Table 1 Published predictive models for mortality in breast cancer patients.

From: A scoring system to predict breast cancer mortality at 5 and 10 years

Reference

Patients

n

Time (years)

Variables

Clinical issues

Methodological issues

Validation

Jimenez-Lee et al.8

BC stages 0–III

389

5

T, N and hormone receptors

Stage IV was excluded

The score for each variable was not justified and the definition of the risk groups was not justified

No

Chang et al.9

BC stages 0–III and follow-up >1 year

818

5

Age, diagnostic methods, tumor grade, N, hormone receptors and chemotherapy

Assessed all-cause mortality, stage IV was excluded, diagnostic methods are not useful, the model was not explained

They used a logistic regression model with censored data and the events-per-variable was less than 10.

AUC = 0.894; p-value (H-L) = 0.945

Fan et al.10

Invasive BC with mastectomy

1016

2 and 5

Age, T, N, M and estrogen receptors

Assessed all-cause mortality, a specific population and the model is laborious

No comment

C-statistic = 0.80; Calibration plot

Faneyte et al.11

BC without distant metastasis, <54 years, ≥4 positive lymph nodes, no previous other malignancies, treated with surgery and adjuvant therapy

739

2

Grade, estrogen receptors and N

Assessed all-cause mortality, a very specific population, the follow-up was very short and the model was not explained

They used a logistic regression model with censored data and it was not internally validated

No

Fontein et al.12

Postmenopausal, endocrine-sensitive and early BC

2602

5

Age, hormone receptors, grade, T, N, HER2, treatment and locoregional recurrence

Assessed all-cause mortality, a very specific population, early BC was not defined, the model is laborious to use and the web tool does not work*

Internal validation was not assessed with bootstrapping

C-index = 0.70–0.79; HSF = 0.995

The Nottingham Prognostic Index13,14,15.

Invasive primary operable BC with no other malignancies

387

5

T, N and grade

Assessed all-cause mortality and a specific population

The choice of cut-points was not explained, the risk groups changed in each publication and no bootstrapping

Graphically

  1. AUC, area under the ROC curve; BC, breast cancer; HER2, human epidermal growth factor receptor 2; HSF, heuristic shrinkage factor; H-L, Hosmer-Lemeshow test. *Tested in October 2016.