Evidence map›Paper›PMID 28589368›Full record

SynthesisBreast cancer research and treatment2017

Reassessing risk models for atypical hyperplasia: age may not matter.

Emanuele Mazzola, Suzanne B Coopey, Molly Griffin, Fernanda Polubriaginof, Julliette M Buckley, Giovanni Parmigiani, Judy E Garber, Barbara L Smith, Michele A Gadd, Michelle C Specht and 2 more

Open access · greenAbstract readMeta-AnalysisReview
In one paragraph

Synthesis in Breast cancer research and treatment, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Model for Predicting Breast Cancer Risk in Women With Atypical Hyperplasia.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 2 countries.

Emanuele MazzolaDepartment of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA. mazzola@jimmy.harvard.edu.ORCID http://orcid.org/0000-0003-0561-7336
Suzanne B CoopeyDivision of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Molly GriffinDivision of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Fernanda PolubriaginofDepartment of Biomedical Informatics, Columbia University, New York, NY, USA.
Julliette M BuckleyDepartment of Surgery, Mater Private Hospital, Citygate, Mahon, Cork, Ireland.
Giovanni ParmigianiDepartment of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.
Judy E GarberDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Barbara L SmithDivision of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Michele A GaddDivision of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Michelle C SpechtDivision of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Anthony GuidiDepartment of Pathology, Newton-Wellesley Hospital, Newton, MA, USA.
Kevin S HughesDivision of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Massachusetts General Hospital · USDana-Farber Cancer Institute · USBon Secours Hospital Cork · IEColumbia University · USNewton Wellesley Hospital · US

Funding

Risk assessment in atypical breast hyperplasiaR03CA188140 · NCI · DANA-FARBER CANCER INST · PI MAZZOLA, EMANUELE · 2014 to 2015
$151k
NCI NIH HHS R03 CA188140
6 · The paper itself

Abstract

purposeThe aim of this study was to investigate the influence of age at diagnosis of atypical hyperplasia ("atypia", ductal [ADH], lobular [ALH], or severe ADH) on the risk of developing subsequent invasive breast cancer or ductal carcinoma in situ (DCIS).

methodsUsing standard survival analysis methods, we retrospectively analyzed 1353 women not treated with chemoprevention among a cohort of 2370 women diagnosed with atypical hyperplasia to determine the risk relationship between age at diagnosis and subsequent breast cancer.

resultsFor all atypia diagnoses combined, our cohort showed a 5-, 10-, and 15-year risk of invasive breast cancer or DCIS of 0.56, 1.25, and 1.30, respectively, with no significant difference in the (65,75] year age group. For women aged (35,75] years, we observed no significant difference in the 15-year risk of invasive breast cancer or DCIS after atypical hyperplasia, although the baseline risk for a 40-year-old woman is approximately 1/8 the risk of a 70-year-old woman. The risks associated with invasive breast cancer or DCIS for women in our cohort diagnosed with ADH, severe ADH, or ALH, regardless of age, were 7.6% (95% CI 5.9-9.3%) at 5 years, 25.1% (20.7-29.2%) at 10 years, and 40.1% (32.8-46.6%) at 15 years.

conclusionIn contrast to current risk prediction models (e.g., Gail, Tyrer-Cuzick) which assume that the risk of developing breast cancer increases in relation to age at diagnosis of atypia, we found the 15-year cancer risk in our cohort was not significantly different for women between the ages of 35 (excluded) and 75. This implies that the "hits" received by the breast tissue along the "high-risk pathway" to cancer might possibly supersede other factors such as age.

Indexed as

AdultAgedAged, 80 and overAge FactorsBiomarkersBreastBreast NeoplasmsFemaleHumansHyperplasiaKaplan-Meier EstimateMiddle AgedNeoplasm GradingPrecancerous ConditionsPrognosisRisk AssessmentBiomarkersAgeBreast atypical hyperplasiaRisk of breast cancer

Identifiers

PMID28589368
PMCPMC6214351
OpenAlexW2623498207

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.