Table 3.
Multivariable risk models for breast cancer recurrence by race*
| Variable | Demo+clinical |
Demo+clinical+subtype | Demo+clinical+EPI |
|||
|---|---|---|---|---|---|---|
| White | Hispanic | African American | White | White | Hispanic | |
| HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | |
| Age, y | ||||||
| <45 | 1 (ref) | — | — | 1 (ref) | 1 (ref) | — |
| 45–54 | 0.70 (0.55 to 0.88) | — | — | 0.68 (0.53 to 0.87) | 0.66 (0.51 to 0.86) | — |
| 55–64 | 0.78 (0.62 to 0.98) | — | — | 0.76 (0.59 to 0.97) | 0.75 (0.58 to 0.98) | — |
| ≥65 | 0.82 (0.63 to 1.07) | — | — | 0.86 (0.66 to 1.13) | 0.88 (0.66 to 1.18) | — |
| Diagnosis year | ||||||
| 1997–2002 | 1 (ref) | 1 (ref) | — | 1 (ref) | 1 (ref) | 1 (ref) |
| 2003–2007 | 1.00 (0.82 to 1.22) | 0.77 (0.48 to 1.24) | — | 0.95 (0.76 to 1.17) | 0.84 (0.66 to 1.08) | 0.87 (0.49 to 1.54) |
| 2008–2012 | 0.68 (0.54 to 0.85) | 0.43 (0.25 to 0.72) | — | 0.65 (0.51 to 0.83) | 0.60 (0.45 to 0.79) | 0.37 (0.19 to 0.71) |
| Cancer detection mode | ||||||
| Screens | 1 (ref) | — | 1 (ref) | 1 (ref) | 1 (ref) | — |
| Symptom | 2.06 (1.64 to 2.60) | — | 1.76 (1.19 to 2.61) | 1.96 (1.54 to 2.49) | 2.11 (1.61 to 2.75) | — |
| Nuclear grade | ||||||
| I or II | 1 (ref) | — | 1 (ref) | 1 (ref) | 1 (ref) | — |
| III | 2.25 (1.81 to 2.80) | — | 1.63 (1.02 to 2.59) | 2.27 (1.78 to 2.90) | 2.20 (1.69 to 2.87) | — |
| Histology | ||||||
| Ductal | — | — | 1 (ref) | — | — | — |
| Lobular | — | — | 0.12 (0.03 to 0.51) | — | — | — |
| Mixed ductal/lobular | — | — | 1.31 (0.57 to 2.99) | — | — | — |
| Other | — | — | 0.45 (0.14 to 1.43) | — | — | — |
| Tumor size, cm | ||||||
| 0–1 | 1 (ref) | — | 1 (ref) | 1 (ref) | 1 (ref) | — |
| 1–2 | 0.96 (0.73 to 1.25) | — | 0.77 (0.45 to 1.30) | 0.90 (0.68 to 1.19) | 0.92 (0.68 to 1.24) | — |
| 2–3 | 1.29 (0.97 to 1.72) | — | 1.20 (0.71 to 2.03) | 1.25 (0.93 to 1.68) | 1.34 (0.97 to 1.84) | — |
| 3–4 | 1.52 (1.09 to 2.12) | — | 2.25 (1.30 to 3.92) | 1.44 (1.02 to 2.04) | 1.29 (0.88 to 1.88) | — |
| 4–5 | 2.25 (1.54 to 3.27) | — | 2.32 (1.19 to 4.51) | 2.23 (1.52 to 3.28) | 2.13 (1.39 to 3.28) | — |
| 5+ | 2.24 (1.62 to 3.11) | — | 4.31 (2.53 to 7.35) | 2.15 (1.53 to 3.01) | 2.09 (1.46 to 3.00) | — |
| No. of positive nodes | ||||||
| 0 | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) |
| 1 or 2 | 1.47 (1.14 to 1.90) | 1.74 (0.91 to 3.35) | 1.51 (0.94 to 2.42) | 1.48 (1.13 to 1.93) | 1.48 (1.11 to 1.98) | 1.48 (0.71 to 3.10) |
| 3 or 4 | 2.29 (1.69 to 3.10) | 3.56 (1.74 to 7.25) | 3.73 (2.25 to 6.19) | 2.29 (1.67 to 3.15) | 1.89 (1.33 to 2.69) | 2.85 (1.17 to 6.91) |
| 5–8 | 3.64 (2.69 to 4.93) | 8.40 (4.31 to 16.37) | 3.68 (2.08 to 6.51) | 3.70 (2.70 to 5.06) | 3.82 (2.73 to 5.33) | 7.91 (3.55 to 17.59) |
| 9–19 | 4.21 (3.11 to 5.71) | 12.31 (6.44 to 23.54) | 6.69 (4.04 to 11.07) | 4.52 (3.27 to 6.23) | 4.41 (3.10 to 6.26) | 16.50 (7.99 to 34.09) |
| ≥20 | 5.99 (3.78 to 9.51) | 15.82 (6.63 to 37.76) | 16.11 (6.80 to 38.16) | 5.87 (3.68 to 9.36) | 6.81 (4.19 to 11.05) | 19.43 (7.80 to 48.39) |
| Lymph or vascular invasion | ||||||
| No | 1 (ref) | 1 (ref) | — | 1 (ref) | 1 (ref) | 1 (ref) |
| Yes | 1.51 (1.24 to 1.84) | 1.58 (1.02 to 2.47) | — | 1.57 (1.28 to 1.93) | 1.81 (1.45 to 2.26) | 1.32 (0.79 to 2.22) |
| Adjuvant hormone therapy | ||||||
| No | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) | 1 (ref) |
| Yes | 0.39 (0.33 to 0.47) | 0.23 (0.16 to 0.35) | 0.45 (0.32 to 0.65) | 0.47 (0.36 to 0.60) | 0.49 (0.36 to 0.65) | 0.20 (0.12 to 0.32) |
| Breast cancer receptor subtype | ||||||
| HmR-positive | — | — | — | 1 (ref) | 1 (ref) | — |
| HER2-positive | — | — | — | 0.93 (0.71 to 1.23) | 0.91 (0.67 to 1.24) | — |
| Triple-negative | — | — | — | 1.46 (1.07 to 2.00) | 1.64 (1.16 to 2.31) | — |
| Alcohol consumption | ||||||
| No | — | — | — | — | 1 (ref) | 1 (ref) |
| Yes | — | — | — | — | 0.77 (0.63 to 0.94) | 0.52 (0.31 to 0.87) |
| Discovery | ||||||
| No. of events/total population | 520/7152 | 99/1278 | 154/1003 | 478/6419 | 410/5456 | 77/1080 |
| AUC | 0.802 | 0.790 | 0.793 | 0.805 | 0.809 | 0.802 |
| Validation | ||||||
| No. of events/total population | 238/2524 | 37/519 | 51/516 | 185/1997 | 108/1160 | 19/253 |
| AUC | 0.803 | 0.838 | 0.748 | 0.818 | 0.811 | 0.766 |
*
AUC = area under the curve; CI = confidence interval; EPI = self-administered questionnaires; HmR = hormone receptor; HER2 = human epidermal growth factor receptor 2; HR = hazard ratio.