The “current” relatives’ ages are required so that the calculated Tyrer Cuzick would match EXACTLY with the downloaded Tyrer Cuzick application.  How does Hughes RiskApps and Hughes RiskApps Express deal with missing ages of relatives?

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If the user wanted ages for all relatives collected in breast imaging, we could add those screens but then mammo will refuse to use it. (It would add 5 minutes or more to the time each patient needs to complete the tablet and that is not acceptable).

Most breast imaging centers do not want to enter all that data.  If the patient has a mother, father, 4 grandparents, 2 total aunts and 2 total uncles and 1 sister and 1 brother and 2 children, that is 14 relatives with 28 total data points (Age and vital status) plus the time spent creating all the relatives in the system.  My guess is few breast imaging centers actually collect this data.

Therefore, we have taken a different tack.  The majority of folks can understand why we do not collect all that data when spelled out in terms of added time with minimal impact on ultimate risk.  The differences are trivial and have little impact in the breast imaging center where we are doing a “screening” family history.  As most counselors want more people seen (higher sensitivity, lower threshold), they are ok with the slight overestimate of risk based on Tyrer Cuzick without all relative ages.

Having said that we have actually studied this in BRCAPRO, and developed a way to get very similar calculations without adding the existence, vital status and age of every family member. We do this by imputing a family and their associated ages.[1]

I think this is the future in the breast imaging suite.

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