Estimating lifetime risk for breast cancer as a screening tool for identifying those who would benefit from additional services among women utilizing mobile mammography.
Estimating lifetime risk for breast cancer as a screening tool for identifying those who would benefit from additional services among women utilizing mobile mammography.
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DOI：
10.1016/j.jcpo.2022.100354
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发表时间：
2022-12
影响因子：
1.3
通讯作者：
Vang, Suzanne
中科院分区：
文献类型：
--
作者：
Wetmore, John B.;Otarola, Lyshsae;Paulino, Lewis J.;Henry, Brittney R.;Levine, Alec F.;Kone, Djeneba;Ulloa, Jennifer;Jandorf, Lina;Margolies, Laurie;Vang, Suzanne
评估使用移动乳房X光检查的女性患乳腺癌的终生风险，并确定可能受益于遗传咨询和教育计划等额外服务的比例。对2214名在流动乳房X光摄影车上进行乳腺癌筛查的妇女的电子健康记录进行了回顾分析。参与者回答了有关他们的人口统计特征、乳房健康和癌症家族史的问题。Logistic回归分析用于评估Tyrer-Cuzick(TC)终身风险评分推荐额外服务的几率。TC十年风险评分为2.76%±2.01%，TC终身风险评分为7.30%±4.80%。使用终生风险评分≥10%，可以确定444名患者(20.23%)可以被转介到额外的服务。以前只有不到1%的患者接受过BRCA基因检测。与那些不符合条件的人(OR=1.31，95%CI：1.03-1.66)相比，那些符合纽约癌症服务计划(即缺乏保险的指标)的人被TC模型推荐获得额外服务的几率要大得多。调整后，筛选行政区和种族/民族与被推荐接受服务没有显著关联。遗传咨询和教育是提高人们对乳腺癌的认识和及早发现乳腺癌的一些可用工具；然而，筛查指南并不强制要求高危个人进行遗传咨询或转介。患者和提供者应该在后续的乳腺癌筛查预约中讨论预测的TC终身风险评分，因为这是一个错过了改善固定地点和流动诊所护理的机会。
To estimate lifetime risk of breast cancer among women utilizing mobile mammography and to determine the proportion that might benefit from additional services, such as genetic counseling and educational programs. Retrospective analysis of electronic health records for 2214 women screened for breast cancer on a mobile mammography van was conducted. Participants answered questions about their demographic characteristics, breast health, and family history of cancer. Logistic regression analyses were used to assess the odds of being recommended for additional services by the Tyrer-Cuzick (TC) lifetime risk score. The average TC ten-year risk score was 2.76 % ± 2.01 %, and the average TC lifetime risk score was 7.30 % ± 4.80 %. Using lifetime risk scores ≥ 10 %, it was determined that 444 patients (20.23 %) could be referred to additional services. Less than one percent of patients had been tested for the BRCA genes previously. The odds of being recommended for additional services by the TC model were significantly greater among those who were eligible for the New York Cancer Services Program (i.e., a proxy for lack of insurance) when compared to those who were ineligible (OR=1.31, 95 % CI: 1.03–1.66). After adjustment, screening borough and race/ethnicity were not significantly associated with being recommended for services. Genetic counseling and education are some of the tools available to promote awareness and early detection of breast cancer; however, screening guidelines do not mandate genetic counseling or referrals for individuals at high-risk. Patients and providers should have discussions about predicted TC lifetime risk scores at follow-up breast cancer screening appointments, as this is a missed opportunity to improve care at both fixed sites and mobile clinics.
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影响因子：
3.3
作者：
Jacobsen, PB;Valdimarsdottir, HB;Offit, K
通讯作者：
Offit, K
影响因子：
2.3
作者：
Andaya, Abegail A.;Enewold, Lindsey;Zhu, Kangmin
通讯作者：
Zhu, Kangmin
影响因子：
1.9
作者：
Morman, Nichole A.;Byrne, Lindsey;Bell, Jeffrey G.
通讯作者：
Bell, Jeffrey G.
影响因子：
2
作者：
Tyrer, J;Duffy, SW;Cuzick, J
通讯作者：
Cuzick, J
影响因子：
1.9
作者：
Kne, Alyssa;Zierhut, Heather;Tsai, Michaela L.
通讯作者：
Tsai, Michaela L.