Erica Silver1, Neil Wenger2, Zhuoer Xie3, David Elashoff4, Kristina Lee5, Lisa Madlensky6, Jacqueline Trent4, Antonia Petruse1, Liliana Johansen1, Arash Naeim1. 1. Department of Hematology and Oncology, David Geffen School of Medicine at University of California, Los Angeles, CA. 2. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, CA. 3. Department of Hematology and Oncology, David Geffen School of Medicine at University of California, Los Angeles, CA. Electronic address: zhuoerxie@ucla.edu. 4. Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA. 5. Hematology Oncology Department, Olive View-UCLA Medical Center, Los Angeles, CA. 6. Division of Medical Genetics, University of California, San Diego, CA.
Abstract
BACKGROUND: Personalized breast cancer risk assessment is important in identifying and managing women at increased risk for breast cancer. However, there has been little evaluation of the practical aspects of implementing a population-based program that identifies and refers high-risk patients for further evaluation. PATIENTS AND METHODS: We implemented a semiautomated approach to collect personal and family history to identify women at high risk of breast cancer. On the basis of the survey, women identified as elevated risk received letters inviting them to telephone consultations with licensed breast health genetic counselors (BHGCs). High-risk women's history was verified and counseling and referrals provided, as appropriate. RESULTS: Among 20,558 women screened, 2000 (9.7%) women were identified as high risk on the basis of patient initial report. However, most (1,580) were excluded from receiving risk communication after BHGC review of risk information with the woman or because of previous attention to breast cancer risk or an abnormal mammogram. Among 420 subjects who received risk letters, 225 received a BHGC consultation. Of these 225 women, 63 were reclassified as average risk, 158 were referred to high-risk clinics, and 5 consultations were incomplete after determining that further information was needed. Of the 158 women referred to high-risk breast clinics, 51 attended an appointment. CONCLUSION: This study highlights the complex nature of a population-based breast cancer screening program in a clinical setting and shows the substantial effort needed to identify newly discovered women at high risk for breast cancer and refer them to appropriate services.
BACKGROUND: Personalized breast cancer risk assessment is important in identifying and managing women at increased risk for breast cancer. However, there has been little evaluation of the practical aspects of implementing a population-based program that identifies and refers high-risk patients for further evaluation. PATIENTS AND METHODS: We implemented a semiautomated approach to collect personal and family history to identify women at high risk of breast cancer. On the basis of the survey, women identified as elevated risk received letters inviting them to telephone consultations with licensed breast health genetic counselors (BHGCs). High-risk women's history was verified and counseling and referrals provided, as appropriate. RESULTS: Among 20,558 women screened, 2000 (9.7%) women were identified as high risk on the basis of patient initial report. However, most (1,580) were excluded from receiving risk communication after BHGC review of risk information with the woman or because of previous attention to breast cancer risk or an abnormal mammogram. Among 420 subjects who received risk letters, 225 received a BHGC consultation. Of these 225 women, 63 were reclassified as average risk, 158 were referred to high-risk clinics, and 5 consultations were incomplete after determining that further information was needed. Of the 158 women referred to high-risk breast clinics, 51 attended an appointment. CONCLUSION: This study highlights the complex nature of a population-based breast cancer screening program in a clinical setting and shows the substantial effort needed to identify newly discovered women at high risk for breast cancer and refer them to appropriate services.
Authors: Celmira Laza-Vásquez; María José Hernández-Leal; Misericòrdia Carles-Lavila; Maria José Pérez-Lacasta; Inés Cruz-Esteve; Montserrat Rué Journal: Int J Environ Res Public Health Date: 2022-01-27 Impact factor: 3.390
Authors: Celmira Laza-Vásquez; Núria Codern-Bové; Àngels Cardona-Cardona; Maria José Hernández-Leal; Maria José Pérez-Lacasta; Misericòrdia Carles-Lavila; Montserrat Rué Journal: PLoS One Date: 2022-02-04 Impact factor: 3.240