Use and Applicability of the Gail Model to Calculate Breast Cancer Risk: A Scoping Review

Stevanato, Kely Paviani; Pedroso, Raíssa Bocchi; Agnolo, Cátia Millene Dell; Santos, Lander dos; Pelloso, Fernando Castilho; Carvalho, Maria Dalva de Barros; Pelloso, Sandra Marisa

doi:10.31557/apjcp.2022.23.4.1117

Cited by 8 publications

(3 citation statements)

References 33 publications

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“…There is no universally accepted guideline to for test providers to ensure that their risk assessment report is understandable by patients. Results from the Gail Model may not be easily understood by patients [39,40]. Moreover, the format of reporting may impact the translation of genetic test results into clinical recommendations, the interpretation of test results, and ultimately, patients’ adherence to the recommended actions [41,42].…”

Section: Discussionmentioning

confidence: 99%

What do women want to see in a personalized breast cancer risk report? A qualitative study of Asian women of two countries

Aldila,

Fiona Ng,

Audrienna

et al. 2023

Preprint

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Introduction: A breast cancer risk assessment tool using Polygenic Risk Score (PRS) assessment of 313 single nucleotide polymorphisms and a risk prediction algorithm from the Gail Model had been established and validated for Asian population. Through facilitated focus group discussions, we assessed the preferences of women from two Asian countries regarding the presentation of risk results, the level of detail provided for explanations, and recommendations for follow-up actions. Methods: This qualitative study was conducted between July to October 2022 with Asian women above the age of 25. We structured a focus group discussion to evaluate the views and perceptions of women in Indonesia and Singapore in relation to personalized breast cancer risk assessment. All participants received either a detailed high-risk or low-risk mock report and were assigned to either high-risk result or low-risk result focus group based on the report they had randomly received. All focus group discussion content was then thematically analyzed. Results: In Singapore, participants preferred a detailed report as it was comprehensive and provided follow-up steps and information to manage their breast cancer risk. Participants raised the need for visuals without colors that project intimidation as well as a summary on the first page of the report to support interpretations. Regarding content, participants expected recommended actions to reduce their risk. Communication styles could also be improved with simplified language. Furthermore, we identified anxious responses from participants receiving high-risk results and relieved responses from those receiving low-risk results. Overall, participants found the report useful and would like to see similar reports on other diseases in the future. Conclusion: Overall, most patients prefer a test report to be well balanced between content and complexity. The study also highlighted the importance of psychological impact of patients receiving their test reports, which is greatly influenced by the patients' degree of understanding and interpretation of the reports. Finally, as most patients would likely increase their engagement with their physicians upon receiving their test results, future studies could be extended to physicians who are directly involved in the patient care delivery of breast cancer prevention.

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Section: Discussionmentioning

confidence: 99%

What do women want to see in a personalized breast cancer risk report? A qualitative study of Asian women of two countries

Aldila,

Fiona Ng,

Audrienna

et al. 2023

Preprint

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“…The Gail scale is used to assess the individual risk of developing breast cancer. It takes into account the age at which menarche occurred, the number of previously performed breast biopsies, the presence of atypical hyperplasia in the biopsy material, the age at which the first live birth occurred, the incidence of breast cancer in first-degree relatives, and age [6].…”

Section: Introductionmentioning

confidence: 99%

Women’s health behaviours regarding early detection of breast cancer

Kamińska,

Bielak,

Surdyka

2024

Med Srod.

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Introduction andObjective. Breast cancer is the most common malignant tumour among women in highly developed countries, including Poland, and ranks first in terms of the incidence of malignant tumours in women. In the early stages of development, breast cancer may be completely asymptomatic, but in the advanced stage of the disease it causes numerous symptoms that impair functioning in every sphere of life. Integrated methods of oncological surgery, radiotherapy, chemotherapy and hormone therapy are used to treat breast cancer. Pro-health behaviours involving the elimination or modification of risk factors are promoted among women, as well as activities enabling early identification of disturbing symptoms related to cancer, such as breast self-examination or participation in a breast cancer prevention programme. Breast cancer diagnosed early has a high cure rate. The aim of this study is to review the literature on the impact of desired behaviours and activities in the field of breast cancer prevention. Brief description of the state of knowledge. Women's knowledge about early diagnosis and risk factors of breast cancer is expanding. New drugs and therapy options have a positive impact on improving the prognosis, but the most important thing is to detect cancer at an early stage. Maintaining the so-called oncological vigilance expressed in knowledge of potential symptoms of breast cancer and the use of preventive and screening tests. Summary. Breast cancer prevention should include educating women of all ages about the need for regular breast self-examination, medical examinations and, above all, participation in preventive programmes. Knowledge about early cancer detection methods, risk factors and prevention methods is vital in the fight against breast cancer in women.

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“…However, it recognizes that the accuracy for ethnic subgroups needs to be further validated. The model also fails to consider many modifiable risk factors that significantly influence an individual's estrogen and androgen exposure [13].…”

Section: Introductionmentioning

confidence: 99%

Application of SHAP for Explainable Machine Learning on Age-Based Subgrouping Mammography Questionnaire Data for Positive Mammography Prediction and Risk Factor Identification

Sun

Tang

et al. 2023

Healthcare

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Mammography is considered the gold standard for breast cancer screening. Multiple risk factors that affect breast cancer development have been identified; however, there is an ongoing debate regarding the significance of these factors. Machine learning (ML) models and Shapley Additive Explanation (SHAP) methodology can rank risk factors and provide explanatory model results. This study used ML algorithms with SHAP to analyze the risk factors between two different age groups and evaluate the impact of each factor in predicting positive mammography. The ML model was built using data from the risk factor questionnaires of women participating in a breast cancer screening program from 2017 to 2021. Three ML models, least absolute shrinkage and selection operator (lasso) logistic regression, extreme gradient boosting (XGBoost), and random forest (RF), were applied. RF generated the best performance. The SHAP values were then applied to the RF model for further analysis. The model identified age at menarche, education level, parity, breast self-examination, and BMI as the top five significant risk factors affecting mammography outcomes. The differences between age groups ranked by reproductive lifespan and BMI were higher in the younger and older age groups, respectively. The use of SHAP frameworks allows us to understand the relationships between risk factors and generate individualized risk factor rankings. This study provides avenues for further research and individualized medicine.

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Use and Applicability of the Gail Model to Calculate Breast Cancer Risk: A Scoping Review

Cited by 8 publications

References 33 publications

What do women want to see in a personalized breast cancer risk report? A qualitative study of Asian women of two countries

What do women want to see in a personalized breast cancer risk report? A qualitative study of Asian women of two countries

Women’s health behaviours regarding early detection of breast cancer

Application of SHAP for Explainable Machine Learning on Age-Based Subgrouping Mammography Questionnaire Data for Positive Mammography Prediction and Risk Factor Identification

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