*Download the complete data elements file at the bottom of this PenTip.
Abbreviations – BC = Breast cancer, TC = Tyrer-Cuzick risk model, Gail = Gail risk model same as NCI model, NMD = National Mammogram Database, Bx = biopsy, Hx = history, HRT = Hormone replacement therapy, BMI = Body Mass Index.
The matrix (chart page 1) indicates individual data elements listed in first column for export, risk models and/or notification. Second column items with “yes” are included in NMB export, third column items with “yes” are utilized in Gail risk model, fourth column items with “yes” are utilized in Tyrer-Cuzick risk model. Fifth column “comments” reflects observations and or where data is obtained.
Tyrer-Cuzick; Incorporates Estrogen usage independently as a risk factor, and alters risk value when used with Progesterone during the overlap usage interval. Estrogen usage greater than 5 years ago does not alter current risk value. Estrogen/Progesterone usage length is derived from “duration” and “plan duration“ data fields. Independent Progesterone usage does not alter risk model.
The Patient Medical and Risk History screen collects majority of the items influencing risk. The grid facilitates capture of patient’s and relatives’ instances of breast cancer, ovarian cancer, and genetic BRCA test results. This screen interacts with PenRad’s patient survey module (tablet or kiosk), and the Hughes Risk Application.
To add a relative ”relation” or self, tap on relation type “(add)” cell, and select relation. Repeat to add others. To change relation type, tap on relation and select new type. Tap remove to remove relation entry.
To update a relative or self with onset age of breast and/or ovarian cancer, and/or genetic BRCA results, tap on row cell to select. If age unknown, select “Unk”. To remove age of, tap blank area on age screen.
To specify results of genetic testing, select result for self and/or relative in row cell.
The Gail model uses the number of FIRST degree relatives (parents, siblings and children) with breast cancer for risk assessment derived from the number indicated in risk factors column. Count advances automatically as first degree relatives with breast cancer are entered into relation grid. User can manually chose number as well. Tyrer-Cuzick primarily uses FIRST and SECOND degree relatives (grandmothers, aunts, cousins) PLUS it requires the on-set age of breast cancer and ovarian cancer if applicable from grid for risk assessment.
Tap the Update Tyrer-Cuzick button to re-calculate risk values if required real-time, values are updated on exit of screen. Entering complete information ensures improved accurate risk assessment with either risk model. Specifying relatives without breast or ovarian cancer reduces overall risk assessment in Tyrer-Cuzick model.
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