New breast cancer screening tool helps general practitioners

September 11, 2006

A new screening tool for the general practitioner effectively identifies patients at risk for hereditary breast cancer, according to a new study. Published in the October 15, 2006 issue of CANCER (http://www.interscience.wiley.com/cancer-newsroom), a peer-reviewed journal of the American Cancer Society, the study reveals a newly developed, simple scoring tool called the "pedigree assessment tool" (PAT) was 100 percent sensitive in identifying women at high risk for the hereditary breast cancer syndrome. The PAT outperformed another commonly used tool, the modified Gail model, in correctly assessing individual patient risk.

Only two to three percent of breast cancers are known to be the result of hereditary syndromes - that is, caused by germline mutations. The most commonly recognized breast cancer genes are BRCA1 and BRCA2. While rare, inheritance of these mutated genes leads to an approximately 80 percent lifetime risk of developing breast cancer. Current management protocols offer hope to these mutation carriers that breast cancer can be either prevented or managed effectively through intensive early detection programs. Therefore, identification of the high risk patients with this hereditary cancer syndrome in the general practice is critical for early referral for genetic counseling and rigorous screening.

Several quantitative assessments are available to physicians to calculate an individual patient's risk for developing breast cancer. One example is the modified Gail model. Collecting familial and individual risk data, the tool is able to quantifiably assess both five-year and lifetime absolute risk of developing invasive breast cancer. One of its weaknesses, according to some, is that it may substantially underestimate breast cancer risk in the subgroup of women with hereditary breast cancer syndromes and is not well-suited for identifying these women.

Led by Kent F. Hoskins, M.D. of the OSF Saint Anthony Center for Cancer Care in Rockford, IL, researchers developed the PAT as a simple, scoring tool to better "identify women in a primary care setting with family cancer histories suggesting a hereditary breast cancer syndrome." In this study, they tested the PAT against the Gail model in a population of 3906 women to identify potential BRCA mutation carriers and risk-stratify them.

PAT scoring was effective at identifying the 86 high risk patients with potential BRCA hereditary syndromes. With a PAT score of 8 or greater (i.e., high BRCA probability), sensitivity and specificity were 100 percent and 93 percent, respectively. In contrast, the Gail model calculations were no better than 73 percent in regards to specificity, and that at the expense of sensitivity, which fell to 27 percent. Further comparison between the PAT and the Gail tools showed that the PAT was more effective at assigning women to the high risk BRCA group.

The authors conclude that this study "demonstrated that a simple point scoring system (PAT) performs very well in identifying women in a screening mammography population who would benefit from referral to a cancer risk clinic for genetic counseling and consideration of DNA testing of appropriate family members."

In the context of developing comprehensive breast screening tools for the general practice, the authors assert that "such a strategy could be effectively employed by combining the Gail model with a tool like the PAT."
-end-
Article: "Validation of a Tool for Identifying Women at High Risk for Hereditary Breast Cancer in Population-Based Screening," Kent F. Hoskins, Alice Zwaagstra, Michael Ranz, CANCER; Published Online: September 11, 2006 (DOI: 10.1002/cncr.22202); Print Issue Date: October 15, 2006.

Wiley

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.