{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T20:48:37Z","timestamp":1776890917795,"version":"3.51.2"},"reference-count":18,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Clin Cancer Inform"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Recent changes in breast cancer (BC) screening guidelines have extended eligibility to women age 40-49 years, yet risk stratification in this group remains challenging. This study evaluated the performance of a complete blood count (CBC)\u2013based BC risk model, originally developed for women age 40-70 years, in women age 40-49 years across diverse clinical settings in Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In this retrospective multicenter study, CBC data from 239,089 women age 40-49 years were analyzed. A ridge regression model using age, neutrophil-to-lymphocyte ratio (NLR), and RBC was evaluated. CBCs were stratified by timing relative to breast diagnostic procedures: same day, 1-90 days prior, and 91-180 days prior. Model performance was assessed using area under the receiver operating characteristic curve (AUC), sensitivity, and specificity, with leave-one-group-out cross-validation across five Brazilian clinical settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The CBC model showed stable performance when CBCs were obtained within 3 months before diagnosis (AUC = 0.63 \u00b1 0.03 for same day; 0.61 \u00b1 0.05 for 1-90 days prior). Performance declined in the 91- to 180-day interval (AUC = 0.58 \u00b1 0.03). NLR increased significantly closer to diagnosis, driven mainly by neutrophilia. At 70% specificity, screening the top 30% identified 47% of cancers (relative risk = 2.07).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The CBC-based model provides a low-cost approach to BC risk stratification in women age 40-49 years, particularly when CBCs are collected within 3 months of evaluation. This opportunistic strategy may be especially valuable in resource-constrained settings where routine mammographic screening is limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/cci-25-00347","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T20:00:13Z","timestamp":1776888013000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Multicentric Validation of a Complete Blood Count\u2013Based Model for Breast Cancer Risk Stratification in Women Age 40-49 Years"],"prefix":"10.1200","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2748-4776","authenticated-orcid":true,"given":"Daniella Castro","family":"Ara\u00fajo","sequence":"first","affiliation":[{"name":"Huna Ltd, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5288-8150","authenticated-orcid":true,"given":"Bruno Arag\u00e3o","family":"Rocha","sequence":"additional","affiliation":[{"name":"Grupo Fleury, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3271-3243","authenticated-orcid":true,"given":"Suzylaine","family":"da Silva Lima","sequence":"additional","affiliation":[{"name":"Huna Ltd, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thiago Buosi","family":"Silva","sequence":"additional","affiliation":[{"name":"Barretos Cancer Hospital, Barretos, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Rabelo","family":"Leite","sequence":"additional","affiliation":[{"name":"Grupo Pardini, Vespasiano, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0597-2469","authenticated-orcid":true,"given":"Daniel","family":"Noce da Silva","sequence":"additional","affiliation":[{"name":"Huna Ltd, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Carolina","family":"Tostes Pint\u00e3o","sequence":"additional","affiliation":[{"name":"Grupo Fleury, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1363-8962","authenticated-orcid":true,"given":"Mateus Frederico","family":"de Paula","sequence":"additional","affiliation":[{"name":"Barretos Cancer Hospital, Barretos, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rejane Cristina","family":"dos Santos Silva","sequence":"additional","affiliation":[{"name":"Grupo Pardini, Vespasiano, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Otavio Jose Eulalio","family":"Pereira","sequence":"additional","affiliation":[{"name":"Grupo Fleury, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9345-6338","authenticated-orcid":true,"given":"Jo\u00e3o Vicente","family":"de Morais Malvezzi","sequence":"additional","affiliation":[{"name":"Grupo Fleury, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia","family":"Helena da Silva","sequence":"additional","affiliation":[{"name":"Grupo Fleury, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fl\u00e1vio Francisco","family":"Machado","sequence":"additional","affiliation":[{"name":"Grupo Pardini, Vespasiano, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4612-2013","authenticated-orcid":true,"given":"Keity","family":"de Moura Pinho","sequence":"additional","affiliation":[{"name":"Grupo Pardini, Vespasiano, 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