| Title |
Bioscore: A Staging System for Breast Cancer Patients that Reflects the Prognostic Significance of Underlying Tumor Biology
|
|---|---|
| Published in |
Annals of Surgical Oncology, July 2017
|
| DOI | 10.1245/s10434-017-6009-x |
| Pubmed ID | |
| Authors |
Elizabeth A. Mittendorf, Mariana Chavez-MacGregor, Jose Vila, Min Yi, Daphne Y. Lichtensztajn, Christina A. Clarke, Sharon H. Giordano, Kelly K. Hunt |
| Abstract |
Biologic factors guide treatment decisions and have a significant impact on prognosis for breast cancer patients. This study was undertaken to develop a staging system incorporating biologic factors in addition to standard anatomic factors in the American Joint Committee on Cancer (AJCC) pathologic stage (PS) to assess disease-specific survival (DSS). Overall, 3327 patients treated with surgery as an initial intervention at MD Anderson Cancer Center from 2007 to 2013 were identified. Multivariate analyses of factors, including PS, T stage (T), nodal stage (N), grade (G), estrogen receptor (ER) status (E) and human epidermal growth factor receptor (HER2) status (H) were performed to identify associations with DSS. A score of 0-4 was assigned for each factor by considering the hazard ratio magnitude. Multiple staging system models were then constructed: PS, PS + G, PS + G + E, PS + G + E + H, T + N, T + N + G, T + N + G + E, and T + N + G + E + H. Model performance was quantified using Harrell's concordance index, and the Akaike Information Criterion (AIC) was used to compare model fits. Comparable cases from California (n = 67,944) were used for validation. Median follow-up was 5.0 years (range 0.1-8.8) and 5-year DSS was 97.9% (95% confidence interval 97.3-98.4). Models incorporating grade, ER status, and HER2 status were most precise with identical C-index (0.81) and comparable AIC (994.9 for PS + G + E + H and 987.8 for T + N + G + E + H). Both models were externally validated. These results confirm the importance of biologic factors in determining prognosis for breast cancer patients. We propose the Bioscore, which incorporates grade, ER and HER2 status with AJCC PS, to provide more refined stratification of breast cancer patients undergoing surgery as an initial intervention with respect to DSS. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 34 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 6 | 18% |
| Student > Master | 6 | 18% |
| Researcher | 6 | 18% |
| Student > Ph. D. Student | 4 | 12% |
| Other | 2 | 6% |
| Other | 5 | 15% |
| Unknown | 5 | 15% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 32% |
| Biochemistry, Genetics and Molecular Biology | 4 | 12% |
| Unspecified | 2 | 6% |
| Engineering | 2 | 6% |
| Sports and Recreations | 2 | 6% |
| Other | 5 | 15% |
| Unknown | 8 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 October 2017.
All research outputs
#18,571,001
of 23,001,641 outputs
Outputs from Annals of Surgical Oncology
#5,038
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#241,311
of 315,211 outputs
Outputs of similar age from Annals of Surgical Oncology
#85
of 98 outputs
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