An important announcement from the National Cancer Institute about the development of a new risk model for African American
women. Press release follows:
New Model Predicts Breast Cancer Risk in African American Women
Liz Savage, Andrea Widener
November 27, 2007
Researchers have developed a new risk prediction model that more accurately estimates the breast cancer risk
of African American women, according to a study published online November 27 in the Journal of the
National Cancer Institute.
The Breast Cancer Risk Assessment Tool, also known as the Gail model, is widely used for estimating breast cancer
risk and for determining which women are eligible for breast cancer prevention trials. However, much
of the model was based on breast cancer data from white women, so it is unclear how well the model applies
to African American women or those from other racial groups. The Women's Contraceptive and Reproductive Experiences
(CARE) study was conducted to obtain data on African American women with and without breast cancer.
Mitchell Gail, M.D., Ph.D., of the National Cancer Institute in Bethesda, Md., and colleagues used data from
the CARE study and the Surveillance, Epidemiology, and End Results (SEER) program to build a new model
for estimating breast cancer risk in African American women. They then used data from two trials—the Women's
Health Initiative and the Study of Tamoxifen and Raloxifene (STAR)—to test the model.
The new CARE model accurately predicted the number of cancers observed in African American women in the Women's
Health Initiative overall and in most subgroups. CARE model risk predictions usually were higher than
those from the Gail model in women aged 45 and older. The researchers estimated that 30 percent of African
American women would have a 5-year breast cancer risk of at least 1.66 percent, which would have qualified
them for participation in the STAR trial, compared with the estimate of 14.5 percent using the Gail
model.
The CARE model is not recommended for women with a previous history of breast cancer, and it may underestimate
breast cancer risks in certain other women, such as those who carry a BRCA mutation.
"Despite these limitations, the CARE model appears to offer more valid and usually larger estimates of invasive
breast cancer risk for African American women than the currently available [Gail model]. Although we
are aware of the need for additional validation studies, we recommend the CARE model for counseling African
American women and for determining the eligibility of African American women for breast cancer prevention trials,"
the authors write.
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Link to Press Release
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