In Reply We thank Hemminki for his comments on our proposed risk-adapted starting age of screening in women (not patients, as written in the first sentence of the comments) with a family history of breast cancer.1 Hemminki compared our results with those in an article written in 2010 by Brandt and colleagues,2 including Hemminki and a coauthor of our article, although results of these studies with different risk measures should not be compared in the first place. Prediction of age-specific 10-year cumulative risk (ie, risk of developing breast cancer in the next 10 years at each age) presented in our study1 and comparison with a threshold risk in women at the age of initial screening in the general population has clinical relevance and application, whereas it is hard to find a clear application for comparing cumulative risk (ie, risk from birth to a certain age) between those with a family history and those without a family history, which was presented in their study.2
Fallah M, Mukama T, Kharazmi E. Determining the Appropriate Risk-Adapted Screening Age for Familial Breast Cancer—Reply. JAMA Oncol. 2020;6(6):934–935. doi:10.1001/jamaoncol.2020.0292
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