Breast cancer risk assessment in primary care

摘要

Breast cancer is the most common cancer (when excluding skin cancers) in women and the second most common cause of cancer death in women, with a lifetime prevalence of 12.5% (American Cancer Society [ACS], 2013a, 2013b; National Cancer Institute [NCI], 2012). Breast cancer screening reduces risk of cancer death, thereby increasing rate of survival to up to 89% for women with stage 1 and 2 breast cancer (Bleyer & Welch, 2012; Howlader et al., 2012). Despite these data, undue harm may occur with unnecessary screening because overidentification of risk, and excessive, costly biopsies may result. Costs and benefits of screening must be weighed. Nurses at all levels can play a pivotal role in promotion of appropriate breast cancer screening and subsequently breast cancer prevention by using accurate screening tools, such as the Tyrer-Cuzick model. Although there are some limitations with this tool, screening at the primary care level has demonstrated improved clinical outcomes (Roetzheim et al., 2012). Its use can help nurses accurately assess a woman's breast cancer risk, by promoting appropriate screening at the primary care level (Roetzheim et al., 2012).