A study has found that adding two hormone measurements to a breast cancer risk prediction tool can increase its accuracy for women aged 35-50.
Improving risk prediction
Researchers found that adding Anti-Müllerian hormone (AMH) and testosterone levels to breast cancer risk calculations improves their accuracy for premenopausal breast cancer.
In future, it could help identify younger women, especially those without family history of the disease, who may benefit from preventive therapy or regular breast screening.
Researchers suggest that combining these hormone measurements with other factors, such as small genetic variations, may further improve future risk prediction models.
Benefit of assessing hormone levels
Breast cancer risk prediction tools use information such as woman’s age, age at first period and first birth, and family history. They can predict the number of women with certain characteristics who will develop breast cancer. But they need to be further improved to accurately tell apart women who will develop breast cancer from those who won’t.
Dr Kotryna Temcinaite, Research Communications Manager at Breast Cancer Now, explained: ‘Currently it’s particularly challenging to estimate how likely younger women with no family history of the disease are to develop breast cancer before the menopause, and some of them may be at a higher risk.’
To improve risk prediction for premenopausal breast cancer, researchers from the New York School of Medicine examined the data from 3,652 women between the ages of 35 and 50 from the UK, USA, Italy and Sweden. This included information from the Breast Cancer Now Generations Study, led by Professor Anthony Swerdlow at The Institute of Cancer Research, London.
They found that when AMH and testosterone levels were considered separately, as well as in combination, they moderately increased the accuracy of a five-year risk assessment. The greatest improvement in accuracy was among women without a family history of the disease.
Easy to include
AMH and testosterone are relatively easy to measure, meaning they can be easily evaluated when assessing breast cancer risk in younger women.
While levels of other hormones change throughout the menstrual cycle, AMH and testosterone levels stay relatively stable. This means the risk levels estimated from these two hormones will not be affected.
Women who have higher levels of AMH for their age tend to reach the menopause when they are older. High AMH levels have been linked to an increased risk of breast cancer both before and after menopause. Levels of testosterone in the blood, measured before and after menopause, have also been previously linked to breast cancer risk.
Moving closer to more tailored approaches
Women aged 50-70 are offered regular breast screening, and women over 70 can request an appointment if they want to. But there is a need to develop accurate ways to know if some younger women would benefit from it too.
‘We need ways to accurately assess women’s chances of developing breast cancer before the menopause, if we want to offer tailored screening and advice,’ said Kotryna. ‘But to achieve this, more research is needed to ensure the predictions are as accurate as possible, reflecting their real likelihood of developing the disease.’
Researchers hope that they can further improve risk prediction tools by assessing other factors, such as small variations in DNA, to further increase the accuracy. In future, it could help younger women make better-informed decisions relating to their chances of developing breast cancer.
The study was published in the journal Breast Cancer Research.
Breast Cancer Now thanks M&S for their generous support of the Breast Cancer Now Generations Study.
Read more about how to reduce your chances of developing breast cancer.