Türk Kadınlarında Meme Kanseri Risk Değerlendirmesi için Gail, NSABP ve NCI Risk Analiz Modellerinin Duyarlılıkları

Year 2018, , 31 - 39, 30.03.2018

Elif Altunbaş Ateş , Betül Bozkurt Ragıp Çam

https://doi.org/10.17098/amj.408963

Abstract

Giriş: Kadınlarda en
sık görülen kanser olan meme kanserine karşı en iyi koruma erken tanıdır. Meme
kanseri gelişimi için yüksek riskli bireyleri tanımlamak için en sık kullanılan
risk değerlendirme yöntemleri Gail ve modifikasyonları olan National Surgical
Adjuvant Breast and Bowel Project (NSABP) ve National Cancer Institute NCI
modelleridir. Araştırmamızda bu modellerin duyarlılıklarını değerlendirmeyi
amaçladık.
Materyal ve Metot: Ankara Numune
Eğitim ve Araştırma Hastanesi ve Ankara Üniversitesi Tıp Fakültesi’nde, Nisan
1998 ile Aralık 2014 tarihleri arasında, meme kanseri tanısı almış 1333 hastayı
retrospektif olarak değerlendirdik.

Bulgular: Gail modeli hastaların %32,52’ sini yüksek riskli olarak tanımladı.
NSABP %15,48 ve NCI modeli %19,39 hastayı yüksek riskli olarak tanımladı.

Sonuç: Üç modelin
duyarlılığını karşılaştırdığımızda Gail modeli en duyarlısıdır; fakat zaten
meme kanseri gelişmiş olan hastaların sadece %32,52’ sini yüksek riskli olarak
tanımlayabilmiştir. Sonuçlar arasında korelasyon vardı; ama anlamlı derecede
farklı idi. Biz, bu üç modelin, düşük duyarlılık ve zayıf uyuşmalarına bağlı
olarak, Türk kadınlarına uygun olmadığına karar verdik. Türk kadınları için,
farklı parametreler eklenerek yeni bir risk değerlendirme modeli geliştirilmesine
ihtiyaç vardır.

Keywords

Meme kanseri, risk değerlendirme, Türkiye

Sensitivities of the Gail, NSABP and NCI Risk Analysis Models for Turkish Women for Breast Cancer Risk Assessment

Abstract

Objectives: The best protection against breast cancer, the most
common cancer in women, is early detection. The most commonly used risk assessment
tools, identifying women at high risk of developing breast cancer, are the Gail
model and its modifications, National Surgical Adjuvant Breast and Bowel
Project (NSABP) and National Cancer Institute (NCI) models. We aimed to
evaluate the sensitivities of these models. 
Materials and Methods: We
retrospectively evaluated 1333 patients who had been diagnosed with breast
cancer at Ankara Numune Education and Research Hospital and Ankara University
Medical Faculty between April 1998 and December 2014.
Results: The Gail model identified
32.52% of the patients as being at high risk. The model NSABP identified 15.48%
as being at high risk and the NCI identified 19.39 %. 
Conclusion: Comparison of the
sensitivity of three models revealed Gail model as the most sensitive one, but
it only identified 32.52 % of the patients who developed breast cancer as being
at high risk. There was a correlation between the results, but results were
significantly different. We conclude that these three models are not applicable
to Turkish women due to their low sensitivity and poor concordance. There is a
need to develop a new risk assessment model with the addition of different
parameters for Turkish women.

Keywords

Breast cancer, Risk Assessments, Turkey

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