Breast Cancer Risk Assessment for the Filipino Women – ROJoson – 12oct11
Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg
October 10, 2012
Breast cancer is very common in the Philippines that it is now causing fear and even phobia on the part of the Filipino women.
The fear and phobia have resulted in Filipino women swinging in a behavior pendulum when it comes to issues of screening and early detection of breast cancer.
At one end of the pendulum, the women in fear and phobia are afraid to do breast self-examination; to see breast specialists; and to do screening diagnostic tests for fear of finding a breast cancer.
At the other end of the pendulum, the women in fear and phobia would readily do breast self-examination; see breast specialists; and do all kinds of screening diagnostic tests just to make sure they don’t have breast cancer, and if they have, consoled at least that they are discovered early enough.
Personally, I think a strategy that will be helpful in controlling the extreme swinging of the behavior pendulum is for all breast specialists to make a breast cancer risk assessment for all their Filipino patients. Hopefully, the breast cancer risk assessment will reduce undue fear and phobia in those who are at low risk of developing breast cancer. It will also guide those who are at high risk on what to do in terms of screening and early detection.
There are many models and tools in breast cancer risk assessment in the Internet. There is no universal agreement on which one to use. None is absolutely perfect in predicting the development of breast cancer.
I have decided to come out with my own which I will be testing for the next 5 years or so.
Here are my disclaimers:
- I will not say it will be a perfect model.
- I am not after the accuracy in predicting the development of breast cancer.
- I am just calculating for the relative risk of a person in developing breast cancer with the end-goal of coming out with a practical guide on breast cancer screening, particularly on frequency.
I am proposing the following breast cancer risk identification and assessment in women with no personal history of breast cancer (meaning not diagnosed to have breast cancer yet). The risk assessment is just based on age and family history.
Note: If I say somebody is at risk, it does not mean that somebody will surely develop a breast cancer. Corollary to this, if I say somebody is at low risk, she can develop breast cancer. I am not allowed to say somebody is NOT at risk. Every female is at risk of developing breast cancer throughout her lifetime and the risk will vary throughout her years of stay on earth.
As I said earlier, I will not say my recommendation will be a perfect model and I am not after the accuracy in predicting the development of breast cancer. My objective is to have a simple and practical system that will make people wary of their realistic risk of developing breast cancer thereby guiding them on what screening procedures to do.
As I said, I will be validating this for the next 5 years. I may modify this along the way if need be.