This tool helps predict long-term mortality for HR+ patients
August 23, 2022
Recurrence is an unfortunate reality for up to 30% of breast cancer patients. When cells that were a part of your original breast cancer break away from the original tumor, they can hide in your breast or another area of your body. Cancer cells can remain in the body even after chemotherapy, radiation, hormone therapy or another type of treatment, essentially lying dormant. These cells have the potential to grow again and can spread to other parts of the body. It’s not fully known why this happens and it’s not a guarantee that recurrence will happen for every patient.
To help shed some light on recurrence risks, the Dana-Farber Cancer Institute in collaboration with Grupo Oncológico Cooperativo del Sur Argentina created an impressive tool—known as ESTIMATE—that can give a population-based estimate of the risk of death for hormone receptor-positive (HR+) breast cancer patients based on specific characteristics.
This tool offers exciting insight to breast cancer patients and is just one example of the major advancements occurring in the oncology field every day. Keep reading to learn more about how ESTIMATE works.
What Is ESTIMATE?
The ESTIMATE (ESTImating Mortality in breAsT cancEr) tool offers individuals a population-based cumulative risk of breast cancer-specific mortality (BCSM), non-BCSM, and all-cause mortality for women with HR+ breast cancer based on specific characteristics (and for flexible periods of time after initial diagnosis).
Each user of the tool enters in their own unique characteristics to give them a custom estimation time frame for recurrence—up to 20 years post-diagnosis. Using your specific inputs, ESTIMATE examines the full study cohort and estimates cumulative incidence of death in the chosen subgroup. The data used for estimates is obtained from the Surveillance, Epidemiology, and End Results (SEER) program.
It’s worth noting that it isn’t recommended to use this tool to make a specific mortality expectancy for individuals, but instead to use it to learn more about mortality risks among given subgroups. As amazing as this tool is, take the results with a grain of salt and never make any changes to your treatment plan without consulting your doctor.
How to Use ESTIMATE
Using the ESTIMATE tool is quite simple, all you have to do is enter the following information into the tool and can then hit “calculate” to get your estimate.
- Age at diagnosis
- Tumor size (T)
- Nodal status (N)
- Tumor grade
- Years survived since initial diagnosis
- Subsequent years over which to estimate risk
Other Calculator Options
The ESTIMATE tool isn’t the only calculator that can help breast cancer patients better understand their prognosis after a breast cancer diagnosis. Here’s a few other interesting options that serve different purposes.
- CTS5. The CTS5 tool was developed for the prediction of late distant recurrence for women diagnosed with ER–positive, primary breast cancer who are recurrence–free after 5 years of endocrine therapy. Data from two large clinical trials (ATAC and BIG1–98) were used to develop the CTS5.
- PREDICT. The PREDICT tool applies to women who have had surgery for early invasive breast cancer and who are deciding which other treatments to have.
- MD Anderson Clinical Calculators. MD Anderson offers a variety of different calculators that apply to specific scenarios like the likelihood of residual cancer after a SLN dissection or experiencing additional positive non-sentinel lymph nodes without neoadjuvant chemotherapy.
A Note on Looking Forward
We’re learning more and more about how breast cancer works and how to overcome it as each day passes by. Today’s breast cancer diagnoses and treatment paths are nothing like they were decades ago. The ESTIMATE tool can provide helpful insights, but it does rely on past data to make predictions. Because so many improvements in treatment and survival have been made, this past data may in fact present a more pessimistic view. This data is valuable, but there is reason to be hopeful that recurrence odds may be even less likely than this tool presents.