1. Department of Gynecology and Obstetrics, Breast Cancer Center, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile.
J Cancer. 2013 Jul 1;4(5):433-46. doi: 10.7150/jca.6481. Print 2013.
Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining "high risk"; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk.
我们需要为乳腺癌高危个体创建一个项目，这促使我们研究了现有关于此类项目的资料。在本文中，我们总结了我们的发现和思考过程，介绍了我们如何开发自己的项目。乳腺癌的发病率在全球范围内呈上升趋势。尽管已经有一些已知的乳腺癌发病风险因素，但大约 60%的乳腺癌患者没有已知的风险因素，尽管这种情况可能会随着进一步的研究而改变，尤其是在遗传学方面。对于基于个人或家族史的风险因素的患者，有不同的模型可用于评估和量化风险。风险水平的分配允许进行有针对性的筛查和降低风险策略。为高乳腺癌风险女性制定专门计划的潜在好处包括：根据风险对患者进行分层，从而使干预更加具有成本效益；生成有助于推动科学发展的有价值的数据；以及将乳腺项目与其他乳腺癌科室区分开来，这可能会增加收入，可用于进一步改善患者护理。来自不同组织的指南提供了针对乳腺癌高危患者的护理指导。然而，运行高风险乳腺癌项目不仅仅是应用指南那么简单。每个高风险项目都需要由其所在机构根据当地资源和国家法规进行设计，特别是与遗传问题相关的法规。成功开发高风险项目包括确定优势、劣势、机会和威胁；制定推广计划；选择风险评估工具；定义“高风险”；并为项目服务的特定人群规划筛查和降低风险策略。本文中的信息可能对其他考虑为高乳腺癌风险患者创建项目的机构有用。
