Various mathematical models for calculating individual breast cancer risk are known nowadays. Currently, the Tyrer-Cuzick algorithm included in the IBIS program is recognized as the most consistent one. In Slovenia, the S-IBIS software was developed within the framework of the Targeted Research Project Development and Implementation of Personalised Breast Cancer Risk Evaluation Tool for Slovenian Population, which is being carried out at the Oncology Institute of Ljubljana. Slovenian IBIS (S-IBIS) is specifically designed to calculate the individual risk of breast cancer in Slovenian women. It is an adjustment of the IBIS software, where Slovenian generation specific population breast cancer risks are applied. S-IBIS is ready for use in the Slovene health system and allows an evidence-based assignment of an asymptomatic individual to a group of general, moderate and high breast cancer risk. As a cut-off for the moderate risk group the S-IBIS life-time risk of 16 percent or more is suggested for a Slovene women at age 25. The cut-offs for ten-years risk are offered as well. Compared with today's system, where the Terms of the health prevention at the primary health care level classifies breast cancer high risk women applying vary subjective qualitative criteria, it is today already possible to classify asymptomatic Slovenian women to a group of general, moderate and high breast cancer risk on the basis of individual numerical criteria using S-IBIS software. Pilot testing of the S-IBIS in the national Breast Cancer Centers shows encouraging results - we believe that the implementation of S-IBIS in the Slovenian healthcare system could reduce the number of unnecessary preventive interventions, while also reducing the waiting time for justified preventive examinations of moderate and high risk women.
F.06 Development of a new product
COBISS.SI-ID: 3137147Breast cancer is in the world as well as in Slovenia the most common cancer in women. Because of its high incidence and prevalence breast cancer represents a major public health and economic problem. In Slovenia the Terms of the health prevention at the primary health care level define preventive procedures for early detection of breast cancer for all women. Screening program for breast cancer (DORA) is organized for women between 50 and 69 years of age. For women between 20 and 50 years of age a clinical breast examination at the primary level at gynecologist is provided, performed once every three years. For women with increased risk of breast cancer at the age of 40, further reviews in the centers for breast cancer are performed every 12-24 months. Terms of the health prevention at the primary health care level are in many points out of date. It is noted that many women are referred to mammography unnecessarily and too often. The primary purpose of the thesis is to reduce inequalities in the diagnostic(standardization) of asymptomatic women under 50 years of age, and reduce the number of referrals of women to breast screening. A prospective cohort study was conducted on a sample of 100 asymptomatic women who were referred to Breast Cancer Centre in the Hospital for Gynecology and Obstetrics Kranj by testing the S-IBIS computer program which calculated individual risk for breast cancer for each woman. The England NICE guidelines were used, under which women were divided into 3 groups according to their risk: the general population risk, women with moderate risk and women with high-risk. Depending on the cause of their visit women were divided into two groups: In the first group there were women who were referred to the preventive examination (first or preventive inspection) while the second group consisted of the entire sample. In the first group of women we found 28 (74%) women at general population risk, in the entire sample 82 (82%). Women with 17%-30% risk level of breast cancer were classified into a moderate-risk group. In the first group there were 10 (26%) women, while in the second group there were 18 (18%) women with moderate risk level. Women who had risk level higher than 30% should be classified in the group of women with high risk level for breast cancer. There were no such women in our sample. In women with the population-like risk (43 women), 13 of them were referred to control mamography after 12 months and 30 of them after 24 months. In the group of moderate risk level women up to 40 years of age 2 of them were referred to control mamography after 24 months. In the group of women aged 40 to 49, four of them were referred to control examination after 12 months and 3 of them after 24 months. If British NICE guidelines were followed in a sample of 52 women, preventive mammography after 12 months would have been justified only in 7 of them with moderate risk level aged 40 to 49 years. That means that 45 (86,5%) women did not need control mamography. Based on the analysis of the results of our study we can conclude that the program S-IBIS is appropriate tool for determining individual risk levels for breast cancer in women and that the use of this computer program could reduce the number of unnecessary referrals of women to breast cancer screening.
F.30 Professional assessment of the situation
COBISS.SI-ID: 2883451The results show that S-IBIS may be used at the primary level.
F.30 Professional assessment of the situation
COBISS.SI-ID: 1540642756