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A comparison of methods currently used in clinical practice to estimate familial breast cancer risks

A comparison of methods currently used in clinical practice to estimate familial breast cancer risks
A comparison of methods currently used in clinical practice to estimate familial breast cancer risks

Background: With the identification of genes predisposing to hereditary breast cancer, the accurate and consistent estimation of a woman's risk of developing breast cancer based on her family history is of paramount importance if national service guidelines are to be developed.

Patients and methods: The residual lifetime risk of developing breast cancer was estimated for 200 women attending a breast cancer genetic assessment clinic by three different methods currently in use in the UK. Risks were computed on the basis of the Cancer and Steroid Hormone (CASH) study data and were classified as 'low/moderate' (< 20%) or 'high' (>20%). These risk categories are representative of those currently used to allocate surveillance and genetic testing. Risks were then compared to estimates derived by other methods used in current clinical practice, including those of Houlston and Murday.

Results: The CASH data-based method ascribed 27% to the high risk category, as compared to 53% for the combined Houlston and Murday methods. A method based on the number of affected relatives alone ascribed only 14% to the high risk category. Overall, 108 (54%) women were placed in the same risk category by all three methods.

Conclusions: This study demonstrates that there is a significant degree of variability between methods currently used to estimate breast cancer risk which has serious implications for individual patient management, service provision and multicentre studies evaluating the benefits of genetic testing for breast cancer susceptibility.

Breast cancer, Genetic counselling, Risk assessment
0923-7534
451-454
Tischkowitz, Marc
1e7750c2-91a5-4079-a1f0-f59a1f42405b
Wheeler, D.
67602ac0-c5c2-4e3a-b038-f37213dc8a2e
France, E.
bec2378d-985a-4a30-a112-2e890f3beff7
Chapman, C.
20a8acbc-9320-4c38-898a-c0ae44e1abd3
Lucassen, A.
2eb85efc-c6e8-4c3f-b963-0290f6c038a5
Sampson, J.
bdba35f3-bc87-4491-9d3f-0def0655a9be
Harper, P.
130f43ae-94f8-48ab-93ff-572fc1927c79
Krawczak, M.
4083976d-03c8-44eb-9bc7-a20ee8aafe43
Gray, J.
257020bc-5231-47d2-9883-263b5eba3edf
Tischkowitz, Marc
1e7750c2-91a5-4079-a1f0-f59a1f42405b
Wheeler, D.
67602ac0-c5c2-4e3a-b038-f37213dc8a2e
France, E.
bec2378d-985a-4a30-a112-2e890f3beff7
Chapman, C.
20a8acbc-9320-4c38-898a-c0ae44e1abd3
Lucassen, A.
2eb85efc-c6e8-4c3f-b963-0290f6c038a5
Sampson, J.
bdba35f3-bc87-4491-9d3f-0def0655a9be
Harper, P.
130f43ae-94f8-48ab-93ff-572fc1927c79
Krawczak, M.
4083976d-03c8-44eb-9bc7-a20ee8aafe43
Gray, J.
257020bc-5231-47d2-9883-263b5eba3edf

Tischkowitz, Marc, Wheeler, D., France, E., Chapman, C., Lucassen, A., Sampson, J., Harper, P., Krawczak, M. and Gray, J. (2000) A comparison of methods currently used in clinical practice to estimate familial breast cancer risks. Annals of Oncology, 11 (4), 451-454. (doi:10.1023/A:1008396129543).

Record type: Article

Abstract

Background: With the identification of genes predisposing to hereditary breast cancer, the accurate and consistent estimation of a woman's risk of developing breast cancer based on her family history is of paramount importance if national service guidelines are to be developed.

Patients and methods: The residual lifetime risk of developing breast cancer was estimated for 200 women attending a breast cancer genetic assessment clinic by three different methods currently in use in the UK. Risks were computed on the basis of the Cancer and Steroid Hormone (CASH) study data and were classified as 'low/moderate' (< 20%) or 'high' (>20%). These risk categories are representative of those currently used to allocate surveillance and genetic testing. Risks were then compared to estimates derived by other methods used in current clinical practice, including those of Houlston and Murday.

Results: The CASH data-based method ascribed 27% to the high risk category, as compared to 53% for the combined Houlston and Murday methods. A method based on the number of affected relatives alone ascribed only 14% to the high risk category. Overall, 108 (54%) women were placed in the same risk category by all three methods.

Conclusions: This study demonstrates that there is a significant degree of variability between methods currently used to estimate breast cancer risk which has serious implications for individual patient management, service provision and multicentre studies evaluating the benefits of genetic testing for breast cancer susceptibility.

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More information

Published date: 1 April 2000
Keywords: Breast cancer, Genetic counselling, Risk assessment

Identifiers

Local EPrints ID: 469441
URI: http://eprints.soton.ac.uk/id/eprint/469441
ISSN: 0923-7534
PURE UUID: 59aaba69-85e2-46c5-9e88-a7fea9459db9
ORCID for A. Lucassen: ORCID iD orcid.org/0000-0003-3324-4338

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Date deposited: 14 Sep 2022 16:52
Last modified: 17 Mar 2024 02:54

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Contributors

Author: Marc Tischkowitz
Author: D. Wheeler
Author: E. France
Author: C. Chapman
Author: A. Lucassen ORCID iD
Author: J. Sampson
Author: P. Harper
Author: M. Krawczak
Author: J. Gray

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