There is no doubt that a complete screening
of breast cancer should include, in addition
to clinical examination, the ultrasound and
mammography, a determination of individual
risk. In fact, women who are identified as
exposed to high risk, must be submitted to
an individualized plan of surveillance as
well as a series of preventive measures, if
necessary, also defined by risk.
It 'so obvious that the calculation
of the risk of breast cancer is not a mere
curiosity, but a very important tool that
can provide the patient more aware and the
doctor a baseline to assess any Intensive
monitoring and preventive treatments in
patients at high risk. Or at least
monitoring of patients at low risk.
Suffice it to think that such a
scientific study, "Breast Cancer Prevention
Trial (Fisher B, Costantino JP, Wickerham
DL. - Tamoxifen for prevention of breast
cancer: report of the National Surgical
Adjuvant Breast and Bowel Project P-1 Study.
- J. Natl Cancer Inst 1998; 90 (18)
:1371-88) has shown that in healthy women,
but high-risk, meaning a risk of developing
breast cancer over 5 years to 1.7%,
preventive therapy with tamoxifen, after a
period of 4 years, 49% reduces the incidence
of breast cancer .. In any case, can be very
useful tips on simple lifestyle that
significantly reduce the real risk of
getting breast cancer.
http://www.senosalvo.com/il_cibo_delluomo.htm
http://www.senosalvo.com/menu_di_lunga_vita.htm
http://www.senosalvo.com/camminare_almeno_30_min_giorno.htm
The calculator Risk of breast cancer
offers the choice between two methods of
calculation: the Gail model and the model of
the NSABP. The first, named after Dr.
Mitchell H. Gail, along with other
colleagues he has published several popular
articles describing the scientific basis for
the calculation of risk. The second
calculation model was developed by the NSABP,
an acronym for the National Surgical
Adjuvant Breast and Bowel Project. The NSABP
is a great organization that has conducted
many important research studies. The NSABP
is playing from the original model of Gail
and modified it for research purposes.
Equally well known is the risk
calculator at the National Cancer Institute:
it has more decimal places of accuracy,
but requires only 6 questions:
The Breast Cancer Risk Assessment Tool was designed
for use by health professionals. If you are
not a health professional, you are encouraged
to discuss the results and your personal risk
of breast cancer with your doctor.
The tool should not be used to calculate breast
cancer risk for women who have already had a
diagnosis of breast cancer,
lobular
carcinoma in situ (LCIS),
or
ductal
carcinoma in situ (DCIS).
The BCRA risk calculator may be updated periodically
as new data or research becomes available.
Although the tool has been used with success
in clinics for women with strong family histories
of breast cancer, more specific methods of estimating
risk are appropriate for women known to have
breast cancer-producing mutations in the BRCA1
or BRCA2 genes.
Other factors may also affect risk and are not
accounted for by the tool. These factors include
previous radiation therapy to the chest for
the treatment of Hodgkin lymphoma or recent
migration from a region with low breast cancer
rates, such as rural China. The tool's risk
calculations assume that a woman is screened
for breast cancer as in the general U.S. population.
A woman who does not have mammograms will have
somewhat lower chances of a diagnosis of breast
cancer.
For information to help your patients understand
cancer risk visit
http://understandingrisk.cancer.gov.
This interactive Web site will help your patients
make informed decisions about how to lower their
risk.
The computer used by us using the Gail
model, and is a slightly less perfect
emulation of the risk calculator for breast
cancer at the National Cancer Institute,
however, adds additional risk factors and
therefore it is more complete. Although this
calculation is based on methods and
statistics to calculate the risk of breast
cancer published in scientific journals
skilled, specific methods used were not
controvalidati. Therefore, these data can be
used only as a guideline for the monitoring
program. The final results are estimates of
a LOW, MEDIUM or HIGH risk of getting breast
cancer very useful for the planning of
surveillance in relation to the age of the
patient.
http://www.senosalvo.com/approfondimenti/fattori_indicatori_carcinoma_mammario.htm
Major risk factors and their relative risk
|
FACTOR |
VARIABLE |
RISK |
|
Age |
> 50 anni |
6,5 |
|
A family history |
1st degree relative < 50 years |
2,0 |
| |
2 first degree relatives |
5,0 |
|
Anamnesis |
Prevous breast irradiation <15 years |
20,0 |
| |
Hyperplasia
|
2,0 |
|
* |
Atypical
|
3,5 |
| |
Mammographic Density |
4,0 |
|
|
DCIS |
>4 |
|
History Hormone
|
Menarche < 11 years |
3,0 |
| |
Menopause > 54 years
|
2,0 |
| |
nulliparity
|
1,99 |
| |
oral contraceptives |
1,4 |
| |
HRT
|
1,4 |
|
Diet |
Hight fat diet
|
1,2 |
| |
Obesity in post menopausal
|
1,2 |
| |
Alcohol consumtion
|
1,3 |
* If you are familiar with atypia are associated with conditions of synergy and the relative risk is doubled (RR = 9).
** fibrodenoma not increase the risk, except for those so-called "complex" (containing cysts, sclerosing adenosis, epithelial calcifications, or alteration of apocrine and papillary type) having a RR = 3. The radial scar RR = 2 and if hyperplasia is associated with RR = 3:
Note: If within ten years after the biopsy revealed hyperplasia with atypia does not manifest itself on a cancer risk is halved.
|
