O012: Clinical utility of a simple risk assessment model for cancer-associated thrombosis to identify breast cancer patients at high risk of symptomatic central venous catheter-related thrombosis

Background and Objectives. Breast cancer has been the most common cancer affecting women in Jordan. In the process of implementing breast cancer prevention and early detection programs, individualized risk assessment can add to the cost-effectiveness of such interventions. Gail model is a widely used tool to stratify patients into different risk categories. However, concerns about its applicability across different ethnic groups do exist. In this study, we report our experience with the application of a modified version of this model among Jordanian women. Methods. The Gail risk assessment model (RAM) was modified and used to calculate the 5-year and lifetime risk for breast cancer. Patients with known breast cancer were used to test this model. Medical records and hospital database were utilized to collect information on known risk factors. The mean calculated risk score for women tested was 0.65. This number, which corresponds to the Gail original score of 1.66, was used as a cutoff point to categorize patients as high risk. Results. A total of 1786 breast cancer patients with a mean age of 50 (range: 19–93) years were included. The modified version of the Gail RAM was applied on 1213 patients aged 35–59.9 years. The mean estimated risk for developing invasive breast cancer over the following five years was 0.54 (95% CI: 0.52, 0.56), and the lifetime risk was 3.42 (95% CI: 3.30, 3.53). Only 210 (17.3%) women had a risk score >0.65 and thus categorized as high risk. First-degree family history of breast cancer was identified among 120 (57.1%) patients in this high-risk group. Conclusions. Among a group of patients with an established diagnosis of breast cancer, a modified Gail risk assessment model would have been able to stratify only 17% into the high-risk category. The family history of breast cancer contributed the most to the risk score.

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A Thrombotic Biomarker-Based Risk Assessment Scoring Model for Disease Recurrence in Breast Cancer Patient Candidate to Systemic Chemotherapy

Blood ◽

10.1182/blood-2019-129820 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 2426-2426

Author(s):

Anna Falanga ◽

Cinzia Giaccherini ◽

Marina Marchetti ◽

Giovanna Masci ◽

Cristina Verzeroli ◽

...

Keyword(s):

Breast Cancer ◽

Risk Assessment ◽

Cancer Patients ◽

Disease Recurrence ◽

Assessment Model ◽

Risk Assessment Model ◽

Breast Cancer Patients ◽

Scoring Model ◽

D Dimer

Background. Hypercoagulability, a common finding in cancer patients, is associated with an increased risk of both thrombosis and tumor development. The HYPERCAN study (ClinicalTrials.gov, ID# NCT02622815) is an ongoing Italian prospective, multicenter, observational study, evaluating the predictive value of thrombotic markers for early cancer diagnosis in healthy subjects and for cancer prognosis and venous thromboembolism in patients with newly diagnosed malignant disease. In this analysis of a large cohort of patients with breast cancer, we evaluated whether pre-chemotherapy thrombotic biomarker levels: 1. are associated with breast cancer-specific clinicopathological features; and 2. may predict for disease recurrence (DR). Patients and Methods. D-dimer, fibrinogen, prothrombin fragment 1+2 (F1+2), and FVIIa/antithrombin complex (FVIIa/AT) levels were measured in 701 early-stage resected breast cancer patients, candidate to adjuvant chemotherapy and prospectively enrolled in the HYPERCAN study. Significant prognostic parameters for DR were identified by Cox-regression multivariate analysis and used for generating a risk assessment model. The study protocol is approved by the local Ethics Committee. Informed written consent is obtained from all study subjects. Results. Increased pre-chemotherapy D-dimer, fibrinogen, and F1+2 levels were significantly associated with a large tumor size (≥ 5 cm) and lymph node positivity. After 3.4 years follow-up, 71 patients experienced a DR. Comparison of the levels of the hypercoagulation variables of patients who experienced relapse versus patients who remained disease-free during follow-up showed that there were no statistical differences for all, but F1+2 biomarker levels, which were significantly higher in the group patients who relapsed [223 (115-618) vs 197 (115-385) pmol/l; p=0.024]. In addition, correlation analyses showed that pre-chemotherapy levels of fibrinogen were significantly and inversely associated with time to relapse (β = -0.317; p=0.012). Cox-multivariate analysis identified F1+2 (HR 2; 95% CI, 1.1-3.6; p=0.019), tumor size ≥ 5cm (HR 2.6; 95% CI, 1.4-4.6; p=0.001), and Luminal B HER2-neg or TN molecular subtypes (HR 3.9; 95% CI, 2.1-7.5; p<0.001) as independent risk factors for DR. Based on these variables, we generated a risk assessment model that significantly identified patients at low- versus high-risk of DR (cumulative incidence: 6.2 vs 20.7%; HR=3.5; p<0.001). Conclusion. Our prospective laboratory data from the HYPERCAN breast cancer subjects were essential for generating a scoring model for DR risk assessment. Future investigations addressing the role of plasma thrombotic biomarkers in breast cancer patients' management are warranted and may provide the rationale for development of new therapeutic strategies. Project funded by AIRC "5xMILLE Multiunit extension program" n. 12237 grant from the "Italian Association for Cancer Research (AIRC)". Disclosures Santoro: Bayer: Consultancy, Speakers Bureau; Amgen: Speakers Bureau; BMS: Consultancy; Sandoz: Speakers Bureau; Eisai: Consultancy, Speakers Bureau; Novartis: Speakers Bureau; Lilly: Speakers Bureau; Celgene: Speakers Bureau; Servier: Consultancy, Speakers Bureau; Gilead: Consultancy, Speakers Bureau; AstraZeneca: Speakers Bureau; Roche: Speakers Bureau; Abb-Vie: Speakers Bureau; Pfizer: Consultancy, Speakers Bureau; Arqule: Consultancy, Speakers Bureau; MSD: Speakers Bureau; Takeda: Speakers Bureau; BMS: Speakers Bureau.

