Understanding Tyrer-Cuzick

Advances in genomics and risk stratification allow us to tailor breast cancer screening recommendations for individual patients. Risk assessment, in particular, identifies women who are candidates for supplemental screening, genetic counseling, or genetic testing.

Recommendations for Women Based on their Risk Assessment

With the goal of providing personalized medicine, Providence Imaging Center has added the Tyrer-Cuzick (Version 8) risk assessment tool as a complementary addition to our array of breast cancer screening and diagnostic services.

The Tyrer-Cuzik (Version 8) model incorporates a comprehensive set of variables to assess a woman’s lifetime risk of breast cancer. It identifies women at greater than average risk of breast cancer who could benefit from supplemental screening with breast MRI or breast ultrasound. The data collected also identifies families at high risk of hereditary cancer who could benefit from a genetics consultation.

The patient’s lifetime risk calculation will be documented on the mammogram report. Breast cancer screening recommendations for each risk category are listed below:

Average Risk – less than 15%
Continued annual screening mammography is recommended. Screening with tomosynthesis is preferred for women with heterogeneously dense or extremely dense breast tissue.

Intermediate Risk – 15 to 19%
Supplemental screening could be considered for women that fall in this risk category with heterogeneously dense or extremely dense breast tissue, after discussion regarding the risks of false positive and insurance issues. This risk group has insufficient evidence to recommend for or against supplemental screening. Screening breast MRI or ultrasound may be appropriate for selected patients.

High Risk – greater than 20%
The American Cancer Society recommends annual screening breast MRI in addition to annual screening mammography, regardless of density. If the patient is unable to receive MRI, then supplemental screening with ultrasound in addition to routine mammography may be appropriate. For women with elevated risk limited to increased breast density, ultrasound can be considered for adjunctive screening after weighing benefits and risks.

Why measure risk?

• Identify women that may be at high risk
• Educate women about their risk
• Recommend risk based screening