Research Perspective Volume 11, Issue 4 pp 1305—1316
Towards a more precise and individualized assessment of breast cancer risk
- 1 University of Vermont Cancer Center, The Robert Larner MD College of Medicine, University of Vermont, Burlington, VT 05405, USA
- 2 Division of Hematology and Oncology, The Robert Larner MD College of Medicine, University of Vermont Medical Center, Burlington, VT 05405, USA
- 3 Department of Biochemistry, and The Robert Larner MD College of Medicine, University of Vermont, Burlington, VT 05405, USA
- 4 Department of Surgery, The Robert Larner MD College of Medicine, University of Vermont, Burlington, VT 05405, USA
Received: October 23, 2018 Accepted: January 24, 2019 Published: February 20, 2019https://doi.org/10.18632/aging.101803
How to Cite
Copyright: Wood et al. This is an open‐access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Many clinically based models are available for breast cancer risk assessment; however, these models are not particularly useful at the individual level, despite being designed with that intent. There is, therefore, a significant need for improved, precise individualized risk assessment. In this Research Perspective, we highlight commonly used clinical risk assessment models and recent scientific advances to individualize risk assessment using precision biomarkers. Genome-wide association studies have identified >100 single nucleotide polymorphisms (SNPs) associated with breast cancer risk, and polygenic risk scores (PRS) have been developed by several groups using this information. The ability of a PRS to improve risk assessment is promising; however, validation in both genetically and ethnically diverse populations is needed. Additionally, novel classes of biomarkers, such as microRNAs, may capture clinically relevant information based on epigenetic regulation of gene expression. Our group has recently identified a circulating-microRNA signature predictive of long-term breast cancer in a prospective cohort of high-risk women. While progress has been made, the importance of accurate risk assessment cannot be understated. Precision risk assessment will identify those women at greatest risk of developing breast cancer, thus avoiding overtreatment of women at average risk and identifying the most appropriate candidates for chemoprevention or surgical prevention.