Family History Cancer Risk Assessment
Risk assessment begins with a full history and an accurate three-generation pedigree. Maternal and paternal (mother and father) factors are equally important, something that some clinicians overlook. Of particular importance are the number of family members with associated cancers, ages relatives developed relevant cancers (the younger the more significant) and bilateral disease.
A number of risk calculation tools are available to help clinicians counsel individuals about their risk of developing breast cancer and/or probability of detecting a mutation in the BRCA1/2 gene.
GAIL MODEL – predicts risk of developing breast cancer over the next 5 years. It utilizes 7 key risk factors, several which are non-genetic (e.g. previous breast biopsy and race/ethnicity).
CLAUS MODEL – does not use any non-hereditary risk factors and is poorly concordant with the Gail Model.
BRCAPRO – this statistical model also allows risk calculation of the probability of carrying a BRCA1/2 mutation based on a family history or breast and ovarian cancer. It does not include any non-hereditary factors.
TYRER-CUZICK MODEL - combines genetic and non-genetic risk factors (i.e oestrogen risk factors, benign breast disease)
BOADICEA MODEL (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm) – is a polygenic risk model
MANCHESTER MODEL – is simple clinical tool to enable likelihood calculation of carrying BRCA1/2 mutation.