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A tool available as an online calculator played a key role in actress Olivia Munn's diagnosis of breast cancer – albeit after she had a “routine mammogram”, as she posted on social media.
The “X-Men: Apocalypse” star, 43; He wrote in an Instagram post She was diagnosed with breast cancer last year and would not have been diagnosed if her doctor, Dr. Tais Aliabadi, had not calculated her risk of breast cancer, she reported Wednesday.
Using that assessment, Aliabadi found that Moon's lifetime chance for breast cancer was 37 percent. Because of that point, Moon had more reviews, which led to her investigation, according to her post.
The Breast Cancer Risk Assessment Tool uses a statistical model to estimate a woman's risk of developing breast cancer in the next five years and over her lifetime or until age 90. National Cancer Institute.
The tool typically includes several questions about the person's medical history, reproductive history, and family history. Although it is often used by health professionals, patients can complete the assessment online.
Two models are commonly used as breast cancer risk assessment tools: the GAIL model and the Tyrer-Cuzick Risk Assessment Calculator. An online version of the Breast Cancer Risk Assessment Tool using the Gail Model can be taken by anyone. bcrisktool.cancer.gov. It shows the patient's five-year estimated risk of developing breast cancer, along with the average risk for women of her age and race in the United States.
“While they accurately estimate a woman's risk, these predictors do not accurately predict which women will develop breast cancer. In fact, some women who do not develop breast cancer have a higher risk of developing breast cancer than women who do,” reports the National Cancer Institute website.
A family history of breast cancer or other cancers is a reason a doctor may want to perform a breast cancer risk assessment on their patients, which is very common for a doctor, says Dr. Jennifer Plicha, director of the Breast Risk Assessment Clinic. of Duke Cancer Institute in Durham, North Carolina
“I personally think every woman should know what her breast cancer risk is. I don't care if you think you are low risk or high risk. I think it's worth at least one discussion. In general, many organizations are actually saying that discussions should start around 25 years,” Plicha said.
“When your doctor asks you a lot of questions and they seem to be sniffling, they're probably doing some kind of informal risk assessment in their head,” she said. “Then you can take the next step, which we call formal risk assessment, and you start using a mathematical model that's been developed to determine a woman's risk.”
If someone takes their own risk assessment online, they should discuss their results with their doctor, Plichta said.
“Anyone doing one of these risk assessments online should follow up with a conversation with the service provider, just to make sure they understand the meaning of what they find and do it correctly,” Plichta said.
“There are definitely times when I've had patients that I thought were high risk, and I would have run a little bit more of a subtle or detailed risk assessment, and they weren't. And I have experienced the opposite,” she said. “I think online tools are good for starting a conversation about this. Some of these online models are a little generic. They're useful, they definitely have a role, and it's a good place to start — but I don't think I'm going to end the conversation there.”
The Breast Cancer Risk Assessment Tool asks for the patient's age, first period, whether they have had a breast biopsy, age at full-term pregnancy, and family history of breast cancer. Among other reasons, Dr. Otis Brawley, a professor of oncology and epidemiology at Johns Hopkins University, said in an email Wednesday.
All of these factors are factored into an algorithm that calculates the risk score. Some people may have high scores even if they do not have gene mutations known to be associated with breast cancer risk.
“It's a way of distinguishing who is at high risk and who is at normal or low risk,” Brawley said, adding that a woman in her 40s has an average risk of 0.9% over five years and 12% over her lifetime.
“It has some caveats that it may underestimate the risk in black women and Hispanic women born outside the U.S. who have been biopsied before,” Brawley said of the assessment tools.
“I'd rather have women do this with a doctor or genetic counselor who knows the downsides,” he said. “The tool is useful, but it can make a woman worry that her risk is higher than it really is, or give someone false assurance that the risk is low.”
A person with a high score on the breast cancer risk assessment may be recommended for additional evaluations of the breast in addition to a routine mammogram.
In Moon's case, she was sent for a breast MRI, or magnetic resonance imaging, which led to an ultrasound and then a biopsy, she wrote in an Instagram post.
Dr. Larry Norton, a breast oncologist and medical director of Evelyn H., said, “The reason someone might have an MRI is because it's calculated based on a mathematical model that they have a high risk of breast cancer.” Lauder Breast Center at Memorial Sloan Kettering Cancer Center.
A mammogram evaluates two things, breast tissue density and breast calcification, which are calcium deposits in the breast tissue.
However, “MRIs look for blood vessels, because one of the things that cancers do when they become cancerous is to make abnormal blood vessels,” Norton said.
“So MRIs supplement mammograms. They don't replace mammograms in most people,” he said.
For some women, a breast risk assessment tool may not be accurate or appropriate, said Robert Smith, senior vice president of early cancer screening sciences for the American Cancer Society, in an email Wednesday.
“A woman with a history of breast cancer or a carrier of a breast cancer susceptibility gene mutation should note the disclaimers about using the device. “If a woman has a history of multiple first- or second-degree relatives with breast cancer, this device is not suitable for them,” he wrote.
“For a woman who is at high risk because of her family history, there are tools that are appropriate for her situation,” he said. “Most women, on average, fall into different risk factors, and the tool doesn't suggest that they should be screened any differently than is currently recommended.”
The US Preventive Services Task Force issued a draft recommendation last year that all women with an average risk of developing breast cancer should begin screening mammograms at age 40, reducing their risk of dying from the disease.
of USPSTF Recommendations are a set of independent medical experts used to guide doctors' decisions and influence insurance plans, and this draft proposal echoes what some groups like the American Cancer Society have been recommending: that average-risk women initiate mammograms themselves. The 40s
of The American Cancer Society recommends Women at high risk for breast cancer based on certain factors a Breast MRI And a mammogram every year, preferably starting at age 30.
Access to a breast cancer risk assessment tool is empowering for patients, Dr. Ruth Oratz, a breast medical oncologist at NYU Langone Health's Perlmutter Cancer Center and a clinical professor at NYU Grossman School of Medicine, said in an email Wednesday.
“Access to information empowers patients. It is important for people to know about their health risks, their family history, and their own personal health status. All these things can affect the risk of getting cancer,” she said.
“Depending on the level of risk and the factors that contribute to that risk, women can take steps to help reduce their risk of breast cancer. It's important to maintain a healthy body weight and not be overweight. It's important to eat healthy foods that aren't loaded with sugar and fat. Alcohol increases the risk of breast cancer.” And we advise women not to drink alcohol every day and not to drink more than one or two drinks on the days they do drink.
“We really advise people not to smoke. “Exercising through exercise and some weight training to maintain muscle mass and strength also contribute to overall health,” she says. “Sometimes medications are given to help reduce the risk of breast cancer. Each individual should discuss this with a breast cancer specialist.”