More on individualized risk.

Last week we noted, in the consideration of who might benefit from hormone replacement, that we now have available screening tests to help us further personalize a recommendation derived from population based studies.


One of these tests is the BREVAGen test, which we have discussed in regard to finding out who is at increased risk.  See http://drwinsett.blogspot.com/2012/01/do-you-want-to-know-your-personal-risk.html.  We may also use this test to find who is at low risk and perhaps learn who might have the scale of risk and benefits tilted towards using combined  hormone replacement (EPT), for prevention of bone loss, for instance.  As you know, the test is a combination of clinical features and genetic information obtained form a cheek swab. 


The American Society of Clinical Oncology and The American Cancer Society recognize the higher risk category and recommend consideration of other screening besides yearly mammography and even consideration of a chemopreventive medicine.  


Another test of risk is the HALO breast pap, which is a 5 minute office procedure to obtain nipple aspirate fluid to test.  The finding of atypia in the ductal fluid cells has been shown to precede cancer development and put that person in the category of consideration for other screening and even chemoprevention as noted above.




An ideal time for these tests would be at menopause when considering hormone replacement and the risks and benefits of the treatment.  The results of these tests would help individualize the treatment decision.




Again, this content is intended to inform and is not specific medical advice.  You may discuss these tests and hormone replacement with your physicians.






Together we can prevent 75,000 breast cancers each year!