A Comparison between the Online Prognostic Tool PREDICT and myBeST for Women with Breast Cancer in Malaysia

SIMPLE SUMMARY: Prognostic tools are valuable for risk communication. The popular PREDICT breast cancer tool was less accurate in predicting survival among Malaysian women. A new web-based prognostic tool, the Malaysian Breast cancer Survival prognostic Tool (myBeST), was developed to address the limitations. It was based on the model’s algorithm derived from local patients’ experiences. In this study, we compare both tools’ prediction performance among women with breast cancer in Malaysia involving a cohort of 532 patients. Both models are satisfactory, but myBeST exceeds PREDICT performances in discriminant properties. Hence, the myBeST model is more applicable to our population to convey survival estimation and manage patient expectations. ABSTRACT: The PREDICT breast cancer is a well-known online calculator to estimate survival probability. We developed a new prognostic model, myBeST, due to the PREDICT tool’s limitations when applied to our patients. This study aims to compare the performance of the two models for women with breast cancer in Malaysia. A total of 532 stage I to III patient records who underwent surgical treatment were analysed. They were diagnosed between 2012 and 2016 in seven centres. We obtained baseline predictors and survival outcomes by reviewing patients’ medical records. We compare PREDICT and myBeST tools’ discriminant performance using receiver-operating characteristic (ROC) analysis. The five-year observed survival was 80.3% (95% CI: 77.0, 83.7). For this cohort, the median five-year survival probabilities estimated by PREDICT and myBeST were 85.8% and 82.6%, respectively. The area under the ROC curve for five-year survival by myBeST was 0.78 (95% CI: 0.73, 0.82) and for PREDICT was 0.75 (95% CI: 0.70, 0.80). Both tools show good performance, with myBeST marginally outperforms PREDICT discriminant performance. Thus, the new prognostic model is perhaps more suitable for women with breast cancer in Malaysia.