Defining the Need for Services for Patients at High Risk of Breast Cancer at a Safety-Net Hospital: An Approach to Narrowing the Disparities Gap.
Level 4 - case-series / case-control
Single-center cross-sectional survey and risk assessment study
PubMed 39138769 · doi:10.1245/s10434-024-15789-6
What was done
A cross-sectional survey and breast cancer risk assessment were administered over a 2-week period in 2023 to women presenting for breast imaging at a safety-net hospital system. Patients with a prior history or diagnosis of breast cancer (n = 35) were excluded. The Tyrer-Cuzick model version 8 was used to calculate 10-year and lifetime breast cancer risk, and NCCN guidelines were used to assess criteria for genetic counseling and testing referral. Patient interest in high-risk services was also surveyed.
What was found
Among 257 included patients, 14.8% (n = 38) had a 10-year risk of 5% or more, 6.2% (n = 16) had a lifetime risk of 20% or more, and 10.5% (n = 27) had a lifetime risk of 15% or more. Criteria for genetic counseling or testing were met by 23.7% (n = 61). Overall, 31.5% (n = 81) qualified for high- or intermediate-risk screening, risk reduction, or genetic assessment, and 92.8% of those qualifying expressed interest in receiving referrals.
Why it matters
This study demonstrates a substantial unmet need and high patient receptivity for formal high-risk breast cancer screening and genetic services within an underserved safety-net population.
Limits
The study was conducted at a single institution over a brief 2-week window with a modest sample size (n = 257), limiting generalizability. Risk assessment relied on self-reported family and medical history without verification, and the study measured expressed patient interest rather than actual referral completion, service uptake, or oncologic outcomes.
Cited by
- supports Breast cancer risk models categorize low risk as less than 15%, intermediate risk as 15% to 20%, and high risk as 20% or greater lifetime risk.