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

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.

journal_name

Breast Cancer Res Treat

journal_title

Breast cancer research and treatment

authors

Weiss A,Grossmith S,Cutts D,Mikami SA,Suskin JA,Graichen MK,Rojas NA,Pace LE,Joyce E,Rhei E,Scheib R,Bychkovsky B,Garber JE,Morganstern D,King TA

doi

10.1007/s10549-018-05116-5

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

229-237

issue

1

eissn

0167-6806

issn

1573-7217

pii

10.1007/s10549-018-05116-5

journal_volume

175

pub_type

杂志文章

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