Kim Geunwon, Bahl Manisha
Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA, USA.
Massachusetts General Hospital, Department of Radiology, Boston, MA, USA.
J Breast Imaging. 2021 Feb 19;3(2):144-155. doi: 10.1093/jbi/wbab001. eCollection 2021 Mar-Apr.
Accurate and individualized breast cancer risk assessment can be used to guide personalized screening and prevention recommendations. Existing risk prediction models use genetic and nongenetic risk factors to provide an estimate of a woman's breast cancer risk and/or the likelihood that she has a or mutation. Each model is best suited for specific clinical scenarios and may have limited applicability in certain types of patients. For example, the Breast Cancer Risk Assessment Tool, which identifies women who would benefit from chemoprevention, is readily accessible and user-friendly but cannot be used in women under 35 years of age or those with prior breast cancer or lobular carcinoma in situ. Emerging research on deep learning-based artificial intelligence (AI) models suggests that mammographic images contain risk indicators that could be used to strengthen existing risk prediction models. This article reviews breast cancer risk factors, describes the appropriate use, strengths, and limitations of each risk prediction model, and discusses the emerging role of AI for risk assessment.
准确且个性化的乳腺癌风险评估可用于指导个性化筛查和预防建议。现有的风险预测模型利用遗传和非遗传风险因素来估计女性患乳腺癌的风险以及她携带某种或某些突变的可能性。每个模型都最适用于特定的临床场景,在某些类型的患者中可能适用性有限。例如,乳腺癌风险评估工具可识别出能从化学预防中获益的女性,该工具易于获取且用户友好,但不能用于35岁以下的女性、有过乳腺癌病史的女性或原位小叶癌患者。基于深度学习的人工智能(AI)模型的新兴研究表明,乳腺钼靶图像包含可用于强化现有风险预测模型的风险指标。本文回顾了乳腺癌风险因素,描述了每种风险预测模型的恰当使用方法、优势和局限性,并讨论了AI在风险评估中的新兴作用。