title: Underestimated survival predictions of the prognostic tools Adjuvant! Online and PREDICT in BRCA1-associated breast cancer patients.
abstract: BRCA1-associated breast cancer is considered an unique clinical entity with its own specific histopathological characteristics. Several recently published large studies have shown that overall survival of BRCA1 mutation carriers having breast cancer is similar to sporadic breast cancer patients. It was also suggested that better response to chemotherapy is one of the most important factors that improves the clinical outcome of breast cancers with unfavorable histopathological subtypes in BRCA1 mutation carriers. Adjuvant! Online and PREDICT are web-based prognostic tools that estimate the survival benefit of adjuvant chemotherapy in primary breast cancer patients. These tools have been extensively validated in different populations; however, the accuracy of the predictions made by Adjuvant! Online and PREDICT among BRCA1 mutation carriers has not yet been investigated. In this study we have found, that predictions of overall and breast cancer-specific survival obtained from Adjuvant! Online and PREDICT were significantly lower than the observed survival percentages in the study population [predicted--observed difference for 10-year overall survival: -9.75%, P < 0.0001 (Adjuvant! Online); -10.21%, P < 0.0001 (PREDICT)]. Thus this study suggests that Adjuvant! Online and PREDICT should be used with caution in this group of patients. Further updating of adjuvant therapy benefit calculation tools by inclusion of the information about inherited genetic alterations should be considered to improve the performance of the prognostic programs among hereditary breast cancer patients.
authors: Oncology Institute, Riga Stradins University, Pilsoņu Street 13, Riga, 1002, Latvia, grigorijs.plakhins@rsu.lv.
authors: Grigorijs
authors: G
authors: Plakhins
authors: Arvids
authors: A
authors: Irmejs
authors: Andris
authors: A
authors: Gardovskis
authors: Signe
authors: S
authors: Subatniece
authors: Inta
authors: I
authors: Liepniece-Karele
authors: Gunta
authors: G
authors: Purkalne
authors: Uldis
authors: U
authors: Teibe
authors: Genadijs
authors: G
authors: Trofimovics
authors: Edvins
authors: E
authors: Miklasevics
authors: Janis
authors: J
authors: Gardovskis
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019313:BRCA1 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D015996:Survival Rate
chemical_list: D019313:BRCA1 Protein
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