scholarly journals BREAst screening Tailored for HEr (BREATHE) - A Study Protocol On Personalised Risk-based Breast Cancer Screening Programme

2021 ◽  
Author(s):  
Jenny Liu ◽  
Peh Joo Ho ◽  
Tricia Hui Ling Tan ◽  
Yen Shing Yeoh ◽  
Ying Jia Chew ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Risk Prediction ◽  
Mammography Screening ◽  
Breast Screening ◽  
Screening Programme ◽  
Early Stage ◽  
Polygenic Risk Score ◽  
National Implementation

Background: Routine mammography screening is currently the standard tool for finding cancers at an early stage, when treatment is most successful. Current breast screening programmes are one-size-fits-all which all women above a certain age threshold are encouraged to participate. However, breast cancer risk varies by individual. The BREAst screening Tailored for HEr (BREATHE) study aims to assess acceptability of a comprehensive risk-based personalised breast screening in Singapore. Methods/Design: Advancing beyond the current age-based screening paradigm, BREATHE integrates both genetic and non-genetic breast cancer risk prediction tools to personalise screening recommendations. BREATHE is a cohort study targeting to recruit ~3,500 women. The first recruitment visit will include questionnaires and a buccal cheek swab. After receiving a tailored breast cancer risk report, participants will attend an in-person risk review, followed by a final session assessing the acceptability of our risk stratification programme. Risk prediction is based on: a) Gail model (non-genetic), b) mammographic density and recall, c) BOADICEA predictions (breast cancer predisposition genes), and d) breast cancer polygenic risk score. Discussion: For national implementation of personalised risk-based breast screening, exploration of the acceptability within the target populace is critical, in addition to validated predication tools. To our knowledge, this is the first study to implement a comprehensive risk-based mammography screening programme in Asia. The BREATHE study will provide essential data for policy implementation which will transform the health system to deliver a better health and healthcare outcomes.

scholarly journals Testing a breast cancer prevention and a multiple disease prevention weight loss programme amongst women within the UK NHS breast screening programme—a randomised feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Michelle Harvie ◽  
David P. French ◽  
Mary Pegington ◽  
Grace Cooper ◽  
Anthony Howell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Disease Prevention ◽  
Cancer Prevention ◽  
Behaviour Change ◽  
Breast Screening ◽  
Screening Programme ◽  
Breast Screening Programme

Abstract Background Excess weight and unhealthy behaviours (e.g. sedentariness, high alcohol) are common amongst women including those attending breast screening. These factors increase the risk of breast cancer and other diseases. We tested the feasibility and acceptability of a weight loss/behaviour change programme framed to reduce breast cancer risk (breast cancer prevention programme, BCPP) compared to one framed to reduce risk of breast cancer, cardiovascular disease (CVD) and diabetes (T2D) (multiple disease prevention programme, MDPP). Methods Women aged 47-73 years with overweight or obesity (n = 1356) in the NHS Breast Screening Programme (NHSBSP) were randomised (1:2) to be invited to join a BCPP or a MDPP. The BCPP included personalised information on breast cancer risk and a web and phone weight loss/behaviour change intervention. The MDPP also included an NHS Health Check (lipids, blood pressure, HbA1c and personalised feedback for risk of CVD [QRISK2] and T2D [QDiabetes and HbA1c]). Primary outcomes were uptake and retention and other feasibility outcomes which include intervention fidelity and prevalence of high CVD and T2D risk. Secondary outcomes included change in weight. Results The BCPP and MDPP had comparable rates of uptake: 45/508 (9%) vs. 81/848 (10%) and 12-month retention; 33/45 (73%) vs. 53/81 (65%). Both programmes had a high fidelity of delivery with receipt of mean (95% CI) 90 (88-98% of scheduled calls, 91 (86-95%) of scheduled e-mails and 89 (76-102) website entries per woman over the 12-month period. The MDPP identified 15% of women with a previously unknown 10-year CVD QRISK2 of ≥ 10% and 56% with 10-year Qdiabetes risk of ≥ 10%. Both groups experienced good comparable weight loss: BCPP 26/45 (58%) and MDPP 46/81 (57%) with greater than 5% weight loss at 12 months using baseline observation carried forward imputation. Conclusions Both programmes appeared feasible. The MDPP identified previously unknown CVD and T2D risk factors but does not appear to increase engagement with behaviour change beyond a standard BCPP amongst women attending breast screening. A future definitive effectiveness trial of BCPP is supported by acceptable uptake and retention, and good weight loss. Trial registration ISRCTN91372184, registered 28 September 2014.

