Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.
Eur J Cancer. 2023 Aug;189:112930. doi: 10.1016/j.ejca.2023.05.018. Epub 2023 Jun 1.
Triple-negative breast cancer (TNBC) is associated with a high risk of breast cancer-specific mortality (BCSM). Estimating the risk of BCSM and non-BCSM in TNBC would aid clinical decision-making. We developed the tool 'ESTIMATE-TN', to assess BCSM, non-BCSM, and all-cause mortality in non-metastatic TNBC.
Using Surveillance, Epidemiology, and End Results (SEER), we created an interactive tool that provides a nonparametric estimate of the cumulative risk of BCSM and non-BCSM between years 0 and 7 from diagnosis, accounting for baseline clinical and pathologic variables, using Gray's subdistribution method.
We included 37,293 women with TNBC diagnosed during 2010-2017. Most patients were White (71.9%) and aged 50-69 years (51.3%). Most tumour characteristics were high-grade (78.6%), T2 (42.4%), and N0 (69.5%). ESTIMATE-TN allows to input patient and tumour characteristics, and the preferred timeframe. For example, patients aged 50-59 years with a new diagnosis of T2, N1, high-grade TNBC have a risk of BCSM at 7 years of 30.8% (95% confidence interval [CI]: 26.3-35.4%) and a risk of non-BCSM over the same period of 2.8% (95% CI: 1.3-4.3%). After 3 years from initial diagnosis, the residual cumulative risks of BCSM and non-BCSM at 7 years are 17.4% (95% CI: 12.6-22.2%) and 1.1% (95% CI: 0-2.5%), respectively.
ESTIMATE-TN is an interactive tool for TNBC that can be used to integrate population-based risks of BCSM and non-BCSM based on patient and tumour characteristics, facilitating our understanding of competing risks of death, which can aid clinical decision-making.
三阴性乳腺癌（TNBC）与乳腺癌特异性死亡率（BCSM）风险较高相关。评估 TNBC 中 BCSM 和非 BCSM 的风险将有助于临床决策。我们开发了一种名为“ESTIMATE-TN”的工具，用于评估非转移性 TNBC 中的 BCSM、非 BCSM 和全因死亡率。
我们使用监测、流行病学和最终结果（SEER）数据库创建了一个交互式工具，该工具使用格雷的亚分布方法，根据基线临床和病理变量，提供从诊断开始 0 至 7 年内 BCSM 和非 BCSM 的累积风险的非参数估计。
我们纳入了 2010 年至 2017 年间诊断的 37293 例 TNBC 患者。大多数患者为白人（71.9%）和 50-69 岁（51.3%）。大多数肿瘤特征为高级别（78.6%）、T2（42.4%）和 N0（69.5%）。ESTIMATE-TN 允许输入患者和肿瘤特征以及首选时间段。例如，年龄在 50-59 岁、新诊断为 T2、N1、高级别 TNBC 的患者，7 年内 BCSM 的风险为 30.8%（95%置信区间[CI]：26.3-35.4%），同期非 BCSM 的风险为 2.8%（95%CI：1.3-4.3%）。从初始诊断后 3 年起，7 年内 BCSM 和非 BCSM 的剩余累积风险分别为 17.4%（95%CI：12.6-22.2%）和 1.1%（95%CI：0-2.5%）。
ESTIMATE-TN 是一种用于 TNBC 的交互式工具，可根据患者和肿瘤特征综合基于人群的 BCSM 和非 BCSM 风险，有助于我们了解死亡的竞争风险，从而辅助临床决策。
