{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T14:01:16Z","timestamp":1789912876403,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate patient-level risk prediction supports treatment decisions in breast cancer. Using the U.S. Surveillance, Epidemiology, and End Results (SEER) registry, we developed and internally validated an interactive web-based survival calculator integrating molecular and anatomical predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed 1 742 998 women diagnosed with breast cancer in SEER between 2010 and 2020, when human epidermal growth factor receptor 2 (HER2) ascertainment was reliable. Predictors included age at diagnosis, HER2, oestrogen\/progesterone receptor (ER\/PR) status, and American Joint Committee on Cancer (AJCC) 6th-edition tumour, node, metastasis (TNM) staging. HER2 was recoded to separate equivocal from unknown\/untested cases. A multivariable Cox model was fitted and assessed on a held-out 30% sample using discrimination and calibration. Robustness was evaluated using stratified Cox, Royston\u2013Parmar flexible parametric, and restricted mean survival time (RMST) analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Discrimination was good (Harrell C-index 0.72; time-dependent area under the time-dependent receiver operating characteristic (ROC) curve 0.76\u20130.78 at 12\u2013120\u00a0months) with close calibration. Older age, distant metastasis, advanced T stage, nodal involvement, and ER\/PR-negative status independently increased mortality. HER2-positive disease showed lower risk, whereas equivocal and unknown HER2 had higher risk. Findings remained stable across sensitivity analyses; RMST showed ~\u200961 fewer restricted-mean survival months for M1 disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The tool provides individualized survival probabilities from routine clinical and molecular inputs. It is prognostic, not predictive, and should complement rather than replace clinical judgement alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pubmed\/fdag066","type":"journal-article","created":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T13:13:27Z","timestamp":1789910007000},"source":"Crossref","is-referenced-by-count":0,"title":["Individualized breast cancer survival prediction in clinical practice: a SEER-derived interactive web tool integrating molecular and anatomical factors"],"prefix":"10.1093","author":[{"given":"Mukesh","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Statistics, MMV, Banaras Hindu University , Varanasi 221005 ,","place":["India"]},{"name":"Division of Population Health and Genomics, School of Medicine, University of Dundee , Dundee DD19SY ,","place":["United 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