背景:妇科和乳腺癌共有几个危险因素。乳腺癌风险评估工具可以识别高风险人群,并加强乳房监测和化学预防。然而,这些工具没有得到充分利用。我们旨在评估常规乳腺癌风险评估在妇科肿瘤诊所中的应用。
方法:使用面向患者的基于Web的工具来收集个人和家族史,并运行四个经过验证的乳腺癌风险评估模型(Tyrer-Cuzick(TC),盖尔,BRCAPRO,和Claus)在妇科肿瘤诊所。我们使用四个经过验证的模型评估了工具的完成情况和乳腺癌高风险患者的识别。
结果:本分析共纳入99例患者。BRCAPRO模型的完成率最高(84.8%),其次是TC模型(74.7%),盖尔模型(74.7%),和克劳斯模型(52.1%)。TC模型确定完成模型的患者中有21.6%具有≥20%的终生乳腺癌风险,与盖尔模型的6.8%相比,BRCAPRO和Claus模型均为0%。Gail模型确定52.5%的患者具有≥1.67%的5年乳腺癌风险。在被确定为乳腺癌高风险并符合筛查条件的患者中,9/9(100%)被转诊到高风险乳腺诊所。
结论:在妇科肿瘤诊所完成TC乳腺癌风险评估的患者中,约1/5的患者被确定为乳腺癌的终生风险显著升高.妇科肿瘤科医生的办公室可能会提供一个方便和可行的设置,将这种风险评估纳入常规患者护理,因为妇科肿瘤学家通常有长期的病人关系,并参与生存护理。
Gynecologic and breast cancers share several risk factors. Breast cancer risk assessment tools can identify those at elevated risk and allow for enhanced breast surveillance and chemoprevention, however such tools are underutilized. We aim to evaluate the use of routine breast cancer risk assessment in a gynecologic oncology clinic.
A patient-facing web-based tool was used to collect personal and family history and run four validated breast cancer risk assessment models (Tyrer-Cuzick (TC), Gail,
BRCAPRO, and Claus) in a gynecologic oncology clinic. We evaluated completion of the tools and identification of patients at elevated risk for breast cancer using the four validated models.
A total of 99 patients were included in this analysis. The
BRCAPRO model had the highest completion rate (84.8%), followed by the TC model (74.7%), Gail model (74.7%), and the Claus model (52.1%). The TC model identified 21.6% of patients completing the model as having ≥20% lifetime risk of breast cancer, compared to 6.8% by the Gail model, and 0% for both the
BRCAPRO and Claus models. The Gail model identified 52.5% of patients as having ≥1.67% 5-year risk of breast cancer. Among patients identified as high-risk for breast cancer and eligible for screening, 9/9 (100%) were referred to a high-risk breast clinic.
Among patients that completed the TC breast cancer risk assessment in a gynecologic oncology clinic, approximately 1 in 5 were identified to be at significantly elevated lifetime risk for breast cancer. The gynecologic oncologist\'s office might offer a convenient and feasible setting to incorporate this risk assessment into routine patient care, as gynecologic oncologists often have long-term patient relationships and participate in survivorship care.