Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese women

Abstract Background Each breast cancer (BC) risk factor has different effects on different populations. However, there are no well-studied and validated BC risk prediction models for Japanese women. We developed accessible predictive models for Japanese women with optimal variables to evaluate risk...

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Main Authors: Michiyo Yamada, Takashi Chishima, Takashi Ishikawa, Kazutaka Narui, Sadatoshi Sugae, Peter J. Tonellato, Itaru Endo
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-13556-8
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author Michiyo Yamada
Takashi Chishima
Takashi Ishikawa
Kazutaka Narui
Sadatoshi Sugae
Peter J. Tonellato
Itaru Endo
author_facet Michiyo Yamada
Takashi Chishima
Takashi Ishikawa
Kazutaka Narui
Sadatoshi Sugae
Peter J. Tonellato
Itaru Endo
author_sort Michiyo Yamada
collection DOAJ
description Abstract Background Each breast cancer (BC) risk factor has different effects on different populations. However, there are no well-studied and validated BC risk prediction models for Japanese women. We developed accessible predictive models for Japanese women with optimal variables to evaluate risk factors for use by both medical institutions and women for primary BC prevention and to increase the BC screening rate. We evaluated the characteristics and distribution diversity of risk factors in this population. Methods This retrospective case–control study of 2,494 Japanese women included data from an original, paper-based questionnaire. The logistic regression models included 18 variables from 6 risk factors based on menopausal status (PRE, premenopausal; PERI, perimenopausal; and POST, postmenopausal). Models were evaluated based on the Akaike Information Criterion, area under the receiver operating characteristic curve (AUC), and internal validation. Bootstrap methods for bias correction in discrimination and calibration and standard deviations were calculated by the modified case–control ratio. Results We created and evaluated 432 candidate models for each group. Notably, BMI, parity, FHx, and smoking history were found to increase risk in all groups. Risk-reducing factors included breastfeeding duration in the PRE and PERI models and regular alcohol consumption in the PERI and POST models. Age reduced risk in the PERI model but increased risk in the POST model. Differences were observed between PRE and PERI versus POST with respect to variable selection in parity and FHx. Our models had moderate discriminatory accuracy. AUCs (confidence intervals) of the PRE, PERI, and POST models were 0.669 (0.625–0.715), 0.669 (0.632–0.702), and 0.659 (0.627–0.693), respectively. Bias-corrected AUCs (standard deviations) were 0.697 (0.041) for PRE, 0.684 (0.033) for PERI, and 0.674 (0.031) for POST, respectively. Our models were well-calibrated after bias correction. Conclusion Our widely available, simple, and cost-effective models with optimal variables could indicate the characteristics of certain genetic and environmental risk factors for BC in Japanese women.
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spelling doaj-art-cecbf8e9be96419eac05ba54b9da2dab2025-02-09T12:41:26ZengBMCBMC Cancer1471-24072025-02-0125111310.1186/s12885-025-13556-8Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese womenMichiyo Yamada0Takashi Chishima1Takashi Ishikawa2Kazutaka Narui3Sadatoshi Sugae4Peter J. Tonellato5Itaru Endo6Department of Gastroenterological Surgery, Yokohama City University Graduate School of MedicineDepartment of Breast Surgery, Showa University Northern Yokohama HospitalDepartment of Breast Surgery and Oncology, Tokyo Medical UniversityDepartment of Breast and Thyroid Surgery, Yokohama City University Medical CenterDepartment of Gastroenterological Surgery, Yokohama City University Graduate School of MedicineCenter for Biomedical Informatics, University of Missouri School of MedicineDepartment of Gastroenterological Surgery, Yokohama City University Graduate School of MedicineAbstract Background Each breast cancer (BC) risk factor has different effects on different populations. However, there are no well-studied and validated BC risk prediction models for Japanese women. We developed accessible predictive models for Japanese women with optimal variables to evaluate risk factors for use by both medical institutions and women for primary BC prevention and to increase the BC screening rate. We evaluated the characteristics and distribution diversity of risk factors in this population. Methods This retrospective case–control study of 2,494 Japanese women included data from an original, paper-based questionnaire. The logistic regression models included 18 variables from 6 risk factors based on menopausal status (PRE, premenopausal; PERI, perimenopausal; and POST, postmenopausal). Models were evaluated based on the Akaike Information Criterion, area under the receiver operating characteristic curve (AUC), and internal validation. Bootstrap methods for bias correction in discrimination and calibration and standard deviations were calculated by the modified case–control ratio. Results We created and evaluated 432 candidate models for each group. Notably, BMI, parity, FHx, and smoking history were found to increase risk in all groups. Risk-reducing factors included breastfeeding duration in the PRE and PERI models and regular alcohol consumption in the PERI and POST models. Age reduced risk in the PERI model but increased risk in the POST model. Differences were observed between PRE and PERI versus POST with respect to variable selection in parity and FHx. Our models had moderate discriminatory accuracy. AUCs (confidence intervals) of the PRE, PERI, and POST models were 0.669 (0.625–0.715), 0.669 (0.632–0.702), and 0.659 (0.627–0.693), respectively. Bias-corrected AUCs (standard deviations) were 0.697 (0.041) for PRE, 0.684 (0.033) for PERI, and 0.674 (0.031) for POST, respectively. Our models were well-calibrated after bias correction. Conclusion Our widely available, simple, and cost-effective models with optimal variables could indicate the characteristics of certain genetic and environmental risk factors for BC in Japanese women.https://doi.org/10.1186/s12885-025-13556-8Breast cancer risk assessmentPredictive modelJapanese womenOptimal variablesLate childbearingDiverse alcoholic effects
spellingShingle Michiyo Yamada
Takashi Chishima
Takashi Ishikawa
Kazutaka Narui
Sadatoshi Sugae
Peter J. Tonellato
Itaru Endo
Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese women
BMC Cancer
Breast cancer risk assessment
Predictive model
Japanese women
Optimal variables
Late childbearing
Diverse alcoholic effects
title Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese women
title_full Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese women
title_fullStr Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese women
title_full_unstemmed Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese women
title_short Breast cancer risk assessment based on a predictive model: evaluation of risk factors among Japanese women
title_sort breast cancer risk assessment based on a predictive model evaluation of risk factors among japanese women
topic Breast cancer risk assessment
Predictive model
Japanese women
Optimal variables
Late childbearing
Diverse alcoholic effects
url https://doi.org/10.1186/s12885-025-13556-8
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