scholarly journals The Discovery of Breast Cancer Risk Gene and Establishment of Prediction Model Based on Estrogen Metabolism Regulation

2020 ◽  
Author(s):  
Feng Zhao ◽  
Zhixiang Hao ◽  
Yanan Zhong ◽  
Yinxue Xu ◽  
Meng Guo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Prediction Model ◽  
Risk Prediction ◽  
Risk Score ◽  
Healthy Subjects ◽  
Estrogen Metabolism ◽  
Polygenic Risk Score ◽  
Polygenic Risk

Abstract Background In this study, we aim to uncover the relationship between estrogen levels and the genetic polymorphism of estrogen metabolism-related enzymes with breast cancer (BC) and establish a risk prediction model based on polygenic risk score. Methods Unrelated BC patients and healthy subjects were recruited for analysis of the estrogen levels and the single nucleotide polymorphisms (SNPs) of estrogen metabolism-related enzymes. The polygenic risk score (PRS) was used to explore the combined effect of multiple genes which was calculated using a Bayesian approach. The independent sample t test was used to evaluate the difference between PRS scores of BC and healthy subjects. Discriminatory accuracy of the models was compared using the area under the receiver operating characteristic curve (ROC). Results The estrogen homeostasis profile was disturbed in BC patients, with parent estrogens (E1, E2) and carcinogenic catechol estrogens (2/4-OHE1, 2-OHE2, 4-OHE2) significantly accumulated in the serum of BC patients. Then,we established PRS model to evaluate the role of multiple genes SNPs. The PRS model 1 (M1) was established from 6 GWAS-identified high risk genes SNPs. On the basis of M1, we added 7 estrogen metabolism enzyme genes SNPs to establish PRS model 2 (M2). The independent sample t test results show that there is no difference between BC and healthy subjects in M1 (P = 0.17), however, there is significant difference between BC and healthy subjects in M2 (P = 4.9*10− 5). The ROC curve results also show that the accuracy of M2 (AUC = 62.18%) in breast cancer risk identification was better than M1 (AUC = 54.56%). Conclusion Estrogens and the related metabolic enzymes gene polymorphisms are closely related to BC. The model constructed by adding estrogen metabolic enzyme genes SNPs has a good ability in breast cancer risk prediction, and the accuracy is greatly improved comparing PRS model only includes GWAS-identified genes SNPs.

scholarly journals Breast cancer risk prediction using a clinical risk model and polygenic risk score

2016 ◽  
Vol 159 (3) ◽  
pp. 513-525 ◽  
Author(s):  
Yiwey Shieh ◽  
Donglei Hu ◽  
Lin Ma ◽  
Scott Huntsman ◽  
Charlotte C. Gard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Risk Prediction ◽  
Risk Score ◽  
Risk Model ◽  
Polygenic Risk Score ◽  
Polygenic Risk ◽  
Clinical Risk

scholarly journals Developing and validating an individualized breast cancer risk prediction model for women attending breast cancer screening

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248930
Author(s):  
Javier Louro ◽  
Marta Román ◽  
Margarita Posso ◽  
Ivonne Vázquez ◽  
Francina Saladié ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Prediction Model ◽  
Risk Prediction ◽  
Mammography Screening ◽  
Benign Breast Disease ◽  
Characteristic Curve ◽  
Breast Disease ◽  
Risk Prediction Model

