Background: We aimed to develop and validate a model predicting breast cancer risk for women targeted by breast cancer screening. Method: This retrospective cohort study included 57,411 women screened at least once in BreastScreen Norway during the period from 2007 to 2019. The prediction model included information about age, mammographic density, family history of breast cancer, body mass index, age at menarche, alcohol consumption, exercise, pregnancy, hormone replacement therapy, and benign breast disease. We calculated a 4-year absolute breast cancer risk estimates for women and in risk groups by quartiles. The Bootstrap resampling method was used for internal validation of the model (E/O ratio). The area under the curve (AUC) was estimated with a 95% confidence interval (CI). Results: The 4-year predicted risk of breast cancer ranged from 0.22–7.33%, while 95% of the population had a risk of 0.55–2.31%. The thresholds for the quartiles of the risk groups, with 25% of the population in each group, were 0.82%, 1.10%, and 1.47%. Overall, the model slightly overestimated the risk with an E/O ratio of 1.10 (95% CI: 1.09–1.11) and the AUC was 62.6% (95% CI: 60.5–65.0%). Conclusions: This 4-year risk prediction model showed differences in the risk of breast cancer, supporting personalized screening for breast cancer in women aged 50–69 years.
背景：本研究旨在开发并验证一个针对乳腺癌筛查目标女性的乳腺癌风险预测模型。方法：这项回顾性队列研究纳入了2007年至2019年间在挪威乳腺癌筛查项目中至少接受过一次筛查的57,411名女性。预测模型包含年龄、乳腺密度、乳腺癌家族史、体重指数、初潮年龄、饮酒量、运动情况、妊娠史、激素替代疗法及良性乳腺疾病等信息。我们计算了女性个体及按风险四分位分组（每组占人群25%）的4年绝对乳腺癌风险估计值。采用Bootstrap重抽样方法对模型进行内部验证（E/O比值），并通过95%置信区间（CI）估算曲线下面积（AUC）。结果：4年预测乳腺癌风险范围为0.22%-7.33%，95%人群的风险介于0.55%-2.31%之间。风险四分位组阈值分别为0.82%、1.10%和1.47%。总体而言，模型存在轻微高估风险趋势（E/O比值=1.10，95% CI：1.09-1.11），AUC值为62.6%（95% CI：60.5%-65.0%）。结论：该4年风险预测模型能有效区分乳腺癌风险差异，为50-69岁女性实施个体化乳腺癌筛查提供了依据。
肿瘤(癌症)患者之家