IBTR! 2.0: 10-year Ipsilateral Breast Tumor Recurrence (without RT)
The Ipsilateral Breast Tumor Recurrence (IBTR) 2.0 is designed for use by physicians to guide medical decision-making regarding the use of radiation therapy in breast cancer patients who have undergone breast conserving surgery and appropriate axillary evaluation. This model calculates an evidence-based estimate of the 10-year ipsilateral breast tumor recurrence risk with and without the addition of whole breast radiation therapy. 

The IBTR 2.0 is not intended for use in the post-mastectomy setting, and it is not meant to address patients with multicentric disease or with in-situ only disease. It is assumed that all pathological specimens have been microscopically assessed with current histopathological standards. It is presumed that patients who are lymph node positive (with the exception of micrometastatic lymph node disease) will receive systemic therapy, either chemotherapy or hormonal therapy. The calculated benefit of hormonal therapy in this model is based on the tamoxifen literature and has been extrapolated to the use of aromatase inhibitors. Recent studies indicate that aromatase inhibitors have a similar, and possibly a slightly superior, impact on local control. 
Research authors: Mona Sanghani, Pauline T. Truong, Rita Abi Raad, Andrzej Niemierko, Mary Lesperance, Ivo A. Olivotto, David E. Wazer, Alphonse G. Taghian
Version: 1.3
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10-Year risk of ipsilateral breast tumor recurrence without radiation therapy is: %

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The arm of the IBTR! nomogram that calculates local recurrence risk with radiation has undergone rigorous validation testing with collaboration of two large institutional datasets. The calculation of local recurrence risk without radiation has not been validated because of unavailability of a large diverse cohort of patients that did not receive radiation therapy. Therefore the predicted recurrence risk without radiation therapy is based on the consistent relative risk reduction of 0.7 seen across multiple randomized trials with the use of breast irradiation.

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This model is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.

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