% IMPORTANT: The following is UTF-8 encoded. This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.
@ARTICLE{Li:142079,
author = {K. Li and G. Anderson and V. Viallon and P. Arveux and M.
Kvaskoff and A. Fournier and V. Krogh and R. Tumino and
M.-J. Sánchez and E. Ardanaz and M.-D. Chirlaque and A.
Agudo and D. C. Muller and T. Smith and I. Tzoulaki and T.
J. Key and B. Bueno-de-Mesquita and A. Trichopoulou and C.
Bamia and P. Orfanos and R. Kaaks$^*$ and A. Hüsing$^*$ and
R. Turzanski-Fortner$^*$ and A. Zeleniuch-Jacquotte and M.
Sund and C. C. Dahm and K. Overvad and D. Aune and E.
Weiderpass and I. Romieu and E. Riboli and M. J. Gunter and
L. Dossus and R. Prentice and P. Ferrari},
title = {{R}isk prediction for estrogen receptor-specific breast
cancers in two large prospective cohorts.},
journal = {Breast cancer research},
volume = {20},
number = {1},
issn = {1465-542X},
address = {London},
publisher = {BioMed Central},
reportid = {DKFZ-2018-02309},
pages = {147},
year = {2018},
abstract = {Few published breast cancer (BC) risk prediction models
consider the heterogeneity of predictor variables between
estrogen-receptor positive (ER+) and negative (ER-) tumors.
Using data from two large cohorts, we examined whether
modeling this heterogeneity could improve prediction.We
built two models, for ER+ (ModelER+) and ER- tumors
(ModelER-), respectively, in 281,330 women $(51\%$
postmenopausal at recruitment) from the European Prospective
Investigation into Cancer and Nutrition cohort.
Discrimination (C-statistic) and calibration (the agreement
between predicted and observed tumor risks) were assessed
both internally and externally in 82,319 postmenopausal
women from the Women's Health Initiative study. We performed
decision curve analysis to compare ModelER+ and the Gail
model (ModelGail) regarding their applicability in risk
assessment for chemoprevention.Parity, number of full-term
pregnancies, age at first full-term pregnancy and body
height were only associated with ER+ tumors. Menopausal
status, age at menarche and at menopause, hormone
replacement therapy, postmenopausal body mass index, and
alcohol intake were homogeneously associated with ER+ and
ER- tumors. Internal validation yielded a C-statistic of
0.64 for ModelER+ and 0.59 for ModelER-. External validation
reduced the C-statistic of ModelER+ (0.59) and ModelGail
(0.57). In external evaluation of calibration, ModelER+
outperformed the ModelGail: the former led to a $9\%$
overestimation of the risk of ER+ tumors, while the latter
yielded a $22\%$ underestimation of the overall BC risk.
Compared with the treat-all strategy, ModelER+ produced
equal or higher net benefits irrespective of the
benefit-to-harm ratio of chemoprevention, while ModelGail
did not produce higher net benefits unless the
benefit-to-harm ratio was below 50. The clinical
applicability, i.e. the area defined by the net benefit
curve and the treat-all and treat-none strategies, was
12.7 × 10- 6 for ModelER+ and 3.0 × 10- 6 for
ModelGail.Modeling heterogeneous epidemiological risk
factors might yield little improvement in BC risk
prediction. Nevertheless, a model specifically predictive of
ER+ tumor risk could be more applicable than an omnibus
model in risk assessment for chemoprevention.},
cin = {C020},
ddc = {610},
cid = {I:(DE-He78)C020-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:30509329},
pmc = {pmc:PMC6276150},
doi = {10.1186/s13058-018-1073-0},
url = {https://inrepo02.dkfz.de/record/142079},
}