Breast cancer risk assessment in a mammography screening program and participation in the IBIS-II chemoprevention trial

Loehberg, Christian R.; Jud, Sebastian M.; Haeberle, Lothar; Dilbat, G.; Hein, Alexander; Rauh, Claudia; Dall, P.; Rix, Nadine; Heinrich, Sabrina; Buchholz, Stefan; Lex, B.; Reichler, Barbara; Adamietz, Boris; Schulz-Wendtland, R.; Beckmann, Matthias W.; Fasching, Peter A.

doi:10.1007/s10549-010-0845-8

Cited by 25 publications

(33 citation statements)

References 44 publications

(32 reference statements)

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“…We have also shown that acceptance of more intensive mammographic screening is high (81% of eligible women), and that uptake to prevention studies is relatively low (17%-20%) in the women we identified as high risk. Nevertheless, uptake to PROCAS and to the preventive interventions offered was considerably greater than in a recent study on risk assessment in a population setting from Germany (44) in which 17.7% (n ¼ 446) of participants met the eligibility criteria for IBIS-II, but only 202 of 445 (45%) wished to be informed of their breast cancer risk and only 0.7% (3/446) eventually entered IBIS-II.…”

Section: Discussionmentioning

confidence: 70%

Assessing Individual Breast Cancer Risk within the U.K. National Health Service Breast Screening Program: A New Paradigm for Cancer Prevention

Evans

Warwick

Astley

et al. 2012

Cancer Prevention Research

109

121

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The aim of this study is to determine breast cancer risk at mammographic screening episodes and integrate standard risk factors with mammographic density and genetic data to assess changing the screening interval based on risk and offer women at high risk preventive strategies. We report our experience of assessing breast cancer risk within the U.K. National Health Service Breast Screening Program using results from the first 10,000 women entered into the "Predicting Risk Of breast Cancer At Screening" study. Of the first 28,849 women attending for screening at fifteen sites in Manchester 10,000 (35%) consented to study entry and completed the questionnaire. The median 10-year Tyrer-Cuzick breast cancer risk was 2.65% (interquartile range, 2.10-3.45). A total of 107 women (1.07%) had 10-year risks 8% or higher (high breast cancer risk), with a further 8.20% having moderately increased risk (5%-8%). Mammographic density (percent dense area) was 60% or more in 8.3% of women. We collected saliva samples from 478 women for genetic analysis and will extend this to 18% of participants. At time of consent to the study, 95.0% of women indicated they wished to know their risk. Women with a 10-year risk of 8% or more or 5% to 8% and mammographic density of 60% or higher were invited to attend or be telephoned to receive risk counseling; 81.9% of those wishing to know their risk have received risk counseling and 85.7% of these were found to be eligible for a risk-reducing intervention. These results confirm the feasibility of determining breast cancer risk and acting on the information in the context of population-based mammographic screening. Cancer Prev Res; 5(7);

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Section: Discussionmentioning

confidence: 70%

Assessing Individual Breast Cancer Risk within the U.K. National Health Service Breast Screening Program: A New Paradigm for Cancer Prevention

Evans

Warwick

Astley

et al. 2012

Cancer Prevention Research

109

121

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“…This might be because of the study design. Earlier studies by our group have shown that awareness of breast cancer risk leads to greater willingness among women to address their own risk of breast cancer, either by obtaining information about the risk or by taking part in chemoprevention studies (Fasching et al, 2007;Loehberg et al, 2010). Inviting healthy control individuals to take part in a case-control study for breast cancer might have led to a bias of this type.…”

Section: Discussionmentioning

confidence: 99%

Mammographic density as a risk factor for breast cancer in a German case–control study

Heusinger

Loehberg

Haeberle

et al. 2011

European Journal of Cancer Prevention

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Mammographic percent density (MD) is recognized as one of the strongest risk factors associated with breast cancer. This matched case-control study investigated whether MD represents an independent risk factor. Mammograms were obtained from 1025 breast cancer patients and from 520 healthy controls. MD was measured using a quantitative computer-based threshold method (0-100%). Breast cancer patients had a higher MD than healthy controls (38 vs. 32%, P<0.01). MD was significantly higher in association with factors such as age over 60 years, body mass index (BMI) of 25-30 kg/m², nulliparity or low parity (one to two births). Average MD was inversely associated with age, BMI, parity and positively associated with age at first full-term pregnancy. MD was higher in women with at least one first-degree relative affected, but only among patients and not in the group of healthy controls (P<0.01/P=0.61). In women with an MD of 25% or more, the risk of breast cancer was doubled compared with women with an MD of less than 10% (odds ratio: 2.1; 95% confidence interval: 1.3-3.4; P<0.01); in the postmenopausal subgroup, the risk was nearly tripled (odds ratio: 2.7; 95% confidence interval: 1.6-4.7; P<0.001). This study provides further evidence that MD is an important risk factor for breast cancer. These results indicate strong associations between MD and the risk of breast cancer in a matched case-control study in Germany.

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“…Additionally incorporating cross-over trial designs where all subjects will have the opportunity to receive study agent and placebo may be a more acceptable option. Emphasizing the importance of trial requirements thorough counseling at study presentation has been observed to improve recruitment of better research team and subject dynamics [14,25,26]. …”

Section: Discussionmentioning

confidence: 99%

Chemoprevention Trial Feasibility Using Botanicals in Exceptionally High Risk Populations for Lung Cancer

et al. 2014

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While chemoprevention with botanicals shows promise in reducing cancer risk, recruitment and retention of participants for trials continues to be costly and presents unique challenges. Knowledge of interest, willingness of target populations and evaluation of design challenges are critical to improve accrual in these chemoprevention trials. Objective The study assessed interest and willingness of former smokers to participate in a chemoprevention trial using a botanical agent. Methods An introductory letter and survey instrument were mailed to 609 consecutive, former heavy smokers, with no cancer, from a database of 826 subjects at the Moffitt Cancer Center. Results 202 (40.4%) subjects returned completed surveys. 92-96% reported interest in receiving free lung exams and knowing their lung cancer risk. 88% were interested in participating in a trial evaluating a botanical agent for lung cancer prevention. Over 92% of subjects reported willingness to comply with study requirements; multiple blood draws and trips to the Center, spiral CTs and chest x-rays. Subjects were relatively less enthusiastic (73-79%) about bronchoscopy, taking multiple study agents and assignment to placebo arm. Conclusions Our study strongly suggests feasibility, highlights potential challenges and the significant interest and willingness of this exceptionally high risk population to participate in chemoprevention trials.

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Breast cancer risk assessment in a mammography screening program and participation in the IBIS-II chemoprevention trial

Abstract: helpful to increase the participation and the understanding of chemopreventive approaches.

Cited by 25 publications

References 44 publications

Assessing Individual Breast Cancer Risk within the U.K. National Health Service Breast Screening Program: A New Paradigm for Cancer Prevention

Assessing Individual Breast Cancer Risk within the U.K. National Health Service Breast Screening Program: A New Paradigm for Cancer Prevention

Mammographic density as a risk factor for breast cancer in a German case–control study

Chemoprevention Trial Feasibility Using Botanicals in Exceptionally High Risk Populations for Lung Cancer

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