The incidence of breast cancer from screening women according to predicted family history risk: Does annual clinical examination add to mammography?

摘要: In breast cancer, mutations of predisposition genes such as BRCA-1/2 and other yet uncharacterised are manifest in up to 10% cases. Although the prior probability presence a cancer predisposing gene can be calculated for individual women, there is no published evidence justify predicted risk selection criteria screening. This study aims define which patient groups with significant family history should screened, whether clinical examination necessary addition mammography. The Claus model was used predict women history. Women were divided into two according their risk: group I consisted at standard (lifetime less than 1:6) II moderate/high greater or equal 1:6). cancer-free point entry, screening annual mammography from age 35 years. 1500 1078 II. period observation 5902.0 4327.8 years, respectively. A total 31 cancers detected, 12 19 median diagnosis 45 years (range 26-66 years) compared 54.5 38-63 (P=0.03). relative developing 2.6 (95% confidence interval (CI) 1.2-5.8). When incidence normal population, standardised ratio significantly higher 2.8 CI: 1.7-4.2). similar that general population (1.1 0.6-1.8)). 26/31 (84%) detected palpable, 14 (54%) not visible on Approximately one-third all palpable routine follow-up. Mammography correctly identified 17/31 (55%), but 29% these palpable. Family programmes effective selected risk. younger justifies an earlier using both