lunes, 20 de mayo de 2019

Implementing a Population-Based Breast Cancer Risk Assessment Program. - PubMed - NCBI

2019 Mar 11. pii: S1526-8209(18)30761-4. doi: 10.1016/j.clbc.2019.02.009. [Epub ahead of print]

Implementing a Population-Based Breast Cancer Risk Assessment Program.

Silver E1, Wenger N2, Xie Z3, Elashoff D4, Lee K5, Madlensky L6, Trent J4, Petruse A1, Johansen L1, Naeim A1.

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Abstract

BACKGROUND:

Personalized breast cancer risk assessment is important in identifying and managing women at increased risk for breast cancer. However, there has been little evaluation of the practical aspects of implementing a population-based program that identifies and refers high-risk patients for further evaluation.

PATIENTS AND METHODS:

We implemented a semiautomated approach to collect personal and family history to identify women at high risk of breast cancer. On the basis of the survey, women identified as elevated risk received letters inviting them to telephone consultations with licensed breast health genetic counselors (BHGCs). High-risk women's history was verified and counseling and referrals provided, as appropriate.

RESULTS:

Among 20,558 women screened, 2000 (9.7%) women were identified as high risk on the basis of patient initial report. However, most (1,580) were excluded from receiving risk communication after BHGC review of risk information with the woman or because of previous attention to breast cancer risk or an abnormal mammogram. Among 420 subjects who received risk letters, 225 received a BHGC consultation. Of these 225 women, 63 were reclassified as average risk, 158 were referred to high-risk clinics, and 5 consultations were incomplete after determining that further information was needed. Of the 158 women referred to high-risk breast clinics, 51 attended an appointment.

CONCLUSION:

This study highlights the complex nature of a population-based breast cancer screening program in a clinical setting and shows the substantial effort needed to identify newly discovered women at high risk for breast cancer and refer them to appropriate services.