breast cancer risk assessment
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Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 45
Author(s):  
Anne Marie McCarthy ◽  
Yi Liu ◽  
Sarah Ehsan ◽  
Zoe Guan ◽  
Jane Liang ◽  
...  

(1) Background: The purpose of this study is to compare the performance of four breast cancer risk prediction models by race, molecular subtype, family history of breast cancer, age, and BMI. (2) Methods: Using a cohort of women aged 40–84 without prior history of breast cancer who underwent screening mammography from 2006 to 2015, we generated breast cancer risk estimates using the Breast Cancer Risk Assessment tool (BCRAT), BRCAPRO, Breast Cancer Surveillance Consortium (BCSC) and combined BRCAPRO+BCRAT models. Model calibration and discrimination were compared using observed-to-expected ratios (O/E) and the area under the receiver operator curve (AUC) among patients with at least five years of follow-up. (3) Results: We observed comparable discrimination and calibration across models. There was no significant difference in model performance between Black and White women. Model discrimination was poorer for HER2+ and triple-negative subtypes compared with ER/PR+HER2−. The BRCAPRO+BCRAT model displayed improved calibration and discrimination compared to BRCAPRO among women with a family history of breast cancer. Across models, discriminatory accuracy was greater among obese than non-obese women. When defining high risk as a 5-year risk of 1.67% or greater, models demonstrated discordance in 2.9% to 19.7% of patients. (4) Conclusions: Our results can inform the implementation of risk assessment and risk-based screening among women undergoing screening mammography.


Author(s):  
Rufina Soomro ◽  
Rabia Niaz

Background: Breast cancer incidence is highest in Pakistan among Asian countries. The known risk factors are family history, hormonal exposure, benign proliferative diseases, and high mammographic density which are included in the TyrerCuzick model. The model needs validation studies to implement in prediction, screening, and prevention strategies among different populations. This study aims to validate the TyrerCuzick model for Pakistan's females. Methods and Materials: A total of 317 biopsy-proven breast cancer patients from the breast surgery clinic at Liaquat National Hospital were included. The 10 years risk score is calculated by applying the TyrerCuzick model software. Subcategories of low risk <2%, moderate risk 2-7%, and high risk >8% were identified. Further risk group stratification is done to find the association with individual factors i.e., age group, menopausal status, family history, and mammographic density. Results: The mean TyrerCuzick score was low to moderate i.e. 2.23±1.66. The score was distributed as low risk 174(54.9%), moderate risk 137(43.2%), and high risk 6(1.9%). Low risk was observed among 116(81.7%) of less than 50 years old, 105(78.9%) premenopausal, 113(59.8%) with no family history, and 120 patients (59.7%) with low mammographic density. Most of the moderate risk was found in 113(64.6%) of more than 50 years old, 109(60.2%) with postmenopausal, 24(61.5%) with family history, 58(50%) with high mammographic density respectively. Conclusion: The TyrerCuzick model can predict risk for developing breast cancer among Pakistan’s femalesclose to accurate among older age, postmenopausal, family history of breast cancer, and high mammographic density.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hashim Talib Hashim ◽  
Mustafa Ahmed Ramadhan ◽  
Kabas Monther Theban ◽  
John Bchara ◽  
Ahed El-Abed-El-Rassoul ◽  
...  

Abstract Background Breast cancer is one of the most common cancers among women worldwide and the leading cause of death among Iraqi women. Breast cancer cases in Iraq were found to have increased from 26.6/100,000 in 2000 to 31.5/100,000 in 2009. The present study aims to assess the established risk factors of breast cancer among Iraqi women and to highlight strategies that can aid in reducing the incidence. Methods 1093 Iraqi females were enrolled in this cross-sectional study by purposive sampling methods. Data collection occurred from July 2019 to September 2019. 1500 women participated in the study, and 407 women were ultimately excluded. The questionnaire was conducted as a self-administrated form in an online survey. Ethical approval was obtained from the College of Medicine in the University of Baghdad. The Gail Model risk was calculated for each woman by the Breast Cancer Risk Assessment Tool (BCRAT), an interactive model developed by Mitchell Gail that was designed to estimate a woman’s absolute risk of developing breast cancer in the upcoming five years of her life and in her lifetime. Results The ages of the participants ranged from 35 to 84 years old. The mean 5–year risk of breast cancer was found to be 1.3, with 75.3% of women at low risk and 24.7% of women at high risk. The mean lifetime risk of breast cancer was found to be 13.4, with 64.7% of women at low risk, 30.3% at moderate risk, and 5.0% at high risk. The results show that geographically Baghdad presented the highest 5-year risk, followed by Dhi Qar, Maysan, and Nineveh. However, the highest lifetime risk was found in Najaf, followed by Dhi Qar, Baghdad, and Nineveh, successively. Conclusion Breast cancer is a wide-spreading problem in the world and particularly in Iraq, with Gail Model estimations of high risk in several governorates. Prevention programs need to be implemented and awareness campaigns organized in order to highlight the importance of early detection and treatment.


Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5813
Author(s):  
Charlotte Kelley-Jones ◽  
Suzanne Scott ◽  
Jo Waller

Any introduction of risk-stratification within the NHS Breast Screening Programme needs to be considered acceptable by women. We conducted interviews to explore women’s attitudes to personalised risk assessment and risk-stratified breast screening. Twenty-five UK women were purposively sampled by screening experience and socioeconomic background. Interview transcripts were qualitatively analysed using Framework Analysis. Women expressed positive intentions for personal risk assessment and willingness to receive risk feedback to provide reassurance and certainty. Women responded to risk-stratified screening scenarios in three ways: ‘Overall acceptors’ considered both high- and low-risk options acceptable as a reasonable allocation of resources to clinical need, yet acceptability was subject to specified conditions including accuracy of risk estimates and availability of support throughout the screening pathway. Others who thought ‘more is better’ only supported high-risk scenarios where increased screening was proposed. ‘Screening sceptics’ found low-risk scenarios more aligned to their screening values than high-risk screening options. Consideration of screening recommendations for other risk groups had more influence on women’s responses than screening-related harms. These findings demonstrate high, but not universal, acceptability. Support and guidance, tailored to screening values and preferences, may be required by women at all levels of risk.


Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5654
Author(s):  
Agnieszka Barańska ◽  
Agata Błaszczuk ◽  
Wiesław Kanadys ◽  
Maria Malm ◽  
Katarzyna Drop ◽  
...  

To perform a meta-analysis of case-control studies that addressed the association between oral contraceptive pills (OC) use and breast cancer (BrCa), PubMED (MEDLINE), Embase, and the Cochrane Library were searched to identify case-control studies of OC and BrCa published between 2009 and 2020. We used the DerSimonian–Laird method to compute pooled odds ratios (ORs) and confidence intervals (CIs), and the Mantel–Haenszel test to assess the association between OC use and cancer. Forty-two studies were identified that met the inclusion criteria and we included a total of 110,580 women (30,778 into the BrCa group and 79,802 into the control group, of which 15,722 and 38,334 were using OC, respectively). The conducted meta-analysis showed that the use of OC was associated with a significantly increased risk of BrCa in general, OR = 1.15, 95% CI: 1.01 to 1.31, p = 0.0358. Regarding other risk factors for BrCa, we found that increased risk was associated significantly with early menarche, nulliparous, non-breastfeeding, older age at first parity, postmenopause, obesity, smoking, and family history of BrCa. Despite our conclusion that birth control pills increase the cancer risk being supported by extensive previous studies and meta-analyzes, further confirmation is required.


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