Türk Kadınlarında Meme Kanseri Risk Değerlendirmesi için Gail, NSABP ve NCI Risk Analiz Modellerinin Duyarlılıkları

Giriş: Kadınlarda en sık görülen kanser olan meme kanserine karşı en iyi koruma erken tanıdır. Meme kanseri gelişimi için yüksek riskli bireyleri tanımlamak için en sık kullanılan risk değerlendirme yöntemleri Gail ve modifikasyonları olan National Surgical Adjuvant Breast and Bowel Project (NSABP) ve National Cancer Institute NCI modelleridir. Araştırmamızda bu modellerin duyarlılıklarını değerlendirmeyi amaçladık. Materyal ve Metot: Ankara Numune Eğitim ve Araştırma Hastanesi ve Ankara Üniversitesi Tıp Fakültesi’nde, Nisan 1998 ile Aralık 2014 tarihleri arasında, meme kanseri tanısı almış 1333 hastayı retrospektif olarak değerlendirdik. Bulgular: Gail modeli hastaların %32,52’ sini yüksek riskli olarak tanımladı. NSABP %15,48 ve NCI modeli %19,39 hastayı yüksek riskli olarak tanımladı. Sonuç: Üç modelin duyarlılığını karşılaştırdığımızda Gail modeli en duyarlısıdır; fakat zaten meme kanseri gelişmiş olan hastaların sadece %32,52’ sini yüksek riskli olarak tanımlayabilmiştir. Sonuçlar arasında korelasyon vardı; ama anlamlı derecede farklı idi. Biz, bu üç modelin, düşük duyarlılık ve zayıf uyuşmalarına bağlı olarak, Türk kadınlarına uygun olmadığına karar verdik. Türk kadınları için, farklı parametreler eklenerek yeni bir risk değerlendirme modeli geliştirilmesine ihtiyaç vardır.

Sensitivities of the Gail, NSABP and NCI Risk Analysis Models for Turkish Women for Breast Cancer Risk Assessment

AbstractObjectives: The best protection against breast cancer, the most common cancer in women, is earlydetection. The most commonly used risk assessment tools, identifying women at high risk of developingbreast cancer, are the Gail model and its modifications, National Surgical Adjuvant Breast and Bowel Project(NSABP) and National Cancer Institute (NCI) models. We aimed to evaluate the sensitivities of thesemodels.Materials and Methods: We retrospectively evaluated 1333 patients who had been diagnosed with breastcancer at Ankara Numune Education and Research Hospital and Ankara University Medical Facultybetween April 1998 and December 2014.Results: The Gail model identified 32.52% of the patients as being at high risk. The model NSABP identified15.48% as being at high risk and the NCI identified 19.39 %.Conclusion: Comparison of the sensitivity of three models revealed Gail model as the most sensitive one,but it only identified 32.52 % of the patients who developed breast cancer as being at high risk. There was acorrelation between the results, but results were significantly different. We conclude that these threemodels are not applicable to Turkish women due to their low sensitivity and poor concordance. There is aneed to develop a new risk assessment model with the addition of different parameters for Turkish women.

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