Breast cancer risk prediction in women aged 35–50 years: impact of including sex hormone concentrations in the Gail model
Abstract Background Models that accurately predict risk of breast cancer are needed to help younger women make decisions about when to begin screening. Premenopausal concentrations of circulating anti-Müllerian hormone (AMH), a biomarker of ovarian reserve, and testosterone have been positively asso...
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BMC
2019-03-01
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Series: | Breast Cancer Research |
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Online Access: | http://link.springer.com/article/10.1186/s13058-019-1126-z |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tess V. Clendenen Wenzhen Ge Karen L. Koenig Yelena Afanasyeva Claudia Agnoli Louise A. Brinton Farbod Darvishian Joanne F. Dorgan A. Heather Eliassen Roni T. Falk Göran Hallmans Susan E. Hankinson Judith Hoffman-Bolton Timothy J. Key Vittorio Krogh Hazel B. Nichols Dale P. Sandler Minouk J. Schoemaker Patrick M. Sluss Malin Sund Anthony J. Swerdlow Kala Visvanathan Anne Zeleniuch-Jacquotte Mengling Liu |
spellingShingle |
Tess V. Clendenen Wenzhen Ge Karen L. Koenig Yelena Afanasyeva Claudia Agnoli Louise A. Brinton Farbod Darvishian Joanne F. Dorgan A. Heather Eliassen Roni T. Falk Göran Hallmans Susan E. Hankinson Judith Hoffman-Bolton Timothy J. Key Vittorio Krogh Hazel B. Nichols Dale P. Sandler Minouk J. Schoemaker Patrick M. Sluss Malin Sund Anthony J. Swerdlow Kala Visvanathan Anne Zeleniuch-Jacquotte Mengling Liu Breast cancer risk prediction in women aged 35–50 years: impact of including sex hormone concentrations in the Gail model Breast Cancer Research Breast cancer risk prediction Anti-Müllerian hormone Testosterone Gail model |
author_facet |
Tess V. Clendenen Wenzhen Ge Karen L. Koenig Yelena Afanasyeva Claudia Agnoli Louise A. Brinton Farbod Darvishian Joanne F. Dorgan A. Heather Eliassen Roni T. Falk Göran Hallmans Susan E. Hankinson Judith Hoffman-Bolton Timothy J. Key Vittorio Krogh Hazel B. Nichols Dale P. Sandler Minouk J. Schoemaker Patrick M. Sluss Malin Sund Anthony J. Swerdlow Kala Visvanathan Anne Zeleniuch-Jacquotte Mengling Liu |
author_sort |
Tess V. Clendenen |
title |
Breast cancer risk prediction in women aged 35–50 years: impact of including sex hormone concentrations in the Gail model |
title_short |
Breast cancer risk prediction in women aged 35–50 years: impact of including sex hormone concentrations in the Gail model |
title_full |
Breast cancer risk prediction in women aged 35–50 years: impact of including sex hormone concentrations in the Gail model |
title_fullStr |
Breast cancer risk prediction in women aged 35–50 years: impact of including sex hormone concentrations in the Gail model |
title_full_unstemmed |
Breast cancer risk prediction in women aged 35–50 years: impact of including sex hormone concentrations in the Gail model |
title_sort |
breast cancer risk prediction in women aged 35–50 years: impact of including sex hormone concentrations in the gail model |
publisher |
BMC |
series |
Breast Cancer Research |
issn |
1465-542X |
publishDate |
2019-03-01 |
description |
Abstract Background Models that accurately predict risk of breast cancer are needed to help younger women make decisions about when to begin screening. Premenopausal concentrations of circulating anti-Müllerian hormone (AMH), a biomarker of ovarian reserve, and testosterone have been positively associated with breast cancer risk in prospective studies. We assessed whether adding AMH and/or testosterone to the Gail model improves its prediction performance for women aged 35–50. Methods In a nested case-control study including ten prospective cohorts (1762 invasive cases/1890 matched controls) with pre-diagnostic serum/plasma samples, we estimated relative risks (RR) for the biomarkers and Gail risk factors using conditional logistic regression and random-effects meta-analysis. Absolute risk models were developed using these RR estimates, attributable risk fractions calculated using the distributions of the risk factors in the cases from the consortium, and population-based incidence and mortality rates. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory accuracy of the models with and without biomarkers. Results The AUC for invasive breast cancer including only the Gail risk factor variables was 55.3 (95% CI 53.4, 57.1). The AUC increased moderately with the addition of AMH (AUC 57.6, 95% CI 55.7, 59.5), testosterone (AUC 56.2, 95% CI 54.4, 58.1), or both (AUC 58.1, 95% CI 56.2, 59.9). The largest AUC improvement (4.0) was among women without a family history of breast cancer. Conclusions AMH and testosterone moderately increase the discriminatory accuracy of the Gail model among women aged 35–50. We observed the largest AUC increase for women without a family history of breast cancer, the group that would benefit most from improved risk prediction because early screening is already recommended for women with a family history. |