Background Several studies have proposed personalized strategies based on women’s individual breast cancer risk to improve the effectiveness of breast cancer screening. We designed and internally validated an individualized risk prediction model for women eligible for mammography screening. Methods Retrospective cohort study of 121,969 women aged 50 to 69 years, screened at the long-standing population-based screening program in Spain between 1995 and 2015 and followed up until 2017. We used partly conditional Cox proportional hazards regression to estimate the adjusted hazard ratios (aHR) and individual risks for age, family history of breast cancer, previous benign breast disease, and previous mammographic features. We internally validated our model with the expected-to-observed ratio and the area under the receiver operating characteristic curve. Results During a mean follow-up of 7.5 years, 2,058 women were diagnosed with breast cancer. All three risk factors were strongly associated with breast cancer risk, with the highest risk being found among women with family history of breast cancer (aHR: 1.67), a proliferative benign breast disease (aHR: 3.02) and previous calcifications (aHR: 2.52). The model was well calibrated overall (expected-to-observed ratio ranging from 0.99 at 2 years to 1.02 at 20 years) but slightly overestimated the risk in women with proliferative benign breast disease. The area under the receiver operating characteristic curve ranged from 58.7% to 64.7%, depending of the time horizon selected. Conclusions We developed a risk prediction model to estimate the short- and long-term risk of breast cancer in women eligible for mammography screening using information routinely reported at screening participation. The model could help to guiding individualized screening strategies aimed at improving the risk-benefit balance of mammography screening programs.

scholarly journals Testing a Breast Cancer Prevention and a Multiple Disease Prevention Weight Loss Programme Among Women Within The UK NHS Breast Screening Programme - A Randomised Feasibility Study

2020 ◽  
Author(s):  
Michelle Harvie ◽  
David P French ◽  
Mary Pegington ◽  
Grace Cooper ◽  
Anthony Howell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Disease Prevention ◽  
Cancer Prevention ◽  
Behaviour Change ◽  
Breast Screening ◽  
Screening Programme ◽  
Breast Screening Programme

Abstract Excess weight and unhealthy behaviours (sedentariness, high alcohol and suboptimal diet) are common among women attending breast screening. These factors increase the risk of breast cancer and other diseases. We tested the feasibility and acceptability of a weight loss/ behaviour change programme framed to reduce breast cancer risk (breast cancer prevention programme, BCPP) compared to one framed to reduce risk of breast cancer, cardiovascular disease (CVD) and diabetes (T2D) (multiple disease prevention programme, MDPP). Methods Women aged 47-73 years with overweight or obesity (n=1356) in the NHS Breast Screening Programme (NHSBSP) were randomized (1:2) to be invited to join a BCPP or a MDPP. The BCPP included personalised information on individual level of breast cancer risk and a web and phone weight loss/behaviour change intervention. The MDPP also included an NHS Health Check (lipids, blood pressure, HbA1c and personalised feedback for risk of CVD [QRISK2] and T2D [QDiabetes and HbA1c]). Uptake, retention, change in weight, and potential harms (anxiety and self-rated health) were assessed, along with the numbers in the MDPP with previously unknown CVD and T2D risk.ResultsThe BCPP and MDPP had comparable rates of uptake; 45/508 (9%) vs. 81/848 (10%) 12-month retention; 33/45 (73%) vs. 53/81 (65%) and numbers (%) losing ≥5% body weight at 12 months; 26/45 (58%) vs. 46/81 (57%) with baseline observation carried forward imputation. Both groups experienced reductions in state anxiety score; BCPP (n=37) -0.7 (-4.6 to 3.2), MDPP (n=60) -3.5 (-6.7 to -0.4) and an increase in the EQ-5D-5L score; BCPP (n=40) 4.1 (0.6 to 7.6), MDPP (n=60) 7.3 (3.6 to 11.1). The MDPP identified 15% of women with a previously unknown 10 year CVD QRISK2 of ≥10% and 56% with 10-year Qdiabetes risk of ≥10%.ConclusionsThe MDPP identified previously unknown CVD and T2D risk factors but does not appear to increase engagement with behaviour change beyond a standard BCPP amongst women attending breast screening. The results suggest a definitive effectiveness trial of the BCPP intervention is warranted, with acceptable uptake and retention, and a clear weight loss signal.Trial Registration ISRCTN91372184, https://doi.org/10.1186/ISRCTN91372184, registered 28 September 2014.

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