scholarly journals Screening strategy modification based on personalized breast cancer risk stratification and its implementation in the national guidelines – pilot study

2020 ◽  
Vol 59 (4) ◽  
pp. 211-218
Author(s):  
Mateja Krajc ◽  
D Gareth Evans ◽  
Ana Blatnik ◽  
Katarina Lokar ◽  
Tina Žagar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Risk Groups ◽  
Cancer Risk Assessment ◽  
Ultrasound Screening ◽  
National Guidelines ◽  
Increased Risk ◽  
Breast Cancer Risk Assessment ◽  
Risk Categories

AbstractBackgroundOne of the most consistent models for estimating personalized breast cancer (BC) risk is the Tyrer-Cuzick algorithm that is incorporated into the International Breast Cancer Intervention Study (IBIS) software. Our main objective was to provide criteria for the classification of the Slovenian population, which has BC incidence below the European average, into risk groups, and to evaluate the integration of the criteria in Slovenian guidelines. Our main focus was on women age <50 with higher BC risk, since no organized BC screening is available for these women.MethodsSlovenian age-specific BC risks were incorporated into IBIS software and threshold values of risk categories were determined. Risk categories were assigned according to the individual’s ten-year risk for women aged 40 and older, and lifetime risk for women between 20 and 39. To test the software, we compared screening strategies with the use vs. no use of IBIS.ResultsOf the 197 women included in the study IBIS assigned 75.1% to the BC risk group, and the rest to the moderately increased risk. Without IBIS 80 women were offered mammographic and 33 ultrasound screening. In contrast, 28 instead of 80 would have been offered mammographic screening and there would have been no referrals for ultrasound if IBIS had been used.ConclusionsThe Slovenian IBIS has been developed, tested and suggested for personalized breast cancer risk assessment. The implementation of the software with the consideration of Slovenian risk thresholds enables a more accurate and nationally unified assessment.

scholarly journals Model for Individualized Prediction of Breast Cancer Risk After a Benign Breast Biopsy

2015 ◽  
Vol 33 (8) ◽  
pp. 923-929 ◽  
Author(s):  
V. Shane Pankratz ◽  
Amy C. Degnim ◽  
Ryan D. Frank ◽  
Marlene H. Frost ◽  
Daniel W. Visscher ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Cancer Risk Assessment ◽  
Increased Risk ◽  
Breast Cancer Risk Assessment ◽  
Benign Biopsy

Purpose Optimal early detection and prevention for breast cancer depend on accurate identification of women at increased risk. We present a risk prediction model that incorporates histologic features of biopsy tissues from women with benign breast disease (BBD) and compare its performance to the Breast Cancer Risk Assessment Tool (BCRAT). Methods We estimated the age-specific incidence of breast cancer and death from the Mayo BBD cohort and then combined these estimates with a relative risk model derived from 377 patient cases with breast cancer and 734 matched controls sampled from the Mayo BBD cohort to develop the BBD–to–breast cancer (BBD-BC) risk assessment tool. We validated the model using an independent set of 378 patient cases with breast cancer and 728 matched controls from the Mayo BBD cohort and compared the risk predictions from our model with those from the BCRAT. Results The BBD-BC model predicts the probability of breast cancer in women with BBD using tissue-based and other risk factors. The concordance statistic from the BBD-BC model was 0.665 in the model development series and 0.629 in the validation series; these values were higher than those from the BCRAT (0.567 and 0.472, respectively). The BCRAT significantly underpredicted breast cancer risk after benign biopsy (P = .004), whereas the BBD-BC predictions were appropriately calibrated to observed cancers (P = .247). Conclusion We developed a model using both demographic and histologic features to predict breast cancer risk in women with BBD. Our model more accurately classifies a woman's breast cancer risk after a benign biopsy than the BCRAT.

Breast Cancer Risk Assessment: A Guide for Clinicians Using the NCCN Breast Cancer Risk Reduction Guidelines

2003 ◽  
Vol 1 (2) ◽  
pp. 297-301 ◽  
Author(s):  
Sofia D. Merajver ◽  
Kara Milliron
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Susceptibility ◽  
Susceptibility Gene ◽  
The United States ◽  
Cancer Risk Assessment ◽  
Increased Risk ◽  
Breast Cancer Risk Assessment

Breast cancer, a complex and heterogeneous disease, is the most common malignancy diagnosed in women in the United States, with over 180,000 new cases and approximately 44,000 deaths per year. Breast cancer risk is influenced by a large number of factors, including age, family history, reproductive and hormonal history, proliferative breast conditions, physical activity, diet, and environmental exposures. These factors all interact in a complex manner to contribute to the risk of developing breast cancer. Because the interactions between risk factors are poorly understood at the molecular level, it is difficult to accurately evaluate the breast cancer risk of a given person presenting with an individual constellation of factors. To better define the population at increased risk that may warrant specific intervention, several models exist to estimate a woman's risk for developing breast cancer and for harboring a germline mutation in a cancer susceptibility gene. This article summarizes these models and gives brief guidelines about which model may be preferable given a specific family history.

Application of Breast Cancer Risk Prediction Models in Clinical Practice

2003 ◽  
Vol 21 (4) ◽  
pp. 593-601 ◽  
Author(s):  
Susan M. Domchek ◽  
Andrea Eisen ◽  
Kathleen Calzone ◽  
Jill Stopfer ◽  
Anne Blackwood ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Brca2 Mutation ◽  
Assessment Tools ◽  
Cancer Risk Assessment ◽  
Advantages And Disadvantages ◽  
Increased Risk ◽  
Breast Cancer Risk Assessment

Breast cancer risk assessment provides an estimation of disease risk that can be used to guide management for women at all levels of risk. In addition, the likelihood that breast cancer risk is due to specific genetic susceptibility (such as BRCA1 or BRCA2 mutations) can be determined. Recent developments have reinforced the clinical importance of breast cancer risk assessment. Tamoxifen chemoprevention as well as prevention studies such as the Study of Tamoxifen and Raloxifene are available to women at increased risk of developing breast cancer. In addition, specific management strategies are now defined for BRCA1 and BRCA2 mutation carriers. Risk may be assessed as the likelihood of developing breast cancer (using risk assessment models) or as the likelihood of detecting a BRCA1 or BRCA2 mutation (using prior probability models). Each of the models has advantages and disadvantages, and all need to be interpreted in context. We review available risk assessment tools and discuss their application. As illustrated by clinical examples, optimal counseling may require the use of several models, as well as clinical judgment, to provide the most accurate and useful information to women and their families.

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.

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