J Breast Cancer.  2013 Mar;16(1):97-103.

Validation of a Web-Based Tool to Predict the Ipsilateral Breast Tumor Recurrence (IBTR! 2.0) after Breast-Conserving Therapy for Korean Patients

• Jung SP
• Hur SM
• Lee SK
• Kim S
• Choi MY
• Bae SY
• Kim J
• Kim MK
• Kil WH
• Choe JH
• Kim JH
• Kim JS
• Nam SJ
• Bae JW
• Lee JE

Abstract

PURPOSE
IBTR! 2.0 is a web-based nomogram that predicts the 10-year ipsilateral breast tumor recurrence (IBTR) rate after breast-conserving therapy. We validated this nomogram in Korean patients.
METHODS
The nomogram was tested for 520 Korean patients, who underwent breast-conserving surgery followed by radiation therapy. Predicted and observed 10-year outcomes were compared for the entire cohort and for each group, predefined by nomogram-predicted risks: group 1, <3%; group 2, 3% to 5%; group 3, 5% to 10%; group 4, >10%.
RESULTS
In overall patients, the overall 10 year predicted and observed estimates of IBTR were 5.22% and 5.70% (p=0.68). In group 1, (n=124), the predicted and observed estimates were 2.25% and 1.80% (p=0.73), in group 2 (n=177), 3.95% and 3.90% (p=0.97), in group 3 (n=181), 7.14% and 8.80% (p=0.42), and in group 4 (n=38), 11.66% and 14.90% (p=0.73), respectively.
CONCLUSION
In a previous validation of this nomogram based on American patients, nomogram-predicted IBTR rates were overestimated in the high-risk subgroup. However, our results based on Korean patients showed that the observed IBTR was higher than the predicted estimates in groups 3 and 4. This difference may arise from ethnic differences, as well as from the methods used to detect IBTR and the healthcare environment. IBTR! 2.0 may be considered as an acceptable nomogram in Korean patients with low- to moderate-risk of in-breast recurrence. Before widespread use of this nomogram, the IBTR! 2.0 needs a larger validation study and continuous modification.

Keyword

Breast neoplasms; Nomograms; Radiotherapy; Recurrence; Validation studies

MeSH Terms

Breast
Breast Neoplasms
Cohort Studies
Delivery of Health Care
Humans
Mastectomy, Segmental
Nomograms
Recurrence

Figure

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  Figure 1 Observed ipsilateral breast tumor recurrence (IBTR) estimates using the Kaplan-Meier method in four predefined groups. (A) Observed IBTR estimates in entire cohort. (B) Observed IBTR estimates in four risk groups.

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  Figure 2 A receiver operating characteristic (ROC) curve. Area under the ROC (AUC) is 0.670 (95% confidence interval, 0.569-0.781). TP=true positive; FP=false positive.

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