What is a Breast Cancer Risk Assessment Score? Should I get one? | Well actually

TThis week, actress Olivia Munn shared an Instagram post revealing that she was diagnosed with breast cancer in early 2023. Although her variant test came back negative for her, she said: BRCA gene (these are, high risk Because she had a “routine mammogram” that winter (possible breast cancer), her doctor decided to calculate her Breast Cancer Risk Assessment Score.

“The fact that she saved my life,” Mann wrote.

The Breast Cancer Risk Assessment Tool takes into account a patient's medical, family, and reproductive history to calculate the likelihood of developing breast cancer in the next five years, or overall lifetime risk.

Mann said her lifetime risk was calculated to be 37%.

So what are these tests? How do they work and who should take them and when? We asked the experts.

What is breast cancer risk assessment?

“Breast cancer risk assessment tools are one way health care providers can estimate whether a woman is likely to develop breast cancer,” said Beth, a professor of oncology and certified genetic counselor at Georgetown Lombardi Comprehensive Care Center. Peshkin explains.

The tool assesses genetic factors, such as family history of cancer, as well as non-genetic factors, such as age, age at menarche, age at first birth, and parity. Have previously had a breast biopsy.

One of the commonly used evaluation tools is the Gail model. National Cancer Institute websitecan be completed in less than 5 minutes.

The Gale model then calculates a person's five-year and lifetime risk of developing breast cancer and compares them to the average risk for women of the same age, race, and ethnicity.

Although the Gale model is quick and easy, more detailed tools would be useful for a more accurate assessment, said Dr. Robert Smith, a cancer epidemiologist and senior vice president of early cancer detection science at the American Cancer Society. He says the Gale model can help indicate whether “the risk is high enough that family history suggests that more powerful assessment tools should be utilized.”

The National Cancer Institute (NCI) also recommends more detailed tools, including: IBIS Breast Cancer Assessment Tool (also known as) Tyler Cusik's Risk Assessment Calculator) or Boadicea Models can also be photographed online. Both take into account factors such as height and weight, and require a more extensive family history.

What does the Breast Cancer Risk Assessment Score mean?

Breast cancer risk assessment scores can be helpful, but experts stress that they are only a first step.

“If someone has a higher-than-average risk on the screening tool, the next step is to talk to their health care provider to determine next steps,” Peshkin says. These may include advanced breast cancer screening procedures such as breast MRI and chemoprevention, which is the use of certain drugs such as tamoxifen to reduce the risk of cancer. In some cases, genetic testing may be recommended, but Dr. Peshkin recommends that patients consult a genetic counselor to determine the potential benefits, limitations, and risks of such testing. .

Smith points out that there are certain risk factors, such as a person's breast density, that health care providers can assess better than online tools.

“Dense breasts can increase the risk of breast cancer not being detected simply because it is invisible.” [on a mammogram]'' he said, adding that for some women, increased breast density is also a marker of increased risk.

Breast cancer assessment tools have several limitations. For example, the Gail model was originally developed using data from the Breast Cancer Detection Demonstration Project, a breast cancer screening study that screened 280,000 white women.

Data from other studies that looked at risk among black, AAPI, and Hispanic women were then added. However, as the NCI website points out, although this model has since been tested in a variety of populations, it “showed good results, but some black/African American women who had previously undergone a biopsy” “We may be underestimating the risk for Hispanic women born outside the United States.”

Additionally, Peshkin suggested that these models “may not be sufficient to identify people who may continue to benefit from genetic testing, including those who already have cancer.” ing.

Smith adds, “If you have a significant family history of breast cancer, this is not a useful tool.”

Who should perform breast cancer risk assessment?

“It makes sense for all adult women to know their breast cancer risk and to recognize that this risk changes as they age and their risk profile changes,” Peshkin says.

Smith says there is “no harm” in taking a breast cancer risk assessment test online. But he recommends people who are concerned about their results follow up with a professional.

“To really understand these results, you need to talk to your doctor.”

When should I undergo breast cancer screening?

Breast cancer screening involves testing a patient's breasts for cancer.Depending on the patient and their personal medical history, physiology, and needs, this may may be involved A clinical breast exam, mammography and/or breast MRI in which a doctor uses their hands to feel for a lump.

Breast cancer screening guidelines are changing.previous Recommendations The United States Preventive Services Task Force (USPSTF), the group tasked with determining these guidelines, states that women ages 50 to 74, who are at average risk for breast cancer, should have a mammogram every two years; A 49-year-old woman says she should get a mammogram. Talk to your doctor or health care provider about when to start getting mammograms and how often.

However, in 2023, the USPSTF announced a new policy. draft recommendation It recommends that women be screened for breast cancer every other year starting at age 40.

“We have long known that breast cancer screening saves lives, and the science now supports that all women should be screened every other year starting at age 40,” the group's draft recommendations said. ing.

in Englandpeople who register as women with their GP will be invited to attend an NHS breast cancer screening every three years between the ages of 50 and 71.