Prognostic models in male breast cancer.
Breast cancer in men is uncommon; it accounts for 1 % of all patients with primary breast cancer. Its treatment is mostly extrapolated from its female counterpart. Accurate predictions are essential for adjuvant systemic treatment decision-making and informing patients. Several predictive models are available for female breast cancer (FBC) including the Morphometric Prognostic Index (MPI), Nottingham Prognostic Index (NPI), Adjuvant! Online and Predict. The aim of this study was to examine and compare the prognostic performance of these models for male breast cancer (MBC).



The population of this study consists of 166 MBC patients. The prognostic scores of the patients are categorized by good, (moderate) and poor, defined by the test itself (MPI and NPI) or based on tertiles (Adjuvant! Online and Predict). Survival according to prognostic score was compared by Kaplan-Meier analysis and differences were tested by logRank. The prognostic performances were evaluated with C-statistics. Calibration was done with the aim to estimate to what extent the survival rates predicted by Predict were similar to the observed survival rates.



All prediction models were capable of discriminating between good, moderate and poor survivors. P-values were highly significant. Comparison between the models using C-statistics (n = 88) showed equal performance of MPI (0.67), NPI (0.68), Adjuvant! Online (0.69) and Predict (0.69). Calibration of Predict showed overestimation for MBC patients.



In conclusion, MPI, NPI, Adjuvant! and Predict prognostic models, originally developed and validated for FBC patients, also perform quite well for MBC patients.
Department of Surgical Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands. c.c.vanderpol@umcutrecht.nl.
Carmen C
0000-0002-1045-2962
CC
van der Pol
Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
Miangela M
MM
Lacle
Department of Surgical Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Arjen J
AJ
Witkamp
Department of Pathology, Gelre Ziekenhuis, Apeldoorn, The Netherlands.
Robert
R
Kornegoor
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Hui
H
Miao
Geneva Cancer Registry, Institute for Social and Preventive Medicine, Geneva University, Geneva, Switzerland.
Christine
C
Bouchardy
Department of Surgical Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Inne
I
Borel Rinkes
Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Elsken
E
van der Wall
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Helena M
HM
Verkooijen
Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
Paul J
PJ
van Diest
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018567:Breast Neoplasms, Male / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D011379:Prognosis; D012984:Software; D015996:Survival Rate; D064878:Web Browser
Adjuvant! Online; Male breast cancer; NPI; Predict; Prognosis; Survival
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