| Autor: |
Zachariae S; Leipzig University, Germany., Quante AS; Technical University of Munich, Munich, Germany., Kiechle M; Technical University of Munich, Munich, Germany., Rhiem K; University of Cologne, Cologne, Germany., Fehm TN; Düsseldorf University Hospital, Düsseldorf, Germany., Schröder JG; Institute of Human Genetics, Biozentrum, Germany., Horvath J; University Hospital Münster, Muenster, Germany., Leinert E; University Hospital Ulm, Ulm, Germany., Dikow N; University Hospital Heidelberg, Heidelberg, Germany., Ronez J; Hannover Medical School, Germany., Schönfeld M; Ludwig-Maximilians-Universität München, Germany., van Mackelenbergh MT; University Hospital Schleswig-Holstein, Kiel, Germany., Schatz UA; Technische Universität München, Munich, Germany., Meisel C; University Hospital Carl Gustav Carus, Germany., Aktas B; University Hospital Leipzig, Leipzig, Germany., Witt D; University of Tübingen, Germany., Mehraein Y; Universitätsmedizin Göttingen, Germany., Weber BHF; University of Regensburg, Regensburg, Germany., Solbach C; Goethe University Frankfurt, Frankfurt, Germany., Speiser D; Charité - Universitätsmedizin Berlin, Germany., Hoyer J; Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bavaria, Germany., Faigle-Krehl G; University Medical Center Freiburg, Germany., Much CD; Greifswald University Hospital, Germany., Mueller-Rausch AV; University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Villavicencio-Lorini P; Martin Luther University Halle-Wittenberg, Germany., Banys-Paluchowski M; University Hospital Schleswig-Holstein, Germany., Pieh D; University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Rhineland-Palatine, Germany., Schmutzler RK; University Hospital Cologne, Germany., Fischer C; Heidelberg University, Heidelberg, Germany., Engel C; Leipzig University, Leipzig, Germany. |
| Abstrakt: |
The German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC) has successfully implemented risk-adapted breast cancer surveillance for women at high breast cancer risk in Germany. Women with a family history of breast and ovarian cancer, but without pathogenic germline variants in recognized breast cancer risk genes, are recommended annual breast imaging if their predicted 10-year breast cancer risk is 5% or higher, using the BOADICEA BC risk model, as outlined in the current GC-HBOC guideline. However, women who initially do not meet this risk threshold may do so later, even if there is no new cancer in their family. To determine when this threshold is crossed, one could annually repeat BOADICEA calculations using an aging pedigree: the 'prediction by aging pedigree' (AP) approach. Alternatively, we propose a simplified and more practical 'conditional probability' (CP) approach which calculates future risks based on the initial BOADICEA assessment. Using data from 6,661 women registered with GC-HBOC, both methods were compared. Initially, 74% of women aged 30 to 48 years had a 10-year breast cancer risk below 5%, but 53% exceeded this threshold at an older age based on the AP approach. Among the women with an initial risk below the threshold, the CP approach revealed that 99% of women exceeded the 5% threshold at the same or an earlier age compared with the AP approach (88% of cases were within the same year or one year earlier). The CP approach has been implemented as a user-friendly web application. |
