Local Researchers Create A New Breast Cancer Risk Model

Doctors work on prevention and early detection strategies for breast cancer based on their ability to identify the people who are at an early risk for the disease. This kind of early detection also plays a role in determining who is eligible to register for prevention trials.

But, while the Gail Model—currently an industry standard for breast cancer risk prediction—works well for white women, it has been shown to underestimate risk in African-American women, according to Boston University’s Slone Epidemiology Center. This, researchers say, is why African-American women are “underrepresented” in breast cancer prevention trials.

Now, researchers at the Slone Epidemiology Center have developed a new breast cancer risk prediction model for African-American women, and they say that it has greater accuracy in predicting breast cancer risk.

The work was published Monday in the Journal of Clinical Oncology. According to the study:

Researchers used prospective data from 55,000 African-American women age 30-69 at baseline in the Boston University Black Women’s Health Study to develop a breast cancer risk prediction model specifically for African-American women. It included family history of breast cancer, history of benign breast disease, age at menarche, age at first birth, bilateral oophorectomy, oral contraceptive use, hormone use, body mass index at age 18 and adult height.

“The model was well calibrated in that it predicted 486 cases in comparison to an observed 506 cases during the additional five years of follow-up,” said the study’s senior author Julie Palmer, a senior epidemiologist at Boston University’s Slone Epidemiology Center and professor of epidemiology at Boston University School of Public Health. “Based on the Black Women’s Health Study model, 14.6 percent of women age 30-69 were predicted to have a five-year risk of at least 1.66 percent. This is considerably higher than the proportion predicted by previous models to be above that end point.”

Palmer says that because previous breast cancer risk prediction models have underestimated risk, and this new model appears to improve that, it could result in a greater number of African-American women being invited to enroll in prediction trials.