classification in any model. Conclusion: Adolescent somatotype and predicted percent MD significantly improved breast cancer risk classification using the Rosner-Colditz model. Further, risk factors specific to ER− disease, such as breastfeeding and vegetable intake, may also help improve risk prediction of this aggressive subtype. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01676806
Volume :
166
Issue :
1
Database :
Complementary Index
Journal :
Breast Cancer Research & Treatment
Publication Type :
Academic Journal
Accession number :
125727678
Full Text :
https://doi.org/10.1007/s10549-017-4391-5