brunette woman with ponytail in the middle of a breast screening administered by a blonde woman in a ponytail

Part 4 – Breast Screening Models

When a woman comes to see me for her annual exam, in addition to all the things we talk about, it’s also important to determine if she needs more than just a screening mammogram and ABUS if indicated

In our office at El Camino Women’s Medical Group we use different breast cancer screening models with patients to determine what’s the best way to screen for breast cancer.

The first is a good family history to determine if genetic testing is appropriate. Many of my patients are shocked to learn that colon and prostate cancer can be linked to breast cancer. 

Next, we use risk assessment models. There are many and they are used in different circumstances, such as trying to determine:

– Who would benefit from genetic testing?

– Who would benefit from having MRI?

– Who would benefit from medication that reduces the risk of developing breast cancer?

The AreYouDense.org website has an excellent compilation of the screening models and when they are recommended.

I might use the Gail Model tool in a patient who has no family history of breast cancer.

I often use the IBIS (International Breast Cancer Intervention) tool such as Tyrer Cruzik. 

The Tyrer-Cuzick model, or IBIS tool, is used to calculate a woman’s chances of carrying the BRCA1 or BRCA2 mutations, and her overall likelihood of developing breast cancer in 10 years and over the course of her lifetime. The tool is used to help inform a person’s decision-making about genetic counselling and testing. If the model predicts a 10% or greater chance that the woman has a mutation in BRCA1, BRCA2, or both, genetic counseling is advised. 

The tool estimates breast cancer risk on the basis of the following risk factors:

  • Age
  • Body mass index
  • Age at menarche
  • Obstetric history
  • Age at menopause (if applicable)
  • History of a benign breast condition that increases breast cancer risk (hyperplasia, atypical hyperplasia, LCIS)
  • History of ovarian cancer
  • Use of hormone replacement therapy
  • Family history (including breast and ovarian cancer, Ashkenazi inheritance, genetic testing if done)

A new risk model was developed in October 2021 by Boston University specifically for Black women. This is truly a breakthrough. 

After utilizing the risk models, the next step is communicating with patients about the best ways to have breast cancer screening. I hope this series of blogs has helped answer your questions. 

You can read more about Mammograms here

Breast Ultrasound here

MRI here

Disclosure: I do not work for any of the companies, products, or groups mentioned in any of these blogs. 

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