Breast Cancer Risk Stratification Using the Tyrer-Cuzick Model and its Clinical Implications

Document Type

Conference Proceeding

Publication Date

6-30-2025

Publication Title

Michigan Medical Education and Health Bulletin

Abstract

Introduction: According to the World Health Organization, breast cancer accounts for over 25% of all cancer diagnoses in women, making it one of the most common malignancies globally. While there is no guaranteed way to prevent breast cancer, individuals can take steps to reduce their risk. Risk factors for breast cancer include non-modifiable factors, such as genetics and age, and modifiable factors, such as lifestyle choices, hormone exposure, and reproductive history. Several risk stratification models have been developed to assess an individual's likelihood of developing breast cancer, including the Gail model, Claus model, and Tyrer-Cuzick model. These models help identify individuals who may benefit from more frequent screening or preventive strategies. Methods: This study involved a retrospective analysis of approximately 200 patients at our institution who underwent screening mammograms between August 1, 2023, and August 31, 2024. Patients with a moderate to high Tyrer-Cuzick score were included. Data collection included demographics (age, gender, race, ethnicity), personal and family history of breast/ovarian cancer, menopausal status, and follow-up breast magnetic resonance imaging (MRI) results. Risk categories were defined as follows: < 15% (average risk), 15–19% (intermediate risk), and >20% (higher than average risk). Results: The primary outcomes included: 1) The proportion of moderate- to high-risk patients who received follow-up breast MRI as recommended; and 2) The rate of additional cancer detection among patients who underwent follow-up imaging. We also did an assessment of potential barriers to integrating Tyrer-Cuzick scoring into clinical practice, including provider adherence, patient compliance, and documentation challenges. Conclusions: The Tyrer-Cuzick model estimates breast cancer risk by incorporating multiple factors, including family history, genetic mutations, reproductive history, and breast density, to provide a personalized lifetime risk score. Our quality improvement project aimed to assess the effectiveness of the Tyrer-Cuzick model in identifying highrisk individuals within a diverse patient population. Specifically, we aimed to evaluate whether patients classified as moderate to high risk underwent recommended additional screening (such as breast MRI) and whether such screening led to additional cancer diagnoses. Additionally, we sought to examine how well the model integrated into clinical workflows and identify potential barriers to its use in routine practice. Future studies should focus on prospective evaluations with larger, diverse populations across multiple institutions to validate the generalizability and effectiveness of the Tyrer-Cuzick model in clinical practice. It will be essential to investigate long-term outcomes associated with risk stratification, including survival rates and quality of life improvements following early detection through supplemental screening methods.

Volume

3

Issue

2 Suppl

First Page

A133

Last Page

A133

Comments

10th Annual Michigan Summit on Quality Improvement, Patient Safety & High Value Care, May 22, 2025, Troy, MI

DOI

10.69735/​001c.141332

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