Abstract
SUMMARY Aim: Information regarding the characteristics and breast cancer risk factors of British women in the standard population attending breast cancer screening is limited. Such information could be useful in personalizing screening and care, and informing and educating women about their risk. Materials & methods: Information about various breast cancer risk factors was obtained from 355 women aged between 46 and 74 years at a UK inner-city breast cancer screening clinic using questionnaires. The risk of breast cancer was calculated using the modified Gail model and analyzed using descriptive and regression statistics. Results: There were 26 women recalled for further assessment and two cases confirmed as invasive breast cancer. Forty-seven women reported first-degree relatives with breast cancer. A total of 58% of our sample was overweight or obese, although 84% reported meeting the recommended target of ≥150 min of exercise per week. A total of 44% were smokers and 23% reported consuming alcohol on a regular basis. The mean lifetime risk score was 9.0% and the mean 5-year risk score was 1.5%. Various non-Gail model risk factors were found to be correlated with risk scores, but the only factor that was significantly different between women recalled for further assessment and those who were not was age of menarche. Conclusion: The results suggest that determining risk factor data in a standard screening population could be useful both to the women, who may have modifiable lifestyle factors that can be changed to improve their risk, and to the clinics, which can identify women at a higher risk who may be unaware and not present themselves as candidates for risk assessment.
Highlights
There were 26 women recalled for further assessment and of these, 16 had some abnormality found, two of which were confirmed as Breast cancer (BC) and subsequently underwent surgery
The Gail model 5-year risk scores reported in this study were found to be correlated with various risk factors such as age at menopause and number of pregnancies, with the lifetime risk score significantly correlated with ever drinking or taking hormone-based contraception, ovary
How can knowledge of BC risk be used in the current BC screening program? In the USA, women at high risk, defined by age, genetics and family history, or Gail model risk score, can be offered MRI screening in addition to mammograms, and even preventative medication such as tamoxifen [35,46]
Summary
BC risk scores found in a standard screening population in an inner-city clinic. This will be discussed within the context of the UK screening program and within the wider view of national and worldwide BC risk measurement. The study uses a representative sample of women attending the clinics, rather than the positive diagnosis only or a ‘cancer-enriched’ sample seen in many other studies. We do not intend to generalize findings to other populations, but they will be used to highlight areas where the current UK screening system has potential for improvement. We chose to use the Gail model because it is a well-validated risk algorithm that does not require detailed family history or genetic information
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