scholarly journals Evaluation of the Tyrer-Cuzick (International Breast Cancer Intervention Study) Model for Breast Cancer Risk Prediction in Women With Atypical Hyperplasia

2010 ◽  
Vol 28 (22) ◽  
pp. 3591-3596 ◽  
Author(s):  
Judy C. Boughey ◽  
Lynn C. Hartmann ◽  
Stephanie S. Anderson ◽  
Amy C. Degnim ◽  
Robert A. Vierkant ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Invasive Breast Cancer ◽  
Atypical Hyperplasia ◽  
Cancer Development ◽  
Cancer Risk Assessment ◽  
Individual Risk ◽  
Breast Cancer Development ◽  
Breast Cancer Risk Assessment

Purpose Accurate breast cancer risk assessment is vital to personalize screening and risk reduction strategies. Women with atypical hyperplasia have a four-fold higher risk of breast cancer. We evaluated the performance of the Tyrer-Cuzick model, which was designed to predict 10-year risk of breast cancer development, in a well-defined cohort of women with atypia. Patients and Methods The Mayo Benign Breast Disease cohort includes 9,376 women who had a benign breast biopsy between 1967 and 1991. Among those, 331 women with atypia were identified by our study pathologists. Risk factor data for the Tyrer-Cuzick model were collated for each woman and used to predict individual risk of developing invasive breast cancer within 10 years. Results Over a median follow-up of 14.6 years, 64 (19%) of the 331 women developed invasive breast cancer. In the first 10 years after biopsy, 31 women developed invasive breast cancer whereas the Tyrer-Cuzick model predicted 58.9. The observed-to-predicted ratio was 0.53 (95% CI, 0.37 to 0.75). The concordance statistic was 0.540, revealing that the Tyrer-Cuzick model did not accurately distinguish, on an individual level, between women who developed invasive breast cancer and those who did not. Conclusion The Tyrer-Cuzick model significantly overestimated risk of breast cancer for women with atypia, and individual risk estimates showed poor concordance between predicted risk and invasive breast cancer development. Thus, we cannot recommend the use of the Tyrer-Cuzick model to predict 10-year breast cancer risk in women with atypical hyperplasia.

Ductal Lavage for Breast Cancer Risk Assessment

2002 ◽  
Vol 9 (6) ◽  
pp. 473-479 ◽  
Author(s):  
Lisa A. Newman ◽  
Cassann Blake
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Invasive Procedure ◽  
Ductal Lavage ◽  
Atypical Hyperplasia ◽  
Cancer Risk Assessment ◽  
Accurate Identification ◽  
Increased Risk ◽  
Breast Cancer Risk Assessment

Background Effective chemoprevention is available for breast cancer, but it is associated with the potential for life-threatening adverse events. Accurate identification of women facing increased risk of breast cancer is therefore essential. Atypical hyperplasia is a histopathologic pattern that has been consistently associated with an elevated future risk of breast cancer. Methods The literature was reviewed to assess the strength of the association between atypical hyperplasia and breast cancer. The rationale for developing a nonsurgical modality to document the presence of atypia is discussed. Results Ductal lavage identifies atypical hyperplasia by retrieving epithelial cells shed into the ductal system with a specially designed catheter. Women with clinical evidence of increased breast cancer risk may consider ductal lavage as a means of determining whether abnormal proliferative activity is occurring in their breasts at a given point in time from ducts yielding fluid. Conclusions Ductal lavage is a minimally invasive procedure that facilitates the detection of atypia via retrieval of breast ductal fluid that can be evaluated cytologically. It can facilitate the selection of women who may benefit from breast cancer risk reduction intervention.

scholarly journals SNPs for breast cancer risk assessment

Oncotarget ◽  
2017 ◽  
Vol 8 (59) ◽  
pp. 99211-99212 ◽  
Author(s):  
Jack Cuzick ◽  
Adam Brentnall ◽  
Mitchell Dowsett
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Risk Assessment ◽  
Breast Cancer Risk Assessment

scholarly journals Bayesian joint ordinal and survival modeling for breast cancer risk assessment

2016 ◽  
Vol 35 (28) ◽  
pp. 5267-5282 ◽  
Author(s):  
C. Armero ◽  
C. Forné ◽  
M. Rué ◽  
A. Forte ◽  
H. Perpiñán ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Risk Assessment ◽  
Breast Cancer Risk Assessment ◽  
Survival Modeling

scholarly journals Commentary ACOG Practice Bulletin July 2017: Breast Cancer Risk Assessment and Screening in Average-Risk Women

2018 ◽  
Vol 91 (1090) ◽  
pp. 20170907 ◽  
Author(s):  
Victoria Mango ◽  
Yolanda Bryce ◽  
Elizabeth Anne Morris ◽  
Elisabetta Gianotti ◽  
Katja Pinker
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Risk Assessment ◽  
Average Risk ◽  
Breast Cancer Risk Assessment

scholarly journals Addressing Barriers to Uptake of Breast Cancer Chemoprevention for Patients and Providers

2015 ◽  
pp. e50-e58 ◽  
Author(s):  
Katherine D. Crew
Keyword(s):  
Breast Cancer ◽  
Primary Prevention ◽  
High Risk ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Chemoprevention ◽  
The United States ◽  
Cancer Risk Assessment ◽  
Breast Cancer Risk Assessment ◽  
Breast Cancer Chemoprevention

Breast cancer is the most common malignancy among women in the United States, and the primary prevention of this disease is a major public health issue. Because there are relatively few modifiable breast cancer risk factors, pharmacologic interventions with antiestrogens have the potential to significantly affect the primary prevention setting. Breast cancer chemoprevention with selective estrogen receptor modulators (SERMs) tamoxifen and raloxifene, and with aromatase inhibitors (AIs) exemestane and anastrozole, is underutilized despite several randomized controlled trials demonstrating up to a 50% to 65% relative risk reduction in breast cancer incidence among women at high risk. An estimated 10 million women in the United States meet high-risk criteria for breast cancer and are potentially eligible for chemoprevention, but less than 5% of women at high risk who are offered antiestrogens for primary prevention agree to take it. Reasons for low chemoprevention uptake include lack of routine breast cancer risk assessment in primary care, inadequate time for counseling, insufficient knowledge about antiestrogens among patients and providers, and concerns about side effects. Interventions designed to increase chemoprevention uptake, such as decision aids and incorporating breast cancer risk assessment into clinical practice, have met with limited success. Clinicians can help women make informed decisions about chemoprevention by effectively communicating breast cancer risk and enhancing knowledge about the risks and benefits of antiestrogens. Widespread adoption of chemoprevention will require a major paradigm shift in clinical practice for primary care providers (PCPs). However, enhancing uptake and adherence to breast cancer chemoprevention holds promise for reducing the public health burden of this disease.

scholarly journals The iPrevent Online Breast Cancer Risk Assessment and Risk Management Tool: Usability and Acceptability Testing

2018 ◽  
Vol 2 (2) ◽  
pp. e24 ◽  
Author(s):  
Louisa L Lo ◽  
Ian M Collins ◽  
Mathias Bressel ◽  
Phyllis Butow ◽  
Jon Emery ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Risk Management ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Risk Assessment ◽  
Management Tool ◽  
Breast Cancer Risk Assessment
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