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Breast Cancer Risk Assessment Study

Cartersville Medical Center Breast Imaging Center of Excellence

Study

According to the Center for Disease Control and Prevention, breast cancer is the most common cancer among women in the United States, affecting over 230,000 in 2013 with an estimated mortality rate of over 40,000. The National Comprehensive Cancer Network emphasizes the need for effective screening programs for breast cancer, as well as, risk reduction strategies. Programs to assess a woman’s risk for the development of breast cancer are quickly becoming more widespread with several tools available to clinicians for the calculation.

At Cartersville Medical Center, breast cancer continues to be one of our top five sites. On average 81 breasts cancers are diagnosed and/or treated at our facility annually. Our goal was to identify women who may be at increased risk for the development of breast cancer and offer education on modifiable risk factors and risk reducing interventions(annual breast MRI screening, referral for the use of chemoprophylactic medications, referral for genetic counseling/testing) to increase early detection and prevention of breast cancer. Our plan was to achieve this through collaboration and communication between patients and healthcare professionals to inform them of their lifetime risk score, calculated via the Tyer-Cuzick Risk Assessment model. The American Society of Clinical Oncology, National Comprehensive Cancer Network and the American Cancer Society recommend this tool as an appropriate tool to calculate lifetime risk, particularly when family history is a factor. According to the literature, 8-17% of the female population qualify as “High risk”, based on a lifetime risk assessment score of > 20%.

Outcomes

A retrospective review of the data at Cartersville Medical Center from October 2015 through December 2015 on 285 patients that were seen at the Breast Imaging Center, found that 23 patients (8%) would have qualified as high-risk based on having a Tyrer-Cuzick lifetime score > 20%. This is within the expected range that is discussed in the current literature. After development and implementation of a policy for Breast Cancer Risk Assessment Process, a review of data from 5/1/2016-7/29/2016 illustrated the following: 760/760, or 100% of patients seen had risk assessment scores calculated. The results revealed 75 patients with a risk score > 20%, which equals 9.9%. All 75 (100%) patients received breast health/risk education.

[1] National Comprehensive Cancer Network. Breast Cancer Screening and Diagnosis (Version 1.2016). BSCR-2. Retrieved from https://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf.

[1] American Cancer Society recommendations for early breast cancer detection in women without breast symptoms: Tools used to assess breast cancer risk. (2015, October 20). Retrieved from http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs.

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[1] Loehberg, C., Jud S., Haeberle, L., Heusinger, K., Dilbat, G., Hein, A.,…Fasching, P. (2010). Breast cancer risk assessment in a mammography screening program and participation in the IBIS-II chemoprevention trial. Breast Cancer Research and Treatment, 121(1), p. 101-110. PMID: 20306293

[1] Evans, D., Warwick, J., Astley, S., Stavrinos, P., Sahin, S., Ingham, S.,…Howell, A. (2012). Assessing individual breast cancer risk within the UK National Health Service Breast Screening Program. Cancer Prevention Research, 5(7), p. 943-951. PMID: 22581816