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Pathology characteristics that optimize outcome prediction of a breast screening trial

The ability of pathology characteristics to predict outcome was tested with the 1029 cancers accumulated in the Edinburgh Randomized Trial of breast screening after 14 years follow-up. The majority (55.7%) were in the screening arm, which also had more operable cases (81.3% vs 62.2%); the reduction...

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Autores principales: Anderson, T J, Alexander, F E, Lamb, J, Smith, A, Forrest, A P M
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2000
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374653/
https://www.ncbi.nlm.nih.gov/pubmed/10945496
http://dx.doi.org/10.1054/bjoc.2000.1286
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author Anderson, T J
Alexander, F E
Lamb, J
Smith, A
Forrest, A P M
author_facet Anderson, T J
Alexander, F E
Lamb, J
Smith, A
Forrest, A P M
author_sort Anderson, T J
collection PubMed
description The ability of pathology characteristics to predict outcome was tested with the 1029 cancers accumulated in the Edinburgh Randomized Trial of breast screening after 14 years follow-up. The majority (55.7%) were in the screening arm, which also had more operable cases (81.3% vs 62.2%); the reduction in the proportion of inoperable breast cancers in a UK female population invited to mammographic screening is a notable effect of the trial. In the 691 operable invasive cases the size, histological type, grade, node status and node number group individually showed highly significant (P< 0.001) association with survival. In multivariate analysis the Nottingham Prognostic Index (NPI) derived from these features showed highly significant association with survival (P< 0.001). However, when first adjusted for NPI, combined addition of pathological size in 6 categories and histological type as special or not had an independent association with survival that was statistically firmly based (P< 0.001). For operable breast cancer the gains are in smaller sizes, better histological features, and higher proportion node negative. The weighting factors applied to pathology indicators of survival in the NPI are not optimal for a population included in a trial of screening. In particular, a linear trend of the index with pathological size is not appropriate. Inclusion of histological type as special or not improves the index further. © 2000 Cancer Research Campaign
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spelling pubmed-23746532009-09-10 Pathology characteristics that optimize outcome prediction of a breast screening trial Anderson, T J Alexander, F E Lamb, J Smith, A Forrest, A P M Br J Cancer Regular Article The ability of pathology characteristics to predict outcome was tested with the 1029 cancers accumulated in the Edinburgh Randomized Trial of breast screening after 14 years follow-up. The majority (55.7%) were in the screening arm, which also had more operable cases (81.3% vs 62.2%); the reduction in the proportion of inoperable breast cancers in a UK female population invited to mammographic screening is a notable effect of the trial. In the 691 operable invasive cases the size, histological type, grade, node status and node number group individually showed highly significant (P< 0.001) association with survival. In multivariate analysis the Nottingham Prognostic Index (NPI) derived from these features showed highly significant association with survival (P< 0.001). However, when first adjusted for NPI, combined addition of pathological size in 6 categories and histological type as special or not had an independent association with survival that was statistically firmly based (P< 0.001). For operable breast cancer the gains are in smaller sizes, better histological features, and higher proportion node negative. The weighting factors applied to pathology indicators of survival in the NPI are not optimal for a population included in a trial of screening. In particular, a linear trend of the index with pathological size is not appropriate. Inclusion of histological type as special or not improves the index further. © 2000 Cancer Research Campaign Nature Publishing Group 2000-07 2000-07-24 /pmc/articles/PMC2374653/ /pubmed/10945496 http://dx.doi.org/10.1054/bjoc.2000.1286 Text en Copyright © 2000 Cancer Research Campaign https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.
spellingShingle Regular Article
Anderson, T J
Alexander, F E
Lamb, J
Smith, A
Forrest, A P M
Pathology characteristics that optimize outcome prediction of a breast screening trial
title Pathology characteristics that optimize outcome prediction of a breast screening trial
title_full Pathology characteristics that optimize outcome prediction of a breast screening trial
title_fullStr Pathology characteristics that optimize outcome prediction of a breast screening trial
title_full_unstemmed Pathology characteristics that optimize outcome prediction of a breast screening trial
title_short Pathology characteristics that optimize outcome prediction of a breast screening trial
title_sort pathology characteristics that optimize outcome prediction of a breast screening trial
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374653/
https://www.ncbi.nlm.nih.gov/pubmed/10945496
http://dx.doi.org/10.1054/bjoc.2000.1286
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