Tyrer-Cuzick and NCCN: Quick Crash Course for Breast Centers in 2024

Our phones at CancerIQ are ringing off the hook for our Tyrer-Cuzick Risk Calculator. We love to see it — breast centers are working hard to get up to date with the new NAPBC standards for 2024. 

It makes sense why there’s so much concern. Breast density is a critical part of cancer risk assessment, prevention and early detection. But so are genetics, screening compliance, navigation and long-term medical management.  

We have to remember that building a successful high-risk breast program isn’t just about adding one more risk model. It’s about broad clinical and financial impact — and a comprehensive high-risk program is how you achieve that.

If your patients have elevated cancer risk, what’s next? How do they get genetic testing? Who will help manage their risk long-term? And how does all this fit into your growth strategy? 

- Feyi Ayodele, CEO & Co-Founder

Learn how a comprehensive approach can help you harness the full value of cancer risk assessment.

If your breast center is exploring new risk assessment models to meet the National Accreditation Program for Breast Centers (NAPBC) 2024 Standards, you’re not alone. 

Many breast centers are focused on incorporating Tyrer-Cuzick Version 8 for the first time to help calculate breast density. But breast density is only part of the picture. Comprehensive cancer risk assessment also includes genetics, lifestyle, screening adherence and more. That’s why so many breast centers leverage precision prevention software like CancerIQ to navigate the ever-changing landscape of cancer prevention and early detection.    

When choosing a risk assessment tool, what models should breast centers look for? 

Here we break down two of the most important risk models in breast cancer prevention — the Tyrer-Cuzick Lifetime risk model and the National Comprehensive Cancer Network (NCCN) Guidelines in Clinical Oncology — and why both models are essential to ensure no high-risk patients fall through the cracks.

What is the Tyrer-Cuzick Lifetime Risk Model?

Tyrer-Cuzick Lifetime Risk Model, or the IBIS tool, calculates a woman's likelihood of developing breast cancer in 10 years and over her lifetime, up to 85 years old. It also estimates the likelihood of being a BRCA1 or BRCA2 mutation carrier. This model focuses primarily on breast cancer, ovarian cancer, and reproductive history, and incorporates factors like breast density. The Tyrer-Cuzick model expresses risk as a percentage, with 20 percent being the threshold for changes in medical management.  

What are the NCCN Guidelines?

The NCCN Guidelines are considered the standard of care in oncology. Reviewed annually by thousands of multidisciplinary clinicians and researchers, NCCN Guidelines are among the most thorough and up-to-date guidelines in medicine.

Specifically, NCCN Guidelines include recommendations that identify high-risk patients who would benefit from genetic counseling and testing. At their core, these sets of guidelines provide a framework for individualized preventive care pathways.

How Does NCCN Differ From Tyrer-Cuzick?

Whereas Tyrer-Cuzick uses non-genetic risk factors to indicate a women's eligibility for breast MRI, the NCCN Guidelines focus on eligibility for genetic testing. Though the NCCN Guidelines and Tyrer-Cuzick are both risk assessment tools, they are used for very different purposes — underscoring the need for both.

If your breast center only uses one risk assessment framework, you may be over- or underestimating patient risk.

For example:

Consider a 35-year-old woman with atypical hyperplasia on a breast biopsy would have a Tyrer-Cuzick 8 Lifetime score of over 43 percent. In this case, the patient would be flagged as eligible for MRI surveillance, because they exceed the 20 percent threshold. However, if she has no other risk factors, the patient would not meet NCCN Guidelines and would not be eligible for genetic counseling or testing. In this case, using NCCN guidelines alone would mean this patient may not receive the preventive care they need.

Now compare a 45-year-old woman with a family history of cancer on her father’s side, including a paternal grandmother with ovarian cancer and a paternal uncle with pancreatic cancer. This patient would not be flagged as high-risk with the Tyrer-Cuzick model. With the NCCN guidelines, however, she would be flagged for genetic testing — and as a BRCA2 mutation carrier — she would be given a preventive care plan for breast MRIs and prophylactic oophorectomy.    

These examples highlight why it’s important for breast imaging centers to incorporate both models in risk assessment to ensure all high-risk patients receive the care they need to prevent and detect cancer in its earliest stages. 

And, if you’re looking to meet, maintain, or secure NAPBC accreditation it may be easier than you think to invest in a program that delivers on your existing patient screening, outreach, and quality improvement priorities.

Learn More

Embracing cancer risk assessment is just the first step to developing a successful high-risk breast program. That’s why at CancerIQ, we offer comprehensive, end-to-end solutions for personalized cancer prevention and early detection. 

Join us for a free webinar to learn how to keep up with new accreditation standards, deliver a higher quality patient experience and generate a clear return on investment for your breast imaging center.   

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