Evaluation of mammographic surveillance services in women aged 40–49 years with a moderate family history of breast cancer: a single-arm cohort study

Duffy, SW; Mackay, James; Thomas, Susan N.; Anderson, Edward; Chen, Chien-Jen; Ellis, Ian O.; Evans, D. Gareth; Fielder, HM; R, Fox; Gui, G. P. H.; Macmillan, Douglas; Moss, Susan; Rogers, Christine A.; Sibbering, Mark; Wallis, MG; Warren, Ruth; Watson, Eila; Whynes, D. K.; Allgood, P; Caunt, J

doi:10.3310/hta17110

Cited by 10 publications

(10 citation statements)

References 42 publications

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“…The FH01 cohort study is described in detail elsewhere. 6,7,26 In brief, FH01 was a one-arm study designed to evaluate the effectiveness of annual mammographic screening in women younger than 50 years with a moderate family history of breast cancer. A total of 6,710 women were enrolled between 2003 and 2007 across the United Kingdom, of whom 91% were aged 40-44 at enrolment.…”

Section: Designmentioning

confidence: 99%

“…Women with a moderate family history of breast cancer may be offered annual mammography from age 40 to 49. 6,7 Mammographic density (MD) is a strong risk factor for breast cancer, both in terms of relative and attributable risk, [10][11][12] in pre-and postmenopausal women. 13 MD reporting using the BI-RADS system is mandatory in many parts of the United States.…”

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confidence: 99%

“…5 There is evidence that targeted screening in women aged 40-49 at intermediate familial risk might be a reasonable approach. 6,7 In England, the NHS breast screening programme (NHSBSP) has been in place since 1988 and invites women aged 50-70 for 3-yearly mammographic screening and is currently being expanded to invite women from age 47 to 73. 8,9 Thus women in their 40s are mostly excluded from the programme, and access to breast cancer screening in this age group is limited.…”

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confidence: 99%

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A case‐control study to assess the impact of mammographic density on breast cancer risk in women aged 40–49 at intermediate familial risk

Assi

Massat

Thomas

et al. 2014

Intl Journal of Cancer

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Mammographic density is a strong risk factor for breast cancer, but its potential application in risk management is not clear, partly due to uncertainties about its interaction with other breast cancer risk factors. We aimed to quantify the impact of mammographic density on breast cancer risk in women aged 40-49 at intermediate familial risk of breast cancer (average lifetime risk of 23%), in particular in premenopausal women, and to investigate its relationship with other breast cancer risk factors in this population. We present the results from a case-control study nested with the FH01 cohort study of 6,710 women mostly aged 40-49 at intermediate familial risk of breast cancer. One hundred and three cases of breast cancer were agematched to one or two controls. Density was measured by semiautomated interactive thresholding. Absolute density, but not percent density, was a significant risk factor for breast cancer in this population after adjusting for area of nondense tissue (OR per 10 cm 2 5 1.07, 95% CI 1.00-1.15, p 5 0.04). The effect was stronger in premenopausal women, who made up the majority of the study population. Absolute density remained a significant predictor of breast cancer risk after adjusting for age at menarche, age at first live birth, parity, past or present hormone replacement therapy, and the Tyrer-Cuzick 10-year relative risk estimate of breast cancer. Absolute density can improve breast cancer risk stratification and delineation of high-risk groups alongside the Tyrer-Cuzick 10-year relative risk estimate.

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Section: Designmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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A case‐control study to assess the impact of mammographic density on breast cancer risk in women aged 40–49 at intermediate familial risk

Assi

Massat

Thomas

et al. 2014

Intl Journal of Cancer

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“…In order to evaluate this, prospective observational cohorts, ideally utilizing a range of sample collection and/or repeated blood collection so that a panel of genes can be evaluated in the plasma would be essential for uncovering whether or not plasma markers can enhance the potential of screening with MRI. For average risk women who are already postmenopausal, mammography has already been shown to be highly effective at reducing mortality [1, 105] so the main question for subsequent research would be whether plasma markers can help make the findings from mammography more useful in terms of informing the screening interval (number of years between screens) as well as improve the overall specificity of mammography to reduce the false positives.…”

