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Table 4 Clinical utility of the 10-year contralateral breast cancer risk prediction models (PredictCBC-1A with PredictCBC-2.0A and PredictCBC-1B with PredictCBC-2.0B)

From: PredictCBC-2.0: a contralateral breast cancer risk prediction model developed and validated in ~ 200,000 patients

PredictCBC-1A and PredictCBC-2.0A

Probability threshold pt (%)

Unnecessary CPMs needed to detect one necessary CPM*

BRCA1/2 mutation carriers

Non-carriers

Net benefit versus treat all patients with CPM (per 1000)

Avoided unnecessary CPMs per 1000 patients using PredictCBC-1A

Additional avoided unnecessary CPMs per 1000 patients using PredictCBC-2.0A

Net benefit versus treat none (per 1000)

Performed necessary CPMs per 1000 patients using PredictCBC-1A

Additional performed necessary CPMs per 1000 patients using PredictCBC-2.0A

4

24

0.1

0.3

1.9

4.8

115.7

15.3

6

15.7

No benefit

0.0

20.0

0.6

9.3

22.9

8

11.5

3.5

40.6

52.0

No benefit

0.0

9.0

10

9.0

8.5

76.9

50.2

No benefit

0.0

3.4

12

7.3

22.4

164.0

15.0

No benefit

0.0

1.1

PredictCBC-1B and PredictCBC-2.0B

Probability threshold pt (%)

Unnecessary CPMs needed to detect one necessary CPM*

Family history

No family history

Net benefit versus treat all patients with CPM (per 1000)

Avoided unnecessary CPMs per 1000 patients using PredictCBC-1B

Additional avoided unnecessary CPMs per 1000 patients using PredictCBC-2.0B

Net benefit versus treat none (per 1000)

Performed necessary CPMs per 1000 patients using PredictCBC-1B

Additional performed necessary CPMs per 1000 patients using PredictCBC-2.0B

4

24

3.4

80.8

5.9

5.4

130.4

0.0

5

19

9.4

177.9

0.0

2.4

46.5

0.1

6

15.7

15.9

248.7

4.0

0.5

7.1

7.5

  1. For PredictCBC versions 1A and 2.0A, at the same probability threshold, the net benefit is exemplified in BRCA1/2 mutation carriers (for avoiding unnecessary CPM) and non-carriers (performing necessary CPM). For PredictCBC versions 1B and 2.0B, at the same probability threshold, the net benefit is exemplified in patients with family history (for avoiding unnecessary CPM) and patients without family history (performing necessary CPM)
  2. CPM contralateral preventive mastectomy
  3. *The number of unnecessary contralateral mastectomies needed to detect one necessary CPM is calculated by: (1 − pt)/pt