SCREENING MAMMOGRAPHY

Background: Worry about risk for breast cancer and pain are associated withmammography use. Both have been found to be a barrier to mammography use by women.Objective: To examine the anxiety and pain associated with mammography use in a sample ofwomen stratified according to breast cancer risk. Design: This prospective observational study.Setting: Department of Obstetric and Gynecology, Benazir Bhutto Hospital. Period: August2011 to June 2012. Patients & Methods: Women awaiting screening mammography in thereception area were asked to complete a questionnaire containing demographics for calculationof breast cancer risk and the Likert scale for anxiety before the procedure and VAS forassessment of pain after the procedure. Results: Our study included 100 women undergoingscreening mammography with an average age of 53.9±8.8 years. 15% were classified “higherrisk” by the Gail model. The average anxiety level was 4.03±1.3 on Likert scale and average painduring the procedure was 3.3±2.18 on VAS. Significant differences (p<0.05) were foundbetween average and higher risk groups. Conclusions: The population of women in this sampleappears to have a level of breast cancer worry and procedure related pain that is proportionalwith their risk for developing breast cancer.

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Stratification of 5-year cancer detection rate in an organized breast screening program based on Gail model risk factors.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.7 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 7-7

Author(s):

Rasika Rajapakshe ◽

Brent Parker ◽

Cynthia Araujo ◽

Stephanie Ruscheinsky ◽

Steven McAvoy ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Cancer Detection ◽

Breast Screening ◽

The United States ◽

Screening Mammography ◽

Model Parameters ◽

Gail Model ◽

Screening Programs

7 Background: The Gail model has been validated in the United States and several European countries, but to our knowledge, it has not been validated in organized breast screening programs in Canada. The Screening Mammography Program of British Columbia (SMPBC) records participant data from a questionnaire based on Gail model parameters (which include family and personal medical history). This study investigates whether the Gail model is a valid tool to predict the breast cancer risk for the population undergoing screening mammography in the province of BC. Methods: Client information of the 223,349 British Columbian women who participated in the year 2000, along with their tumor status from 2000-2004, was extracted from the provincial database. A software program was developed to rapidly calculate the absolute 5-year Gail score from questionnaire data. Participant data was separated into .5% risk intervals and also into quintiles based on increasing Gail scores, and the mean absolute risks were compared to the actual five year rate of cancer as detected by the SMPBC. Results: Overall, goodness of fit between Gail score and SMPBC detection (E/O) across the categories can be rejected (χ2=247.9, df=9, p value < .001). The Gail model significantly underpredicts the cancer detection for risk categories up to 2%, however it provides a sufficient fit for categories 2%-4% as the E/O ratio is not significantly different from 1.0 in these intervals. For the highest risk interval, categorized as greater than 4% risk, the model significantly overpredicts cancer detection. Additionally, when presented in quintiles, the Gail model under-predicts risk in all but the highest quintile (1.77-11.43% risk range). Conclusions: Our results, based on participants of SMPBC, suggest that the Gail model significantly under-predicts cancer detection. Although this model provides a sufficient fit for women with a Gail score between 1.51-4%, it does not predict breast cancer risk accurately for low and high risk women in the Screening Mammography Program of BC.

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Accuracy of Self-Reported Screening Mammography Use: Examining Recall among Female Relatives from the Ontario Site of the Breast Cancer Family Registry

ISRN Oncology ◽

10.1155/2013/810573 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Meghan J. Walker ◽

