Breast Cancer
Conditions
Keywords
BCRAT, IBIS, Breast Cancer, BRCA1, BRCA2, BRCA, BRCA 1/2, Tyrer-Cuzick, CEDM, PRS
Brief summary
The primary aim of this study is to determine if the addition of an individual polygenic risk score (PRS) in addition to the Breast Cancer Risk Assessment Tool (BCRAT) or Tyrer-Cuzick (IBIS) score will aid women at risk of breast cancer in making a decision to take (or not take) medications to prevent breast cancer.
Detailed description
This is a minimal risk prospective multisite study with a single arm incorporating the PRS into a standard breast cancer risk reduction consultation, followed by annual surveys over 10 years to determine if and how the availability of the PRS influenced patient decisions regarding preventive medicine and medication compliance. Because women know beforehand that the PRS is pending, study participants will be advised that a final decision to take preventive medicine must be deferred until after the PRS results are made available. Nevertheless, a survey of understanding of risk and benefit and assessment of willingness to take preventive medicine will be done prior to receiving the PRS results and then another survey will be completed after receiving the PRS score.
Interventions
GENETICPolygenic Risk Score
A Polygenic Risk Score (PRS) is a blood based genetic test which assesses 300 common breast cancer susceptibility loci (Single Nucleotide Polymorphisms). The PRS has been retrospectively validated and categorizes women into three categories of lifetime risk of developing breast cancer: Low Risk (\<15% lifetime risk), Above Average Risk (15 to 40%), and high risk (\>40 %).
Sponsors
Mayo Clinic
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
35 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Women \>= 35 years old and =\< 75 years old with at least one of the following: * A National Cancer Institute (NCI)-BCRAT 5 year risk of \>= 3% which corresponds to the level in which there is moderate evidence of treatment benefit outweighing risk according to the United States (US) Preventative Services Task Force * IBIS (Tyrer-Cuzik) score for the 10 year risk of breast cancer of \>= 5% * History atypical ductal hyperplasia or atypical lobular hyperplasia with a BCRAT \>= 3% or IBIS \>= 5% * History of lobular carcinoma in situ with a BCRAT \>= 3% or IBIS \>= 5% OR * Women \>= 18 years old or =\< 75 years old with a BRCA 1 or 2 mutation, CHEK 2, PALB 2, ATM, or other hereditary breast mutation carrier per investigator * Willing and able to provide an email address to receive study surveys * Able to participate in all aspects of the study * Understand and sign the study informed consent
Exclusion criteria
* Women whose BCRAT falls below the threshold (\<3 % 5 year risk) of moderate benefit according to the US Preventative Task Force AND Women whose IBIS score is \<8% for the 10 year risk * Women with known contra-indications to Tamoxifen, raloxifene ,exemestane, or anastrazole * Current or prior use of Tamoxifen, raloxifene, exemestane or anastrazole * Unable to give informed consent * Prior history of invasive breast cancer, ductal carcinoma in situ or other breast cancers * At high risk due to prior radiation therapy to the chest * Women who are pregnant or breastfeeding * Prior risk reducing or prophylactic mastectomy * Unwilling or unable to provide an email address for study surveys to be sent to * Subject has a known history or any condition or factor judged by the investigator to preclude participation in the study or which might hinder adherence
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Patient self-reported intention to take a breast cancer preventing medication | up to 6 months after initial consultation |
Secondary
| Measure | Time frame |
|---|---|
| Proportion of patients who are taking preventative medications each year for 10 years | Each year for up to 10 years |
| Endocrine related quality of life scores each year for 10 years | Each year for up to 10 years |
| Proportion of patient who are pursuing supplemental screening for 10 years | Each year for up to 10 years |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORSandhya Pruthi, MD
Mayo Clinic
Outcome results
None listed