Chemoprevention Indication Score: a user-friendly tool for prevention of XXXX - pilot analysis.

@entity1 @entity440 @entity0
BACKGROUND: Despite the results of prospective randomized placebo controlled studies, endorsement from various professional societies, and approval by the FDA, the chemoprevention of @entity0 is limited. This is attributable to the perceived risks of complications with @entity440 . Individualized risk-benefit calculation regarding the use of @entity440 is burdensome for practical clinical use. We propose a Chemoprevention Indication Score (CIS) that is easy to compute and reliable to identify @entity1 suitable for chemoprevention. MATERIAL AND METHODS: Chart-review of all @entity1 attending a university-based high-risk breast clinic identified the @entity1 offered chemoprevention and those who accepted it. Age, Gail risk score, past medical history and physician's reasons for not offering @entity440 were recorded. CIS was developed weighing risks and benefits of @entity440 ; high, moderate and low indication score categories were defined for recommendation of @entity440 . CIS was validated by cross-tabulating with the rate of physician recommendation of @entity440 and by agreement with Gail's risk-benefit index. RESULTS: Between 2004 and 2006,105 @entity1 attended the high-risk clinic. Median (interquartile) age was 47 (42-53) yrs; 142(90%) were Caucasian. Median (interquartile) Gail score was 2.3 (1.0-3.2). Forty-eight (46%) @entity1 were offered @entity440 while 15(14%) complied. @entity440 was offered to 1 of 5(20%) @entity1 with low; 32 of 82(39%) @entity1 with moderate and 15 of 18(83%) @entity1 with high CIS [p=0.0008]. The McNemar's test for agreement between CIS (<6 vs. >or=6) and Gail's risk-benefit index was significant at p<0.0001 and Kruskal-Wallis test comparing median Gail's risk-benefit index across CIS was significant at p<0.0001. CONCLUSION: Inability to identify appropriate candidates has been a great barrier towards acceptance of chemoprevention for @entity0 . The CIS can be used for individual risk-benefit analysis for recommendation of @entity0 chemoprevention. However, CIS needs to be validated on a larger scale with methodologically more rigorous studies before proposing generalized use in the community.