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Abstract P2-06-05: Development and validation of a new non-parametric breast cancer risk assessment model on US and European screening populations

10.1158/1538-7445.sabcs16-p2-06-05 ◽

2017 ◽

Author(s):

S Ragusa ◽

E Gauthier ◽

L Dartois ◽

J Tice ◽

V Dancourt ◽

...

Keyword(s):

Breast Cancer ◽

Risk Assessment ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Assessment Model ◽

Cancer Risk Assessment ◽

Risk Assessment Model ◽

Breast Cancer Risk Assessment ◽

Development And Validation ◽

Non Parametric

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Effectiveness of Caprini Venous Thrombosis Risk Assessment Model in Patients with Hematologic Malignancies and Central Venous Thrombosis

Advances in Clinical Medicine ◽

10.12677/acm.2020.1012497 ◽

2020 ◽

Vol 10 (12) ◽

pp. 3324-3330

Author(s):

丽霞高

Keyword(s):

Risk Assessment ◽

Venous Thrombosis ◽

Hematologic Malignancies ◽

Assessment Model ◽

Risk Assessment Model ◽

Central Venous ◽

Thrombosis Risk ◽

Central Venous Thrombosis

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Preliminary analysis and assessment of breast cancer risk in Japanese women.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e13092 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e13092-e13092

Author(s):

Michiyo Yamada ◽

Takashi Ishikawa ◽

Sadatoshi Sugae ◽

Kazutaka Narui ◽

Eiji Arita ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Risk Assessment ◽

Family History ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Japanese Women ◽

Assessment Model ◽

Risk Assessment Model ◽

Brinkman Index

e13092 Background: No comprehensive breast cancer risk assessment model for Japanese women exists. Consequently, we have collected Japanese women’s data to investigate key BC risk factors with an objective of deriving a Japanese-women specific BC risk assessment model. Methods: We conducted a retrospective case-control study (paper-based with postal survey) at 15 institutions during 2014-2015. A survey was distributed to Japanese females aged 20-80 who had BC check-up. All pertinent data of a total of 34 factors including demographic and reproductive factors, social history and eating habits was collected. Cases and controls were divided into three groups respectively, premenopausal (PRE; 20 ≤ age < 45), perimenopausal (PERI; 45 ≤ age ≤ 55) and postmenopausal group (POST; 55 < age ≤ 80). Cases and control variables were compared by t-test, chi-square test and Wilcoxon rank sum test. Preliminary BC risk was calculated by logistic regression analysis. Results: A total of 3975 female Japanese datasets were collected, of which 2494 were complete (all variables present) with 1401 controls and 1093 cases were used. There were 222 cases and 332 controls for PRE, 404 cases and 537 controls for PERI, and 467 and 532 controls for POST. The univariate analysis demonstrated that BMI was significantly higher in cases than in controls in all groups (P < 0.01) as was “number of deliveries” in PRE and POST (P < 0.001) and Brinkman index in PRE and PERI (p = 0.017). Multivariate analysis revealed that BC risk was positively associated with BMI (OR 1.080, 95% CI 1.017–1.148, p = 0.012) in PRE, BMI (OR 1.121, 95% CI 1.072–1.174, p < 0.01) and brinkman index (OR 1.000005, 95% CI 1.000002–1.000008, p < 0.01) in PERI, age (OR 1.054, 95% CI 1.028–1.081, p < 0.010), BMI (OR 1.153, 95% CI 1.076-1.171, p < 0.01) and family history (OR 1.497, 95% CI 1.103–2.033, p = 0.001) in POST, while negatively associated with regular exercise (OR 0.672, 95% CI 0.517–0.873, p = 0.003) in POST. Conclusions: BMI in all groups, in addition, the Brinkman index in PERI and age and family history in POST are BC risk factors. Exercise is a protective risk factor in POST. However, the preliminary results are incomplete and further analysis will be conducted before a full risk assessment model is proposed for Japanese women.

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