NCCN guidelines recognize Tyrer Cuzick, Claus, BRCAPRO and Boadicea. Gail is not recognized as appropriate.
National Comprehensive Cancer Network. Available
The American Cancer Society (ACS) recognizes Tyrer Cuzick, Claus, and BRCAPRO. American Cancer Society in its supplementary materials specifically excludes Gail also for MRI.
Kevin
Can you please comment on the inclusion of Proliferative changes without atypia, ie usual ductal hyperplasia on Tyrer Cuzick model. (as well as other proliferative changes such as papillomas). This significantly increases risk in this model. I see it in some on line models but not all (in particular it is being used by gynecologists who are ordering more MRI’s than I would normally order). I see it (benign proliferative disease) is not an entry on the Mastery of Breast Surgery program.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714021/#!po=74.000
Benign Breast Disease, Mammographic Density and the risk of breast cancer by Tice et al suggests that benign proliferative disease and density in combination are significant risk factors.
Can you outline which model you use in which situations?
Threshold for genetic testing: BRCAPRO
Threshold for MRI: ? T-C and which version
Threshold for consideration for chemoprevention
Is there consideration for adding to the Hughes RiskApps, a model that takes into account breast density?
Thank you
I have always been underwhelmed by proliferative changes without atypia but by rights, it is part of the model. Its impact seems to be larger than it should be in TC, but those are the numbers.