Cancer Guidelines and Risk Models Flashcards
1
Q
NCCN BRCA testing guidelines
A
- Diagnosed with breast cancer 45 or younger
- Diagnosed with breast cancer 50 or younger with one of the following:
- An additional breast primary
- 1 or more close relative with breast cancer at any age
- 1 or more close relative with pancreatic cancer
- 1 or more close relative with prostate cancer
- Diagnosed with TNBC at 60 or younger
- Diagnosed with breast cancer at any age with one of the following
- 1 or more close relative with breast cancer diagnosed at 50 or younger
- 2 or more close relatives with breast cancer at any age
- 1 or more close relatives with ovarian cancer
- 2 or more close relatives with pancreatic or prostate cancer
- A close male relative with breast cancer
- AJ ancestry
- Personal history of ovarian cancer
- Personal history of male breast cancer
- First or second degree relative meeting any of the above criteria
2
Q
Amsterdam I Criteria
A
- At least 3 individuals with colon cancer on the same side of the family
- At least 1 must be a first degree relative of the other two
- At least 2 generations affected with colon cancer on the same side of the family
- At least 1 diagnoses of colon cancer at or before age 40
3
Q
Amsterdam II Criteria
A
- At least 3 individuals affected with a Lynch-related cancer (CRC, endometrial, small bowel, ureter, renal pelvis)
- One must be a first-degree relative of the other two
- At least 2 generations affected with Lynch-related cancer
- At least 1 individual with a Lynch-related cancer diagnosis at or before age 40
4
Q
Bethesda Criteria
A
- Criteria for testing at tumor for MSI
- CRC in a patient under 50 years old
- Presence of synchronous or metachronous CRC or Lynch-related tumors
- Previous CRC tumor with MSI-H histology in a patient under age 60
- CRC diagnosed in one or more first-degree relatives with a Lynch-related cancer, with at least one of the cancers being diagnosed before age 50
- CRC diagnosed in two or more first or second-degree relatives with a Lynch-related cancer regardless of age of diagnosis
5
Q
NCCN Lynch testing guidelines
A
- Known familial mutation in an MMR gene
- Meets revised Bethesda guidelines
- Meets Amsterdam II criteria
- Diagnosis of endometrial cancer at or before age 50
6
Q
Gail Model
A
- Calculates risk for developing breast cancer
- For unaffected probands only
- Incorporates biopsy history, age at menarche, and age at first livebirth
- Only uses first degree maternal relatives
- Doesn’t include age of onset
- Doesn’t include family history of ovarian cancer
- Can help determine tamoxifen eligbility
7
Q
Claus Model
A
- Used to calculate risk of developing breast cancer
- For unaffected probands only
- Uses maternal and paternal first and second degree relatives with breast and ovarian cancer
- Uses current age and age of onset
- Only uses two affected family members
- Doesn’t use male breast cancer
- Can help determine annual MRI eligibility
8
Q
Tyrer-Cuzik (IBIS) Model
A
- Calculates breast cancer risk and risk of having a mutation
- Uses weight, height, biopsy history, age at menarche, age at first livebirth, mutation status of BRCA and lower penetrance genes
- Uses first and second degree relatives with breast or ovarian cancer
- Uses cousins with breast cancer
- Proband must be female
- Doesn’t incorporate other BRCA-related cancers (prostate, pancreatic, male breast)
9
Q
Couch II/Penn II Model
A
- Used to calculate the probabilty of having a BRCA mutation
- Uses number of women with breast cancer under age 50
- Multiple breast or ovarian primaries
- Ovarian and fallopian tube cancers
- Male breast, prostate, and pancreatic cancers
- Incorporates AJ ancestry
10
Q
BRCAPro
A
- Calculates breast cancer risk and risk of having a mutation
- Incorporates unilateral and bilateral invasive breast cancers in first and second degree relatives, hormone receptor status of proband, ovarian cancer in first and second degree relatives
- Incorporates age of onset and age of all unaffected relatives
- Incorporates AJ ancestry, mutation status, and BSO history
- Doesn’t incorporate prostate or pancreatic cancer
11
Q
BOADICEA model
A
- Calculates breast cancer and mutation risk
- Allows for entry of all family members
- Incorporates breast, ovarian, prostate, and pancreatic cancers
- Requires year of birth for all family members
- Time consuming
12
Q
Population breast cancer screening guidelines
A
- CBEs every 3 years beginning at age 20
- CBE yearly beginning at age 40
- Mammograms yearly beginning at age 40
13
Q
BRCA-positive breast cancer screening/prevention guidelines
A
- SBEs beginning at age 18
- CBEs every 6-12 months beginning at age 25
- Annual breast MRI beginning at age 25
- Annual mammogram and MRI beginning at age 30
- Tamoxifen can lower risk for contralateral breast cancer by up to 50% (not effective for TNBC, so less effective for BRCA1 carriers)
- Prophylactic mastectomy can reduce risk by up to 90%
14
Q
BRCA-positive ovarian cancer screening/prevention guidelines
A
- Transvaginal U/S and CA-125 levels every 6 months at age 30 or 5-10 years before the earliest diagnosis in the family
- Very limited ability for screening, rarely detects early stage cancer, no longer recommended by the NCCN
- Oral contraceptive use for 5 or more years can reduce risk for ovarian cancer by up to 60%
- Prophylactic BSO can reduce risk by up to 96% - recommended between the ages of 35-40 after childbearing is complete
15
Q
Population colorectal cancer screening guidelines
A
- Colonoscopy beginning at age 50 and every 10 years after
- If adenomatous polyps are found, follow high-risk guidelines