Section: Dna Methylation Markers For Secondary Prevention and Early Dmentioning

confidence: 99%

Epigenetic Biomarkers of Breast Cancer Risk: Across the Breast Cancer Prevention Continuum

Terry

McDonald

et al. 2016

Advances in Experimental Medicine and Biology

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Epigenetic biomarkers, such as DNA methylation, can increase cancer risk through altering gene expression. The Cancer Genome Atlas (TCGA) Network has demonstrated breast cancer-specific DNA methylation signatures. DNA methylation signatures measured at the time of diagnosis may prove important for treatment options and in predicting disease-free and overall survival (tertiary prevention). DNA methylation measurement in cell free DNA may also be useful in improving early detection by measuring tumor DNA released into the blood (secondary prevention). Most evidence evaluating the use of DNA methylation markers in tertiary and secondary prevention efforts for breast cancer comes from studies that are cross-sectional or retrospective with limited corresponding epidemiologic data, raising concerns about temporality. Few prospective studies exist that are large enough to address whether DNA methylation markers add to the prediction of tertiary and secondary outcomes over and beyond standard clinical measures. Determining the role of epigenetic biomarkers in primary prevention can help in identifying modifiable pathways for targeting interventions and reducing disease incidence. The potential is great for DNA methylation markers to improve cancer outcomes across the prevention continuum. Large, prospective epidemiological studies will provide essential evidence of the overall utility of adding these markers to primary prevention efforts, screening, and clinical care.

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“…For patients at familial risk of breast cancer preventive measures such as risk-reducing prophylactic surgery, chemoprevention or increased surveillance can reduce cancer incidence and/or mortality (Carbine et al 2018;Cuzick et al 2013;Domchek et al 2010;Duffy et al 2013). In England, the National Institute for Health and Care Excellence (NICE) guideline for identification and management of familial breast cancer risk includes referral criteria for general practitioners (NICE 2013).…”

Section: Introductionmentioning

confidence: 99%

Characteristics predicting recommendation for familial breast cancer referral in a cohort of women from primary care

et al. 2020

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Family history of breast and related cancers can indicate increased breast cancer (BC) risk. In national familial breast cancer (FBC) guidelines, the risk is stratified to guide referral decisions. We aimed to identify characteristics associated with the recommendation for referral in a large cohort of women undergoing FBC risk assessment in a recent primary care study. Demographic, family history, psychological and behavioural factors were collected with family history questionnaires, psychological questionnaires and manual data extraction from general practice electronic health records. Participants were women aged 30-60 with no previous history of breast or ovarian cancer. Data from 1127 women were analysed with stepwise logistic regression. Two multivariable logistic models were developed to predict recommendations for referral: using the entire cohort (n = 1127) and in a subgroup with uncertain risks (n = 168). Model performance was assessed by the area under the receiver operating curve (AUC). In all 1127 women, a multivariable model incorporating five family history components (BC aged < 40, bilateral BC, prostate cancer, first degree relative with ovarian cancer, paternal family history of BC) and having a mammogram in the last 3 years, performed well (AUC = 0.86). For the 168 uncertain risk women, only paternal family history of BC remained significant (AUC = 0.71). Clinicians should pay particular attention to these five family history components when assessing FBC risk, especially prostate cancer which is not in the current national guidelines.

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Evaluation of mammographic surveillance services in women aged 40–49 years with a moderate family history of breast cancer: a single-arm cohort study

Cited by 10 publications

References 42 publications

A case‐control study to assess the impact of mammographic density on breast cancer risk in women aged 40–49 at intermediate familial risk

A case‐control study to assess the impact of mammographic density on breast cancer risk in women aged 40–49 at intermediate familial risk

Epigenetic Biomarkers of Breast Cancer Risk: Across the Breast Cancer Prevention Continuum

Characteristics predicting recommendation for familial breast cancer referral in a cohort of women from primary care

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