Patient Medical and Risk Additions
There are a few updates to the Breast Cancer Risk model offered by Tyrer-Cuzick. Previously no consideration computed for Father, Son or Brother with breast cancer. These are factored in with the new release. These relatives do not automatically add into the first-degree count for Gail model, only Mother, Daughters and Sisters. From initial review, the new “7” version, appears to output values 10% higher then the previous model.
For those that are not aware, PenRad dynamically processes Tyrer-Cuzick and Gail values as data is entered or changed. This provides instantaneous calculation without multiple pages of data entries like various web services offer, plus eliminates tapping a calculate button, and restart or re-enter if data needs to be altered.
Tyrer-Cuzick version 8 is in process as the writing of this PenTip. This factors in breast density. It appears risk values are significantly reduced as breast density is less dense (majority of the screening population). When released, PenRad will use the last known breast density, or the current density value offered by Volpara, Hologic and iCad density algorithms, all available with automatic worklist and patient integration.
To facilitate the data export to the NMB, several “unknown” responses were added to conform with their data model exchange. As most of us would select an item that is “true”, if applicable, and not select it if “unknown” or “false”, however now the request appears to select “unknown” if unknown. Logic is integrated to automate.
One would assume that the respond is “unknown” for all items, because until detected how would one know?
Added to Medical and Risk History screen with select/deselect logic; Unknown if non-1st degree family BC, Unknown if personal gynecological cancer, Unknown if family Hx gynecological cancer, Family Hx gynecological cancer, Unknown if Bx of atypical hyperplasia, Unknown if Bx of LCIS, Unknown if HRT usage.
Added code to automatically “comb” though the patient’s pathology exams and select biopsy history types for the breast cancer risk engines, instead of manual selection by staff. If selected manually it remains selected.
Personal breast cancer history is automatically selected where pathology exam contains:
Any malignancy or is reflected in breast history screen.
Biopsy of Atypical Hyperplasia is automatically selected where pathology exam contains:
ADH-Atypical Ductal Hyperplasia, ALH-Atypical Lobular Hyperplasia
Biopsy of Hyperplasia is automatically selected where pathology exam contains:
HY-Hyperplasia, VGH-Virginal Hyperplasia, LH-Lobular Hyperplasia, ANH-Axillary Node Hyperplasia,
DHU-Ductal Hyperplasia, FAH-Fibroadenomatoid Hyperplasia, PSH-Pseudoangiomatous Stromal Hyperplasia
Biopsy of LCIS is automatically selected where pathology exam contains:
LS-Lobular Carcinoma In Situ, PLCIS-Pleomorphic Lobular Carcinoma In Situ
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