Are you aware of the risk of breast cancer? (Breast Cancer Risk Assessment) Let's talk about this!

It's normal for many of us to feel a little scared and nervous when we hear the word "cancer." But did you know that if we are aware of certain diseases, especially breast cancer, and understand the risks, we can prevent the great harm that can be caused by them? Today we are going to talk about a very important topic. That is Breast Cancer Risk Assessment. Don't worry, we will talk about this very simply, in a way that you can understand.

Simply put, what is this breast cancer risk assessment?

Think of it like a weather report. The weather report doesn't say "it's going to rain today," it says "there's a chance of rain." That's how it is. A breast cancer risk assessment is a way of calculating the likelihood, or chance, of you developing breast cancer in your lifetime. It can never say 100% accurately "you will get cancer" or "you won't."

This is done to see if your risk is higher or lower than normal compared to other women your age and background. This information is very important to your doctor. Because it can help you decide how much attention you need to pay to your breast health and what tests you need to have. Currently, these risk assessment methods are designed only for women. They are not used to measure the risk of breast cancer in men.

So, how do these risk assessment methods work?

There are currently more than 24 different models that measure breast cancer risk. Most of these are online questionnaires that you can complete on your own in as little as 10 minutes. Once you answer these questions, the software calculates a score based on your risk factors .

A risk factor is something that increases the chance of developing a disease. Let's look at the main risk factors for breast cancer. To understand this clearly, see the table below.

What are the main risk assessments used?

Different assessment methods give different weights to these risk factors. That is, they calculate the scores differently. Let's look at some of the most commonly used methods.

The Gail Model (BCRAT)

This is the most well-known and widely used method in the world. It was developed by the National Cancer Institute in the United States. This questionnaire takes less than five minutes to complete. It mainly gives an idea of ​​the risk of developing cancer in the next five years and by the age of 90.

The main questions asked in this are:

• your age
• Race/ethnicity
• History of having children
• Whether a breast biopsy has been performed previously
• Age at first menstruation
• Family history of breast cancer

If this results in a five-year risk of 1.67% or more, it is considered "high-risk." If so, your doctor may prescribe a drug like Tamoxifen, which reduces the risk of cancer. However, this method is not suitable for people who have had cancer before or who are known to have a genetic mutation like BRCA.

IBIS (Tyrer-Cuzik Model)

This method is a little more detailed than the Gail model. It calculates the risk over the next 10 years and over a lifetime. It also takes into account factors such as:

• Breast density
• Body Mass Index (BMI)
• History of ovarian cancer
• Use of hormone therapy (HRT)
• Knowing about the BRCA1 or BRCA2 gene mutation

Based on the results, doctors can decide how often you need breast screening, or whether you need to have a BRCA gene test.

BRCAPRO

This is a bit more specific. This assessment mainly looks at how likely you are to have a BRCA1 or BRCA2 gene mutation in your body. This depends almost entirely on your family history of cancer. It requires a lot of in-depth information, especially the age at which family members developed cancer, genetic testing they have had, and breast or ovarian removal surgeries. Based on the results of this, you can decide whether or not you should have genetic testing.

How will my doctor use these results?

This is the most important thing. If you take an online assessment like this and it says you're "high-risk," don't panic or be afraid. It doesn't mean you have cancer. It's just a good place to start a conversation between you and your doctor.

Based on these results, your doctor may take steps like these:

• Recommending more frequent breast exams: You may be asked to have mammograms or other tests (e.g., MRI) more frequently than usual.
• Referral for Genetic Counseling: You may be referred to a specialist to explain whether testing for genetic mutations that increase your risk of cancer is appropriate and how the results will affect your life and family.
• Prescribing risk-reducing medications: Medications like Tamoxifen can prevent the growth of cancer cells.
• Discussing Preventive Surgery: For someone at very high risk (e.g., someone with a BRCA gene mutation), a prophylactic mastectomy can be discussed before cancer develops. This can greatly reduce the risk.

How reliable are the results of these assessments?

This is something we need to talk about honestly. These assessment methods are based on data collected from large populations. That is, the information from hundreds of thousands of women who have developed cancer is compared to your information, and this result is given. But none of us are statistics. Even if we have the same risk factors, no two people's bodies are the same.

Therefore, these methods have several limitations:

• Data Variations: The data used in some assessment methods may be biased towards one race, so the results may not be equally accurate for everyone.
• Not applicable to all cancers: These methods mostly calculate invasive cancers. Also, they cannot provide information about someone who has already developed cancer.
• Not considering all risk factors:Not all risk factors are covered by a single assessment. Some are more genetic, while others are more lifestyle. That's why sometimes your doctor will ask you to do more than one assessment.

Ultimately, a breast cancer risk assessment cannot predict whether you will develop cancer. But it can alert your doctor to your risk. Getting screened for breast cancer is important for everyone. This assessment is just one more tool to help you decide how to take care of your health. It can also help you get regular checkups. The goal is to find cancer early, when it can be treated.