[SCREENING WOMEN AT HIGH RISK FOR BREAST CANCER - BRCA AND BEYOND].
Bibliographic record
Abstract
BACKGROUND: Radiologic screening for breast cancer is performed with the goal of diagnosing the disease at an earlier stage, thus reducing morbidity and mortality. Screening recommendations for women at higher than average risk for breast cancer differ from those of women with an average risk, and include yearly breast MRI and mammography starting at a young age. OBJECTIVES: Review the morbidity and mortality, and check whether the goal of early diagnosis was achieved in the participants of the High-Risk Ontario Breast Screening Program at the Princess Margaret Cancer Centre, Ontario Canada. METHODS: A prospective cohort study was conducted of 2,081 women participating in the Princess Margaret Cancer Centre high risk screening program 2011-2018. Demographic, imaging, and if applicable biopsies, diagnosis and treatment data were captured in a prospectively maintained database starting with each participant's enrolment in the program. RESULTS: A total of 32% of the participants were carriers of pathogenic variants in breast cancer related genes (BRCA, NF, CHEK2, TP53 etc.), 8% had a history of therapeutic chest radiotherapy, and the remaining 60% had a calculated elevated lifetime risk based on family history or personal risk factors, without an identifiable pathogenic mutation or previous radiation. During the follow-up period 89 breast cancer cases were diagnosed at the median age of 49 years. Median tumor size at diagnosis was 0.9 cm, correlating with a T1 disease. Nodal disease was found only in 4 cases. Breast cancer incidence was the same in the mutation carriers and chest radiotherapy groups, but 3-fold lower in the third group. Diagnosis of breast cancer was most commonly conducted by MRI imaging, and only 6% of cases were diagnosed based solely on mammography findings. Furthermore, 38 women died during follow-up, 29 of them (76%) were BRCA carriers who died from ovarian carcinoma. CONCLUSIONS: Diagnosis at an early stage was achieved in this cohort of women followed in the high risk screening program. Most cases were diagnosed by MRI, thus emphasizing the importance of identifying women at high risk for breast cancer and referring them to the appropriate screening program.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.010 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".