Table 1.

Common CISNET Breast Cancer Model Input Parameters

Input	Description	Updated since 2016	Race-specific	Sourcesa
Breast cancer incidence without screening	Age-period-cohort model using SEER breast cancer incidence with a period effect for mammography removed	Yes. Recent years added, 1980 instead of 1970 birth cohort.	Yes; incidence varied by race. Same data source.	Gangnon,21 Holford22
Breast density	Prevalence of breast density (BI-RADS a, b, c, d) by age group (40–44, 45–49, 50–64, 65–74, 75–89)	Yes	Yes; density varied by race. Same data source.	BCSC
Mammography performance b	Sensitivity and false-positive recall of initial and subsequent mammography by age (40–44, 45–49, 50–64, ≥65) and screening interval (annual, biennial) and density (a,b,c,d) for DM and DBT	Yes	Screening sensitivity did not vary by race. False-positive recalls did vary by race. Same data source.	BCSC6
Breast cancer stage distribution (AJCC or SEER Summary Stage)	Stage distributions by mode of detection, age group (40–44, 45–49, 50–64, 65–74, 75–89), screening round/interval (first, annual, biennial) for screen-detected cancers, and density (a, b, c, d)	Yes	Yes; stage distributions varied by race. Same data source.	BCSC
ER/HER2 joint distribution	The distribution of ER/HER2 subtypes by age (40–49, 50–74, 75–89) and stage at diagnosis	Yes	Yes; subtype distributions varied by race. Same data source.	BCSC
Survival in the absence of screening and treatment	25-y breast cancer survival before systemic treatment by joint ER/HER2 status, age group, AJCC/SEER stage or tumor size	No	No; base survival did not vary by race.	Munoz,65 Plevritis66
Treatment dissemination	Treatments and rates of use by time period, ER/HER2, stage and age for initial breast cancer diagnosis	Yes	No; treatment assignment did not vary by race.	Caswell-Jin,25 Mandelblatt,26 Plevritis66
Treatment effects	Meta-analyses of clinical trial results by ER/HER2 for initial local therapy. Clinical trial reports for efficacy of systemic primary and metastatic therapy, and of newer targeted therapies.	Yes	Yes; treatment effectiveness reduced for Black patients based on published NCCN data.34	Caswell-Jin,25 Early Breast Cancer Trialists’ Collaborative,27,28,67–70 Plevritis,66 Warner34
Other-cause mortality	Age- and cohort-specific mortality rates from non-breast cancer causes by year and level of comorbidity	Yes	Yes; other-cause mortality rates varied by race. Same data source.	Cho,71 Gangnon,35 Lansdorp-Vogelaar36
Quality of life	Utility weights for general health and decrements for screening, diagnostic evaluation, and stage-specific treatment	No	No; utility weights did not vary by race.	de Haes,45 Hamner,43,44 Stout46

Abbreviations: AJCC, American Joint Committee on Cancer; BCSC, Breast Cancer Surveillance Consortium; BI-RADS, Breast Imaging Reporting and Data Systems; CISNET, Cancer Intervention and Surveillance Modeling Network; DM, digital mammography; DBT, digital breast tomosynthesis; ER, estrogen receptor; HER2, Human epidermal growth factor receptor 2; NCCN, National Comprehensive Cancer Network; SEER, Surveillance, Epidemiology, and End Results.

^aAdditional information regarding model inputs including BCSC data is available in the online Technical Report.¹⁸

^bWith treatment, screen detection of breast cancer at an earlier stage could lead to improve survival, reduced risk of death, and/or greater chance of cure with a small tumor size, depending on model.