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Assessing individual breast cancer risk within the U.K. national health service breast screening program : a new paradigm for cancer prevention

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Evans, D. G. R., Warwick, Jane, Astley, S. M., Stavrinos, P., Sahin, S., Ingham, S., McBurney, H., Eckersley, B., Harvie, M., Wilson, M., Beetles, U., Warren, R. M. L., Hufton, A., Sergeant, J. C., Newman, W. G., Buchan, I., Cuzick, J. and Howell, A. (2012) Assessing individual breast cancer risk within the U.K. national health service breast screening program : a new paradigm for cancer prevention. Cancer Prevention Research, Volume 5 (Number 7). pp. 943-951. doi:10.1158/1940-6207.CAPR-11-0458

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Official URL: http://dx.doi.org/10.1158/1940-6207.CAPR-11-0458

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Abstract

The aim of this study is to determine breast cancer risk at mammographic screening episodes and integrate standard risk factors with mammographic density and genetic data to assess changing the screening interval based on risk and offer women at high risk preventive strategies. We report our experience of assessing breast cancer risk within the U.K. National Health Service Breast Screening Program using results from the first 10,000 women entered into the "Predicting Risk Of breast Cancer At Screening" study. Of the first 28,849 women attending for screening at fifteen sites in Manchester 10,000 (35%) consented to study entry and completed the questionnaire. The median 10-year Tyrer–Cuzick breast cancer risk was 2.65% (interquartile range, 2.10–3.45). A total of 107 women (1.07%) had 10-year risks 8% or higher (high breast cancer risk), with a further 8.20% having moderately increased risk (5%–8%). Mammographic density (percent dense area) was 60% or more in 8.3% of women. We collected saliva samples from 478 women for genetic analysis and will extend this to 18% of participants. At time of consent to the study, 95.0% of women indicated they wished to know their risk. Women with a 10-year risk of 8% or more or 5% to 8% and mammographic density of 60% or higher were invited to attend or be telephoned to receive risk counseling; 81.9% of those wishing to know their risk have received risk counseling and 85.7% of these were found to be eligible for a risk-reducing intervention. These results confirm the feasibility of determining breast cancer risk and acting on the information in the context of population-based mammographic screening.

Item Type: Journal Article
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Journal or Publication Title: Cancer Prevention Research
Publisher: American Association for Cancer Research
ISSN: 1940-6207
Official Date: July 2012
Dates:
DateEvent
July 2012Published
Volume: Volume 5
Number: Number 7
Page Range: pp. 943-951
DOI: 10.1158/1940-6207.CAPR-11-0458
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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