sábado, 2 de febrero de 2019

Customized breast cancer risk assessment in an ambulatory clinic: a portal for identifying women at risk. - PubMed - NCBI

Customized breast cancer risk assessment in an ambulatory clinic: a portal for identifying women at risk. - PubMed - NCBI



 2019 Jan 21. doi: 10.1007/s10549-018-05116-5. [Epub ahead of print]

Customized breast cancer risk assessment in an ambulatory clinic: a portal for identifying women at risk.

Weiss A1,2,3Grossmith S1,2Cutts D1,2Mikami SA1,2Suskin JA1,2Graichen MK1Rojas NA1,2Pace LE1,4Joyce E1,2Rhei E1,2,3Scheib R1,3,5Bychkovsky B1,3,5Garber JE1,3,5Morganstern D1,4,5,6King TA7,8,9.

Abstract

PURPOSE:

Existing high-risk clinic models focus on patients with known risk factors, potentially missing many high-risk patients. Here we describe our experience implementing universal risk assessment in an ambulatory breast center.

METHODS:

Since May 2017, all breast center patients completed a customized intake survey addressing known breast cancer risk factors and lifestyle choices. Patient characteristics, family history, risk scores, and lifestyle factors were examined; patients with high-risk breast lesions were excluded. Patients were considered at increased risk by model thresholds Gail 5-year risk > 1.7% (35-59 years), Gail 5-year risk > 5.5% (≥ 60 years), or Tyrer-Cuzick (T-C) v7 lifetime risk > 20% (any age).

RESULTS:

From May 2017-April 2018, there were 874 eligible patients-420 (48%) referred for risk assessment (RA) and 454 (52%) for non-specific breast complaints (NSBC). Overall, 389 (45%) were at increased risk of breast cancer. Gail 5-year risks were similar between RA and NSBC patients. However, RA patients more frequently met criteria by T-C score (P = 0.02). Of all patients at increased risk, 149 (39%) were overweight (BMI > 25) or obese (BMI > 30) and only 159 (41%) met recommended exercise standards. NSBC patients who met criteria were more frequently smokers (8% vs 1%, P < 0.01); all other demographic/lifestyle factors were similar among high-risk patients regardless of referral reason.

CONCLUSIONS:

Universal risk assessment in a comprehensive breast health center identified 45% of our population to be at increased risk of breast cancer. This clinical care model provides a unique opportunity to identify and address modifiable risk factors among women at risk.

KEYWORDS:

Breast cancer; High-risk program; Modifiable risk factors; Prevention; Risk assessment

PMID:
 
30666540
 
DOI:
 
10.1007/s10549-018-05116-5

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