Kerala Doctor Couple Develops Breast Cancer Risk Calculator Based On Extensive Study

Breast cancer is the most common killer among women. In India, the number of breast cancer cases are increasing rapidly. October is also observed as Breast Cancer Awareness Month to raise awareness about the disease, its risk, prevention, and diagnosis.

In order to reduce the risk of death due to the disease, early diagnosis of cancer and risk calculation is very important for which various ways are being devised around the world to make the diagnosis processes easier and convenient. 

According to a report in the Indian Express, a doctor couple from Kerala has developed a tool that can assess the danger of breast cancer development for a woman, in her lifetime.

How The Breast Cancer Risk Calculator Works

The breast cancer risk calculator comes up with a score and is determined by the answers you give to a set of seven questions. 

In order to get diagnosed in the early stages of the disease to prevent death or severe complications, it helps women in determining the kind and frequency of medical screening that they need.

There are seven parameters that the calculator takes into account to create a score, which include current age, age at menarche, age at first live birth, number of live births, history of breastfeeding, number of first-degree relatives with breast cancer, and the total number of breast biopsies. 

Women above 30 years of age are at the highest risk of breast cancer and the tool is most accurate for this age group of women, according to reports. 

A higher score would determine that the woman must undergo regular screening and check-ups. However, you should not skip screening if you have a low score. Regular breast cancer screening and self-examination of breasts are still recommended.

“The sensitivity is 76 per cent, therefore the risk predicted is not an absolute value. However, we see it as a motivator for adopting early detection methods. Based on the score you get, it tells you how often you should be undergoing screening. If your score is below 0.5, you are at low-risk. Anything between 0.5 and 0.75 indicates moderate risk. A score higher than 0.75 shows you are at high-risk,” said Dr. Jose.

Know more about the couple

The couple is Dr. Regi Jose, professor of community medicine at the Sree Gokulam Medical College in Thiruvananthapuram, and her husband Dr. Paul Augustine, head of the division of surgical oncology at the Regional Cancer Centre (RCC) in T’puram. Based on an extensive study on the usefulness of the Gail model in estimating the risk of development of breast cancer, in women in Kerala both of them have devised the risk calculator.

The tool may be useful in identifying high-risk women in our society

Dr. Jose was a part of the thesis which was conducted between June 2003, and March 2005. With a sample size of 1580 that included women diagnosed with breast cancer and that without a history of it, the study was conducted at the RCC and incorporation areas of T’puram.

According to the study, the Gail model was ‘less sensitive’ and major risk factors were among the study population who were of increasing age, previous breast biopsy, first-degree relatives with breast cancer, late age initial to live birth (FLB), and not breastfeeding.

The tool is useful in the US, but not as useful to identify high-risk women in our society. 

“The sensitivity of the Gail model among women here was found to be only 14.2 per cent and so it may not be useful here. So to understand the risk among women here and help develop a score, I did statistical modeling and created a logistic regression equation. With the help of seven variables, the calculator we devised can do a risk prediction ranging between 0 and 1,” said Dr. Jose, reported the daily.

How often should you get screened based on the results of the online calculator?

This calculator gives you a score that is based on the frequency of the screening required to diagnose cancer as early as possible.

 “We advise even those at low-risk to undergo a clinical breast examination from 30 years of age and a baseline mammogram at 50 years. For those at moderate risk, the frequency of clinical breast examination must be every six to twelve months. The problem with our people is that they undergo a mammogram or clinical breast examination just once and if there is nothing to suggest cancer then, they feel they are safe for life and do not continue to get checked later. That’s not how it works. There must be motivation for regular check-ups,” she said.

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