topic |
Breast cancer risk prediction Anti-Müllerian hormone Testosterone Gail model |
url |
http://link.springer.com/article/10.1186/s13058-019-1126-z |
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doaj-5173ace532a544d39c8c04eefe3f07c52021-03-02T05:34:18ZengBMCBreast Cancer Research1465-542X2019-03-0121111210.1186/s13058-019-1126-zBreast cancer risk prediction in women aged 35–50 years: impact of including sex hormone concentrations in the Gail modelTess V. Clendenen0Wenzhen Ge1Karen L. Koenig2Yelena Afanasyeva3Claudia Agnoli4Louise A. Brinton5Farbod Darvishian6Joanne F. Dorgan7A. Heather Eliassen8Roni T. Falk9Göran Hallmans10Susan E. Hankinson11Judith Hoffman-Bolton12Timothy J. Key13Vittorio Krogh14Hazel B. Nichols15Dale P. Sandler16Minouk J. Schoemaker17Patrick M. Sluss18Malin Sund19Anthony J. Swerdlow20Kala Visvanathan21Anne Zeleniuch-Jacquotte22Mengling Liu23Department of Population Health, New York University School of MedicineDepartment of Population Health, New York University School of MedicineDepartment of Population Health, New York University School of MedicineDepartment of Population Health, New York University School of MedicineEpidemiology and Prevention Unit, Fondazione IRCCS - Istituto Nazionale dei TumoriDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of HealthDepartment of Pathology, New York University School of MedicineDepartment of Epidemiology and Public Health, University of Maryland School of MedicineDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical SchoolDivision of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of HealthDepartment of Biobank Research, Public Health and Clinical Medicine, Umeå UniversityDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical SchoolDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthCancer Epidemiology Unit, Nuffield Department of Population Health, University of OxfordEpidemiology and Prevention Unit, Fondazione IRCCS - Istituto Nazionale dei TumoriDepartment of Epidemiology, University of North CarolinaEpidemiology Branch, National Institute of Environmental Health SciencesDivision of Genetics and Epidemiology, The Institute of Cancer ResearchDepartment of Pathology, Harvard Medical SchoolDepartment of Surgery, Umeå University HospitalDivision of Genetics and Epidemiology, The Institute of Cancer ResearchDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthDepartment of Population Health, New York University School of MedicineDepartment of Population Health, New York University School of MedicineAbstract Background Models that accurately predict risk of breast cancer are needed to help younger women make decisions about when to begin screening. Premenopausal concentrations of circulating anti-Müllerian hormone (AMH), a biomarker of ovarian reserve, and testosterone have been positively associated with breast cancer risk in prospective studies. We assessed whether adding AMH and/or testosterone to the Gail model improves its prediction performance for women aged 35–50. Methods In a nested case-control study including ten prospective cohorts (1762 invasive cases/1890 matched controls) with pre-diagnostic serum/plasma samples, we estimated relative risks (RR) for the biomarkers and Gail risk factors using conditional logistic regression and random-effects meta-analysis. Absolute risk models were developed using these RR estimates, attributable risk fractions calculated using the distributions of the risk factors in the cases from the consortium, and population-based incidence and mortality rates. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory accuracy of the models with and without biomarkers. Results The AUC for invasive breast cancer including only the Gail risk factor variables was 55.3 (95% CI 53.4, 57.1). The AUC increased moderately with the addition of AMH (AUC 57.6, 95% CI 55.7, 59.5), testosterone (AUC 56.2, 95% CI 54.4, 58.1), or both (AUC 58.1, 95% CI 56.2, 59.9). The largest AUC improvement (4.0) was among women without a family history of breast cancer. Conclusions AMH and testosterone moderately increase the discriminatory accuracy of the Gail model among women aged 35–50. We observed the largest AUC increase for women without a family history of breast cancer, the group that would benefit most from improved risk prediction because early screening is already recommended for women with a family history.http://link.springer.com/article/10.1186/s13058-019-1126-zBreast cancer risk predictionAnti-Müllerian hormoneTestosteroneGail model |