Evidence map›Paper›PMID 40953336›Full record

SynthesisJCO clinical cancer informatics2025

Development and Validation of an Ipsilateral Breast Tumor Recurrence Risk Estimation Tool Incorporating Real-World Data and Evidence From Meta-Analyses: A Retrospective Multicenter Cohort Study.

Yasuaki Sagara, Atsushi Yoshida, Yuri Kimura, Makoto Ishitobi, Yuka Ono, Yuko Takahashi, Takahiro Tsukioki, Koji Takada, Yuri Ito, Tomo Osako and 1 more

Abstract readMulticenter StudyMeta-AnalysisValidation Study
In one paragraph

Synthesis in JCO clinical cancer informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yasuaki SagaraDepartment of Breast and Thyroid Surgical Oncology, Hakuaikai Sagara Hospital, Kagoshima, Japan.ORCID 0000-0001-5705-1739
Atsushi YoshidaDepartment of Breast Surgical Oncology, St Luke's International Hospital, Tokyo, Japan.
Yuri KimuraDepartment of Breast Surgical Oncology, The Cancer Institute Hospital of JFCR, Tokyo, Japan.ORCID 0000-0002-3457-9378
Makoto IshitobiDepartment of Breast Surgery, Osaka Habikino Medical Center, Habikino, Japan.
Yuka OnoDepartment of Radiation Oncology and Image-Applied Therapy, Kyoto University, Kyoto, Japan.
Yuko TakahashiDepartment of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
Takahiro TsukiokiDepartment of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
Koji TakadaDepartment of Breast Surgical Oncology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Yuri ItoDepartment of Medical Statistics, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.ORCID 0000-0002-1407-2393
Tomo OsakoDivision of Pathology, The Cancer Institute of Japanese Foundation for Cancer Research, Tokyo, Japan.ORCID 0000-0001-9250-4035
Takehiko SakaiDepartment of Breast Surgical Oncology, The Cancer Institute Hospital of JFCR, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIpsilateral breast tumor recurrence (IBTR) remains a critical concern for patients undergoing breast-conserving surgery (BCS). Reliable risk estimation tools for IBTR risk can support personalized surgical and adjuvant treatment decisions, especially in the era of evolving systemic therapies. We aimed to develop and validate models to estimate IBTR risk. PATIENTS AND

methodsThis multicenter retrospective cohort study included 8,938 women who underwent partial mastectomy for invasive breast cancer between 2008 and 2017. Prediction models were developed using Cox proportional hazards regression and validated via bootstrap resampling. Model performance was assessed using Harrell's C-index, Brier scores, calibration plots, and goodness-of-fit tests.

resultsDuring a median follow-up of 9.0 years (IQR, 6.6-10.9), IBTR occurred in 320 patients (3.6%). The initial model, based on variables from Sanghani et al, achieved a Harrell's C-index of 0.74. Incorporating hormonal receptor status, human epidermal growth factor receptor 2 status, radiotherapy, and targeted therapy as predictors reduced the C-index to 0.65, despite their clinical relevance. Importantly, the inclusion of these factors improved calibration, demonstrating better alignment between predicted and observed IBTR probabilities. Although the hazard ratios (HRs) for radiotherapy aligned with the Early Breast Cancer Trialists' Collaborative Group meta-analyses (MA), those for chemotherapy and endocrine therapy showed slight differences. Therefore, HRs from the MA were used to represent treatment effects in our model.

conclusionWe have developed and internally validated a new risk estimation model for IBTR using Cox regression and bootstrap methods. A Web-based risk estimation tool is now available to facilitate individualized risk assessment and treatment planning.

Indexed as

Breast NeoplasmsNeoplasm Recurrence, LocalAdultAgedFemaleHumansMastectomy, SegmentalMiddle AgedPrognosisRetrospective StudiesRisk AssessmentRisk Factors

Identifiers

PMID40953336
PMCPMC12442782

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.