{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:23:14Z","timestamp":1792711394157,"version":"4.5.0"},"reference-count":46,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"\n Importance<\/jats:title>\n Women receiving breast cancer (BC) treatment are at risk for heart failure or cardiomyopathy (HF\/CM). No standard method exists to identify women at risk who might benefit from preventive cardiac strategies and surveillance during and after treatment.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To develop and validate a model predicting the 10-year risk of developing HF\/CM in women receiving systemic treatment for invasive early-stage BC to inform cardiac risk management.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This longitudinal cohort study of patients cared for in Kaiser Permanente Southern California, a vertically integrated health care system. The goal of the study was to predict the 10-year HF\/CM risk using multivariable elastic-net Cox proportional hazards models. Women aged 18 to 79 years with newly diagnosed invasive local or regional BC from 2008 to 2020, with a median follow-up of 5.2 years, were included. The cohort was randomly split into derivation (60%) and validation (40%) cohorts. Data were analyzed from April 2024 to May 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n HF\/CM risk predictors included age at BC diagnosis, race and ethnicity, area-level socioeconomic status, local and systemic BC treatments, cancer stage, obesity, and history of hypertension, diabetes, hyperlipidemia, smoking, and other CV conditions.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n Incident HF\/CM events. Women were categorized into low-, moderate-, and high-risk groups based on the tertiles of the risk score in the derivation cohort.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 26\u202f044 women included in the total cohort, the median (IQR) age was 61 (52-68) years. The risk model had good calibration and high accuracy in predicting HF\/CM risk in the 3 subgroups, with HF\/CM risk in the validation cohort matching the estimates from the derivation for identifying women at low risk (1.7%; 95% CI, 1.1%-2.4%) and high risk (19.4%; 95% CI. 17.3%-21.5%) of HF\/CM at 10 years. The model\u2019s discrimination ability was good, based on the time-dependent area under the curve of 0.79 at 10 years in the validation cohort.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This risk prediction model among women with early-stage BC was able to prospectively identify those at risk of HF\/CM over a 10-year period based on the selected BC treatment and clinical variables available at BC diagnosis. The model can be used to inform risk-guided cardiac management for these women.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoncol.2025.4178","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T15:31:15Z","timestamp":1761233475000},"page":"1479","source":"Crossref","is-referenced-by-count":9,"title":["Risk Prediction Model for Development of Heart Failure or Cardiomyopathy After Breast Cancer Treatment"],"prefix":"10.1001","volume":"11","author":[{"given":"Ana","family":"Barac","sequence":"first","affiliation":[{"name":"Inova Schar Heart and Vascular, Fairfax, Virginia"},{"name":"Georgetown University Medical Center, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiling","family":"Chou","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute, Columbia, 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