Anna M. Chiarelli ◽

Lucia Mirea ◽

Gord Glendon ◽

Paul Ritvo ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Familial Risk ◽

Screening Mammography ◽

Multinomial Regression ◽

Breast Cancer Family ◽

Cancer Family ◽

Almost All ◽

Mammography Use

Evidence of the accuracy of self-reported mammography use among women with familial breast cancer risk is limited. This study examined the accuracy of self-reported screening mammography dates in a cohort of 1,114 female relatives of breast cancer cases, aged 26 to 73 from the Ontario site of the Breast Cancer Family Registry. Self-reported dates were compared to dates abstracted from imaging reports. Associations between inaccurate recall and subject characteristics were assessed using multinomial regression. Almost all women (95.2% at baseline, 98.5% at year 1, 99.8% at year 2) accurately reported their mammogram use within the previous 12 months. Women at low familial risk (OR = 1.77, 95% CI: 1.00–3.13), who reported 1 or fewer annual visits to a health professional (OR = 1.97, 95% CI: 1.15, 3.39), exhibited a lower perceived breast cancer risk (OR = 1.90, 95% CI: 1.15, 3.15), and reported a mammogram date more than 12 months previous (OR = 5.22, 95% CI: 3.10, 8.80), were significantly more likely to inaccurately recall their mammogram date. Women with varying levels of familial risk are accurate reporters of their mammogram use. These results present the first evidence of self-reported mammography recall accuracy among women with varying levels of familial risk.

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Screening Mammography: Patient Perceptions and Preferences Regarding Communication of Estimated Breast Cancer Risk

American Journal of Roentgenology ◽

10.2214/ajr.16.16779 ◽

2017 ◽

Vol 208 (5) ◽

pp. 1163-1170 ◽

Cited By ~ 7

Author(s):

Nita Amornsiripanitch ◽

Mark Mangano ◽

Bethany L. Niell

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Screening Mammography ◽

Patient Perceptions

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Utility of relative and absolute measures of mammographic densityvsclinical risk factors in evaluating breast cancer risk at time of screening mammography

British Journal of Radiology ◽

10.1259/bjr.20150522 ◽

2016 ◽

Vol 89 (1059) ◽

pp. 20150522 ◽

Cited By ~ 7

Author(s):

Mohamed Abdolell ◽

Kaitlyn M Tsuruda ◽

Christopher B Lightfoot ◽

Jennifer I Payne ◽

Judy S Caines ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Screening Mammography

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A streamlined model for use in clinical breast cancer risk assessment maintains predictive power and is further improved with inclusion of a polygenic risk score

PLoS ONE ◽

10.1371/journal.pone.0245375 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245375

Author(s):

Richard Allman ◽

Erika Spaeth ◽

John Lai ◽

Susan J. Gross ◽

John L. Hopper

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

African American ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Risk Score ◽

Clinical Risk Factors ◽

Polygenic Risk Score ◽

Gail Model ◽

Clinical Risk

Five-year absolute breast cancer risk prediction models are required to comply with national guidelines regarding risk reduction regimens. Models including the Gail model are under-utilized in the general population for various reasons, including difficulty in accurately completing some clinical fields. The purpose of this study was to determine if a streamlined risk model could be designed without substantial loss in performance. Only the clinical risk factors that were easily answered by women will be retained and combined with an objective validated polygenic risk score (PRS) to ultimately improve overall compliance with professional recommendations. We first undertook a review of a series of 2,339 Caucasian, African American and Hispanic women from the USA who underwent clinical testing. We first used deidentified test request forms to identify the clinical risk factors that were best answered by women in a clinical setting and then compared the 5-year risks for the full model and the streamlined model in this clinical series. We used OPERA analysis on previously published case-control data from 11,924 Gail model samples to determine clinical risk factors to include in a streamlined model: first degree family history and age that could then be combined with the PRS. Next, to ensure that the addition of PRS to the streamlined model was indeed beneficial, we compared risk stratification using the Streamlined model with and without PRS for the existing case-control datasets comprising 1,313 cases and 10,611 controls of African-American (n = 7421), Caucasian (n = 1155) and Hispanic (n = 3348) women, using the area under the curve to determine model performance. The improvement in risk discrimination from adding the PRS risk score to the Streamlined model was 52%, 46% and 62% for African-American, Caucasian and Hispanic women, respectively, based on changes in log OPERA. There was no statistically significant difference in mean risk scores between the Gail model plus risk PRS compared to the Streamlined model plus PRS. This study demonstrates that validated PRS can be used to streamline a clinical test for primary care practice without diminishing test performance. Importantly, by eliminating risk factors that women find hard to recall or that require obtaining medical records, this model may facilitate increased clinical adoption of 5-year risk breast cancer risk prediction test in keeping with national standards and guidelines for breast cancer risk reduction.

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