Calculating future 10-year breast cancer risks in risk-adapted surveillance: A method comparison and application in clinical practice

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Silke Zachariae - , Leipzig University (Author)
  • Anne S Quante - , Technical University of Munich (Author)
  • Marion Kiechle - , Technical University of Munich (Author)
  • Kerstin Rhiem - , University of Cologne (Author)
  • Tanja N Fehm - , University Hospital Duesseldorf (Author)
  • Jörg-Gunther Schröder - , Institute of Human Genetics, Biozentrum, Germany. (Author)
  • Judit Horvath - , University Hospital Münster (Author)
  • Elena Leinert - , Ulm University Medical Center (Author)
  • Nicola Dikow - , University Hospital Heidelberg (Author)
  • Joelle Ronez - , Hannover Medical School (MHH) (Author)
  • Mirjam Schönfeld - , Ludwig Maximilian University of Munich (Author)
  • Marion T van Mackelenbergh - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Ulrich A Schatz - , Technical University of Munich (Author)
  • Cornelia Meisel - , Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus Dresden (Author)
  • Bahriye Aktas - , University Hospital Leipzig (Author)
  • Dennis Witt - , University of Tübingen (Author)
  • Yasmin Mehraein - , University Medical Center Göttingen (Author)
  • Bernhard H F Weber - , University of Regensburg (Author)
  • Christine Solbach - , Goethe University Frankfurt a.M. (Author)
  • Dorothee Speiser - , Charité – Universitätsmedizin Berlin (Author)
  • Juliane Hoyer - , Center for Teacher Education and Educational Research, Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Gesine Faigle-Krehl - , University Medical Center Freiburg (Author)
  • Christiane D Much - , Greifswald University Hospital (Author)
  • Alma-Verena Mueller-Rausch - , University Hospital Hamburg Eppendorf (Author)
  • Pablo Villavicencio-Lorini - , Martin Luther University Halle-Wittenberg (Author)
  • Maggie Banys-Paluchowski - , Universitätsklinikum Schleswig-Holstein - Campus Lübeck (Author)
  • Daniel Pieh - , University Medical Center Mainz (Author)
  • Rita K Schmutzler - , University of Cologne (Author)
  • Christine Fischer - , Heidelberg University  (Author)
  • Christoph Engel - , Leipzig University (Author)

Abstract

The German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC) has successfully implemented risk-adapted breast cancer surveillance for women at high breast cancer risk in Germany. Women with a family history of breast and ovarian cancer, but without pathogenic germline variants in recognized breast cancer risk genes, are recommended annual breast imaging if their predicted 10-year breast cancer risk is 5% or higher, using the BOADICEA BC risk model, as outlined in the current GC-HBOC guideline. However, women who initially do not meet this risk threshold may do so later, even if there is no new cancer in their family. To determine when this threshold is crossed, one could annually repeat BOADICEA calculations using an aging pedigree: the 'prediction by aging pedigree' (AP) approach. Alternatively, we propose a simplified and more practical 'conditional probability' (CP) approach which calculates future risks based on the initial BOADICEA assessment. Using data from 6,661 women registered with GC-HBOC, both methods were compared. Initially, 74% of women aged 30 to 48 years had a 10-year breast cancer risk below 5%, but 53% exceeded this threshold at an older age based on the AP approach. Among the women with an initial risk below the threshold, the CP approach revealed that 99% of women exceeded the 5% threshold at the same or an earlier age compared with the AP approach (88% of cases were within the same year or one year earlier). The CP approach has been implemented as a user-friendly web application.

Details

Original languageEnglish
JournalCancer prevention research (Philadelphia, Pa.)
Publication statusE-pub ahead of print - 22 Nov 2024
Peer-reviewedYes

External IDs

unpaywall 10.1158/1940-6207.capr-24-0328

Keywords

Sustainable Development Goals