Risk assessment tools for women with breast atypia: A systematic review

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-09-02 DOI:10.1016/j.amjsurg.2025.116598

Tori C. Nierenberg , Juliet C. Dalton , Rylan Howell , Samantha Kaplan , Akiko Chiba , Ton Wang , Jennifer K. Plichta

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引用次数: 0

Abstract

Background

Breast atypia is a benign breast disease found in a minority of percutaneous biopsies and is associated with an increased risk of breast cancer. Risk assessment calculators/tools have variable performance in this subgroup. We systematically reviewed tools developed or validated for women with breast atypia to guide clinicians and inform future model development.

Methods

We searched three databases for original studies published prior to November 13, 2023, that investigated the development or validation of risk assessment tools in atypia patients. PROBAST was used to assess the risk of bias and applicability.

Results

From 6252 records, 12 studies (1993–2022) were included (91.6 % U.S.-based; median sample size 540). The Gail model (C-index 0.5) and Tyrer-Cuzick model (0.49–0.54) performed poorly. Newer models demonstrated improved calibration (0.59–0.68), though 41.6 % had high risk of bias.

Conclusions

Current tools inadequately predict breast cancer risk in atypia patients. Novel, population-specific models are needed.

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乳房非典型性女性的风险评估工具：系统回顾

背景乳腺异型性是在少数经皮活检中发现的一种良性乳腺疾病，与乳腺癌风险增加有关。风险评估计算器/工具在这个子组中有不同的表现。我们系统地回顾了为乳房非典型性女性开发或验证的工具，以指导临床医生并为未来的模型开发提供信息。方法：我们检索了三个数据库，检索了2023年11月13日之前发表的研究非典型性患者风险评估工具开发或验证的原始研究。PROBAST用于评估偏倚风险和适用性。结果从6252份记录中，纳入了12项研究（1993-2022）（91.6%基于美国，中位样本量为540）。Gail模型（C-index 0.5）和Tyrer-Cuzick模型（0.49-0.54）表现较差。较新的模型显示出改进的校准（0.59-0.68），尽管41.6%具有高偏倚风险。结论目前的工具不能充分预测非典型性乳腺癌患者的风险。我们需要新颖的、针对特定人群的模型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.