MammoPlus service: any one know anything about it?

peggy_j

Not sure where to post this. My mother in Michigan has received info from her breast cancer screening center for a new service called MammoPlus. It's free but...I'm not sure it does all that much, beyond what she can do on her own. Can I get a  sanity check from the wise women of BC.org? Info:

http://www.mercyhealthmuskegon.com/mammoplus

http://www.stmarymercy.org/mammoplus-faq

To me, it looks like they do additional "screening" by asking the questions from this National Cancer Institute Breast Cancer Risk Assessment Tool:

http://www.cancer.gov/bcrisktool/

I ran the tool for my mom and her risk is slightly higher than avg because...of my history of BC (sorry Mom!). But it's not alarmingly high. My MO has me trained to ask: what will I do differently based on the result of this test? My sense is that my mom is already doing everything she can. (they're not going to recommend preventative tamox, for example). We have no family history except for...me. My thought on this service is that it might be helpful if someone doesn't know the risk factors for BC, and it sounds like they have provide medical counseling, if needed.

Anyway, I'd love to hear your thoughts and/or any advice to share w/ my mom. 

leaf

With regard to the National Cancer Institute Breast Cancer Risk Assessment Tool:

http://jnci.oxfordjournals.org/content/98/23/1673....

I'm not particularly blaming them for using this tool; its probably the best we have for women without a significant family history, but we just don't have the tools to accurately predict which individuals will get breast cancer.  That breast cancer risk tool will predict well how many women in a group will get breast cancer, but not which individuals will get breast cancer.

Decarli et al. also assessed each model's performance at the level of
the individual woman. A model that discriminates well
at this level should consistently predict a higher
risk of breast cancer for women who will be diagnosed with the disease
than for women who will not. Decarli et al. randomly
selected pairs of women, one of whom was diagnosed with breast cancer
and one of whom was not, to determine the frequency
with which each model calculated a higher risk for the woman who
developed
breast cancer. The resulting calculation produced a
concordance statistic, whose value could range from 0.50 (equivalent to
a coin toss) to 1.0 (perfect discrimination). The
concordance statistics for the Italian and Gail models were essentially
the same, approximately 0.59 (with 95% confidence
intervals that ranged from 0.54 to 0.63). In other words, for 59% of the
randomly selected pairs of women, the risk estimated
for the woman who was diagnosed with breast cancer was higher than the
risk estimated for the woman who was not.
Unfortunately, for 41% of the pairs of women, the woman with breast
cancer received
a lower risk estimate than her cancer-free
counterpart. Thus, for any given woman, the two models were better at
prediction
than a coin toss—but not by much. <emphasis mine>

http://jnci.oxfordjournals.org/content/98/23/1673....

Although a woman's risk may be accurately estimated, these predictions do not allow
one to say precisely which woman will develop breast cancer. In fact, some women
who do not develop breast cancer have higher risk estimates than some women who
do develop breast cancer.

http://www.cancer.gov/bcrisktool/about-tool.aspx

In my humble opinion, we are in our infancy with regard to understanding breast cancer risk (at least without major risk factors such as significant family history, radiation Treatment exposure for things like lymphoma, etc.)

peggy_j

Thanks Leaf. This was very helpful esp the reminder (how can I forget?) that these stats don't tell us much--it's all a crap-shoot  This was helpful when I discussed it with my mom this weekend.