Association of Polygenic-Based Breast Cancer Risk Prediction With Patient Management

• DOI: 10.1200/po-24-00716
• Publication Date: 2025-05-07T19:59:16Z
• Authors: Katherine Johanse...; Elisha Hughes; Alexander Gutin; W. Brady DeHart; Laura Becker; Jeffery Jasper; Sarah Ratzel; D. Claire Miller; Devika Chawla; Pamela Morin; Julia Certa; Allison W. Kurian
• Keywords: Breast MRI; McNemar's test; Breast imaging; Odds

PURPOSE Breast cancer (BC) risk prediction is more accurate when clinical and polygenic factors are combined (combined score [CRS]), but little known about how CRS results affect real-world patient management. METHODS Deidentified medical pharmacy claims data were linked with Tyrer-Cuzick (TC) evaluated for BC Patients divided into subcohorts on the basis of lifetime predicted by TC (“+”: ≥20% risk, “–”: <20%): CRS+ TC+, TC–, CRS– TC–. Claims related to screening mammography (SM) in patients younger than 40 years, breast magnetic resonance imaging (MRI), genetic counseling (GC) compared 360 days before after testing. Differences pre- post-CRS management using McNemar tests, was multivariable logistic regression. RESULTS After testing, TC+ had 1.6-2.2-fold increases SM years (all P < .02) 4.7-5.6-fold MRI .001). The TC– 1.9-2.3-fold GC (both those MRI, did not increase subcohort. subcohort, significantly higher odds receiving age (odds ratio [OR], 3.80-5.19), (OR, 11.55-23.09), 2.03-2.91; all CONCLUSION either or likely receive enhanced who <20% suggesting that clinicians considered