Kattan et al developed a tool for predicting mortality in a woman with breast cancer who does not receive adjuvant therapy. This can help inform the patient about therapeutic options. The authors are from Memorial Sloan-Kettering Cancer Center in New York City.
Parameters:
(1) age of the patient in years
(2) presence of multifocality
(3) size in centimeters
(4) type and grade of the tumor
(5) lymphovascular invasion
(6) staining of axillary lymph node metastases on hematoxylin and eosin (H&E) and immunohistochemistry
|
Parameter |
Finding |
Points |
|
focality |
unifocal |
0 |
|
|
multifocal |
9 |
|
type and grade |
infiltrating ductal Grade I/III |
0 |
|
|
infiltrating ductal Grade II/III |
82 |
|
|
infiltrating ductal Grade III/III |
83.3 |
|
|
lobular carcinoma |
100 |
|
lymphovascular invasion |
no |
0 |
|
|
yes |
18 |
|
staining in axillary lymph nodes |
negative on H&E and immunohistochemistry (IHC) |
0 |
|
|
negative of H&E and positive on immunohistochemistry (IHC) |
3 |
|
|
both H&E and immunohisto-chemistry positive for tumor |
41 |
The data for age and size were modeled in JMP:
|
Age |
Points |
|
< 25 |
12 |
|
25 - 75 |
(-0.22 * (age in years)) + 16.53 |
|
> 75 |
0 |
|
Size |
Points |
|
0 - 9 |
(9.59696* (size in cm)) - 0.436364 |
|
> 9 |
86 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: > 200
• The higher the total score the more likely that the patient will die of the tumor within 15 years.
|
Points |
15 Year Probability of Disease Specific Death |
|
8.5 |
1% |
|
30.4 |
2% |
|
43.8 |
3% |
|
53 |
4% |
|
66.3 |
6% |
|
76.3 |
8% |
|
83.5 |
10% |
|
97.4 |
15% |
|
107.4 |
20% |
|
122.7 |
30% |
|
134 |
40% |
|
143.8 |
50% |
|
153 |
60% |
|
161.2 |
70% |
|
170.8 |
80% |
|
178.7 |
87% |
|
Points |
15 Year Probability of Disease Specific Death |
|
< 8.5 |
< 1% |
|
8.5 - 97.4 |
((0.0000193 * ((points)^3)) - (0.001021 * ((points)^2)) + (0.0649145 * (points)) + 0.492181) / 100 |
|
97.4 - 178.5 |
((-0.000085 * ((points)^3)) + (0.0392755 * ((points)^2)) - (4.98572 * (points)) + 206.49388) / 100 |
|
> 178.5 |
> 87% |
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
