{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:43:34Z","timestamp":1783406614283,"version":"3.54.6"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n              <jats:title>Background<\/jats:title>\n              <jats:p>Breast cancer risk models guide screening and chemoprevention decisions, but the extent and effect of variability among models, particularly at the individual level, is uncertain.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Objective<\/jats:title>\n              <jats:p>To quantify the accuracy and disagreement between commonly used risk models in categorizing individual women as average vs. high risk for developing invasive breast cancer.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Design<\/jats:title>\n              <jats:p>Comparison of three risk prediction models: Breast Cancer Risk Assessment Tool (BCRAT), Breast Cancer Surveillance Consortium (BCSC) model, and International Breast Intervention Study (IBIS) model.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Subjects<\/jats:title>\n              <jats:p>Women 40 to 74 years of age presenting for screening mammography at a multisite health system between 2011 and 2015, with 5-year follow-up for cancer outcome.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Main Measures<\/jats:title>\n              <jats:p>Comparison of model discrimination and calibration at the population level and inter-model agreement for 5-year breast cancer risk at the individual level using two cutoffs (\u2265 1.67% and \u2265 3.0%).<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Key Results<\/jats:title>\n              <jats:p>A total of 31,115 women were included. When using the \u2265 1.67% threshold, more than 21% of women were classified as high risk for developing breast cancer in the next 5 years by one model, but average risk by another model. When using the \u2265 3.0% threshold, more than 5% of women had disagreements in risk severity between models. Almost half of the women (46.6%) were classified as high risk by at least one of the three models (e.g., if all three models were applied) for the threshold of \u2265 1.67%, and 11.1% were classified as high risk for \u2265 3.0%. All three models had similar accuracy at the population level.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Conclusions<\/jats:title>\n              <jats:p>Breast cancer risk estimates for individual women vary substantially, depending on which risk assessment model is used. The choice of cutoff used to define high risk can lead to adverse effects for screening, preventive care, and quality of life for misidentified individuals. Clinicians need to be aware of the high false-positive and false-negative rates and variation between models when talking with patients.<\/jats:p>\n            <\/jats:sec>","DOI":"10.1007\/s11606-023-08043-4","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T17:28:17Z","timestamp":1675790897000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Variability Among Breast Cancer Risk Classification Models When Applied at the Level of the Individual Woman"],"prefix":"10.1007","author":[{"given":"Jeremy S.","family":"Paige","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph I.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pin-Chieh","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam R.","family":"Brentnall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne C.","family":"Hoyt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Naeim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7311-6835","authenticated-orcid":false,"given":"Joann G.","family":"Elmore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"issue":"1","key":"8043_CR1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1214\/19-STS729","volume":"35","author":"AR Brentnall","year":"2020","unstructured":"Brentnall AR, Cuzick J. 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G. Elmore serves as Editor-in-Chief of Primary Care (Adult) topics at UpToDate. Dr. C. I. Lee receives textbook royalties from Oxford University Press, UpToDate, Inc., and McGraw Hill, Inc.; previously received personal fees from GRAIL, Inc. for work on a data safety monitoring board; and receives personal fees from the American College of Radiology for journal editorial board work; all outside the submitted work. Dr. W. Hsu has received a research grant support from Siemens Medical Solutions. Dr. A. Brentnall reports receiving royalty payments from licenses for commercial use of the IBIS algorithm, through Cancer Research UK.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"Pin-Chieh Wang, University of California, Los Angeles, conducted the data analysis. P. Wang had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}