Belgian validation of the INFLUENCE 3.0 model predicting 5-year locoregional and contralateral breast cancer recurrence.
5 affiliations
- 1Department of Radiation Oncology, UZ Leuven, Herestraat 49, Leuven, 3000, Belgium.
- 2Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands.
- 3Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands. Electronic address: [email protected].
- 4Evidencio Medical Decision Support, Haaksbergen, the Netherlands.
- 5Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
Abstract
Background
Breast cancer (BC) surveillance primarily aims to detect locoregional recurrence (LRR) and contralateral breast cancer (CBC), but current strategies are largely one-size-fits-all and not tailored to individual risks. The Dutch INFLUENCE 3.0 prediction model provides personalised 5-year LRR and CBC risks to support shared decision-making on surveillance. In this study, INFLUENCE 3.0 is externally validated in a Belgian population.Methods
All female BC patients curatively treated between 2000 and 2018 at the University Hospitals of Leuven were included. Calibration was assessed using the Integrated Calibration Index (ICI), E50, E90 metrics, and calibration plots. Discrimination was evaluated by calculating the Area Under the Curve (AUC) for each year, based on cumulative events up to that year.Results
The final Leuven cohort included 8548 patients, of whom 7549 were not treated with neoadjuvant systemic therapy (non-NST) and 999 were (NST). Calibration metrics were generally acceptable, with ICI and E50 values below 0.01 in most subgroups. Calibration plots showed overestimation of predicted risks, particularly at lower predicted risk levels. Discrimination for LRR risk was good to very good (AUC 0.72-0.86 in the non-NST group; >0.82 in the NST group). For CBC risk, discrimination was poor in the non-NST group (AUC ≈ 0.5) and moderate-to-very good in the NST group (AUC 0.68-0.88).Conclusion
INFLUENCE 3.0 showed acceptable calibration and discrimination for LRR risk, and although CBC risk discrimination in the non-NST group was poor. The overall risk estimates - primarily the LRR risks - may still help in guiding tailored surveillance schemes.
Related
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BibTeX
@article{vorst2026belgian,
title = {{Belgian validation of the INFLUENCE 3.0 model predicting 5-year locoregional and contralateral breast cancer recurrence.}},
author = {Aline van der Vorst and Carlijn Grimberg and Marissa C van Maaren and Tom A Hueting and Caroline Weltens and Sabine Siesling and Catharina G M Groothuis-Oudshoorn},
journal = {Breast (Edinburgh, Scotland)},
year = {2026},
month = oct,
doi = {10.1016/j.breast.2026.104944},
url = {https://europepmc.org/article/MED/42858729},
note = {CC BY},
}
RIS
TY - JOUR
TI - Belgian validation of the INFLUENCE 3.0 model predicting 5-year locoregional and contralateral breast cancer recurrence.
AU - Aline van der Vorst
AU - Carlijn Grimberg
AU - Marissa C van Maaren
AU - Tom A Hueting
AU - Caroline Weltens
AU - Sabine Siesling
AU - Catharina G M Groothuis-Oudshoorn
PY - 2026
DA - 2026/10/07
JO - Breast (Edinburgh, Scotland)
DO - 10.1016/j.breast.2026.104944
UR - https://europepmc.org/article/MED/42858729
AB - Background Breast cancer (BC) surveillance primarily aims to detect locoregional recurrence (LRR) and contralateral breast cancer (CBC), but current strategies are largely one-size-fits-all and not tailored to individual risks. The Dutch INFLUENCE 3.0 prediction model provides personalised 5-year LRR and CBC risks to support shared decision-making on surveillance. In this study, INFLUENCE 3.0 is externally validated in a Belgian population.Methods All female BC patients curatively treated between 2000 and 2018 at the University Hospitals of Leuven were included. Calibration was assessed using the Integrated Calibration Index (ICI), E50, E90 metrics, and calibration plots. Discrimination was evaluated by calculating the Area Under the Curve (AUC) for each year, based on cumulative events up to that year.Results The final Leuven cohort included 8548 patients, of whom 7549 were not treated with neoadjuvant systemic therapy (non-NST) and 999 were (NST). Calibration metrics were generally acceptable, with ICI and E50 values below 0.01 in most subgroups. Calibration plots showed overestimation of predicted risks, particularly at lower predicted risk levels. Discrimination for LRR risk was good to very good (AUC 0.72-0.86 in the non-NST group; >0.82 in the NST group). For CBC risk, discrimination was poor in the non-NST group (AUC ≈ 0.5) and moderate-to-very good in the NST group (AUC 0.68-0.88).Conclusion INFLUENCE 3.0 showed acceptable calibration and discrimination for LRR risk, and although CBC risk discrimination in the non-NST group was poor. The overall risk estimates - primarily the LRR risks - may still help in guiding tailored surveillance schemes.
SN - 0960-9776
SN - 1532-3080
ER -