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PREDICT BREAST CANCER CALCULATOR : NEW VERSION V.3

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Hi Everyone !

Just thought I'd share this here. Predict Breast Online has released a newer version of their survival calculator. This new version is based on women diagnosed between 2000 and 2017, vs. 1999 and 2003 for the former version. It now includes more details such as PR receptor status, radiation treatments, etc.

https://breast.v3.predict.cam/tool

See following link : https://www.medrxiv.org/content/10.1101/2023.07.18.23292777v1

It seems like the former version over-estimated the mortality quite significantly.

In my own case with the same details:

V.2 » 5y : 95%, 10y : 87%, 15y : 79%

V.3 » 5y : 99%, 10y: 97%, 15y : 94%

WAY BETTER. I'll take that as a good/positive news :-)

Hope this will be of interest to some of you

As regards RECURRENCE Risks calculator, I like to use the following from Cleveland Clinic (but this only applies to T1-2 N1 Breast cancers) : https://riskcalc.org/BreastPMRT/

All the best

Comments

  • threetree
    threetree Member Posts: 1,478
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    Thanks for posting this.

    Beesie - if you are still out there anywhere, you might be interested in this.

  • zen1028
    zen1028 Member Posts: 84
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    Thank you…Thank you…Thank you. I too will take any good news. 😂

  • kaynotrealname
    kaynotrealname Member Posts: 422
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    I didn't go up quite as much as you but still pretty significant. With old model at 10 years I was 92% and at 15 I was at 85%. The new model put me at 97% at 10 years and 93% at 15. Which I'll take since at this point only 97% of us will be alive at 15 years according to Predict so my new percentage isn't too far off. Anyway there is some chatter on-line about this and no one is sure whether it's the new treatments for early case breast cancer that's doing it or that we now have stage 4 folks living so much longer. The new stats don't include recurrences by the way. It's just for overall survival. Plus the benefits of endocrine therapy and chemo has gone down considerably according to this new calculator. It's almost like surgery has changed somehow and we're all getting much better surgeries but I don't think that's the case. I personally think this is reflecting what all of us are suspecting - Stage 4 life expectancies have improved tremendously which is why we are all more likely to be alive longer now.

  • ratherbesailing
    ratherbesailing Member Posts: 129
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    Thanks for posting!

  • m_and_g
    m_and_g Member Posts: 14
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    I am very pleased with my results on the new version of Predict, thank you for posting. Not sure I would have done anything different but my total benefit from radiation was 1 percent/one person at 15 years. Unfortunately, I had a horrible reaction to radiation which then required approximately 13 procedures to correct and enable some sort of reconstruction. The results are definitely not good, but I refuse to have another surgery. Not to scare anyone this was just my personal experience and is not indicative of the norm.

  • m_and_g
    m_and_g Member Posts: 14
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  • jlgif94
    jlgif94 Member Posts: 12
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    You're very welcome everyone, glad this was helpful :)

    @m_and_g Sorry to read this.. Seems like you had a rough journey through radiation.. I finished 30 sessions 1 month ago and so far so good apart from the usual burns and discomfort. But glad this helps put your mind a bit more at ease!

    @kaynotrealname - My numbers went up significantly because I'm only 29 years old, and it seems like the previous model was pretty pessimistic for 'very young' breast cancer patients. Now the new model seems to mostly focus on the type of cancer, grade etc. and not so much on the age anymore. This could be the reason.. Also this seems more aligned now with the AJCC 8th edition, which puts me at a Prognostic stage of 1A vs. 2B before.

    In fact, Predict does not include recurrence risks. This is only a survival calculator, but at this point I believe it's safe to assume that if the predicted survival % is very high, it probably means the risks of (distant) recurrence is per se pretty low. This would also match with the recurrence risk calculated by the Cleveland Clinic calculator I shared in my post - at least in my own personal case.

    I think, all in all, that this is based on a mix of several points : yes, stage 4 patients do live longer and have more options now than ever, + early stage cancers are better treated (Extended endocrine therapy/ OFS in Young women/ Improved targeted therapies in HER2 positive cancers like myself, Immunotherapy in triple negative cancer, etc.) + most importantly a better understanding of what makes one's diagnosis more aggressive than another… hence the histology of the cancer now seems to matter more than anything else, and more than ever before. But I may be wrong.

    I've read a study done by Dr. Neuman - University of Wisconsin (I purchased the PDF version of the article) on breast cancer recurrences. It shows how crucial the subtype is in terms of recurrence risks. Now, even Stage 3 Triple Positive breast cancer patients have a risk of recurrence of 15% at 5 years… vs. 45% in triple negative patients (Stage 3). I'm a stage 2 Triple Positive patients and this put me at a 7-9%-ish risk at 5 years.. I'll take this. I do personally believe that more than the fact that more people live longer with Stage 4 BC, this new model really takes into consideration recent advances in various types of BC and it simply shows that most of BC subtypes are now more treatable than ever before. Let's see what comes out of the Version 4 in a decade ++ from now lol. Let's not forget that Predict does not include stage 4 patients in their calculation tool, as the cohort of patients selected are only stage 1-3.

  • ctmbsikia
    ctmbsikia Member Posts: 758
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    What does PMRT mean on the reoccurrence calculator? I don't know if this is good? My OS (overall survival is. 88% at 15 yrs. I'm in year 6. Thanks for posting the info!!!

    Outcome

    5-year

    10-year

    No PMRT

    PMRT

    No PMRT

    PMRT

    Local Recurrence

    7%

    2%

    10%

    2%

    Distant Recurrence

    10%

    9%

    17%

    16%

    Any Recurrence

    13%

    10%

    22%

    17%

    Breast Cancer Mortality

    6%

    6%

    13%

    12%

  • kaynotrealname
    kaynotrealname Member Posts: 422
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    Hi Jig! Great comments. The only thing that I find puzzling though is that if the increase in survival rates was because of better treatment than you'd think that would be reflective in the increase of survival when treatments are taken into account. But instead, for instance with me, my endocrine therapy and chemo percentage went down as far as how it increased my survival and not up. I maybe get one to two percentage points from it now instead of 4 to 12. That's why I think it must be taking into account how much longer stage 4 patients are living.

  • maggie15
    maggie15 Member Posts: 1,081
    edited June 25
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    Thanks for the update! PMRT is post mastectomy radiation therapy. The few percentage points from radiation therapy toward overall survival don't seem worth all the problems it caused for me (I'd take a local recurrence instead) but the older version didn't consider radiation at all. It all points to better treatment. Stage 4 patients are living longer because of more and better treatments even though the calculator is not meant for them; OS would take this into account by default since stage 1 - 3 patients generally progress to stage 4 if that is the cause of death. Also, overall survival includes death for any reason so improved treatment for all types of diseases is a factor.

  • jlgif94
    jlgif94 Member Posts: 12
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    Hi @kaynotrealname and @maggie15

    Appreciate your comments and insights. It does seem to make sense indeed :)

    One last thing I also read somewhere, is that the previous model was probably too pessimistic with the survival WITHOUT treatments for some specific subtypes. That would also mean it was too optimistic as regards the effects/benefits of each treatment on the survival. I think this could explain why your numbers (endocrine therapy and chemo) went down with the new model… I don't know if that makes sense? hahah

    But apart from this, I understand both of your points regarding Stage 4, I think you're right !