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New model predicts breast cancer risk in African American women
Will Boggs, MD
Reuters Health

Last Updated: 2007-12-03 15:29:24 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A new model predicts the individualized risk of invasive breast cancer in African American women, according to a report in the December 5th issue of the Journal of the National Cancer Institute.

"An improved model for projecting risk for African American women is now available and will be incorporated into the NCI's Breast Cancer Risk Assessment Tool shortly," Dr. Mitchell H. Gail from the National Cancer Institute, Bethesda, Maryland told Reuters Health.

"This tool was made possible because African American women participated in the CARE study, data from which were used to develop the model, and in the Women's Health Initiative, that provided data for validation of the new model."

Dr. Gail and colleagues used these data to project absolute invasive breast cancer risk for African American women and compared those projections with those from the current NCI Breast Cancer Risk Assessment Tool.

The attributable risk of breast cancer associated with the modeled risk factors was lower for African American women in the CARE model than in the NCI Breast Cancer Risk Assessment Tool, the authors report, with the CARE model having higher baseline risk estimates.

As a result, the 5-year baseline absolute risk estimates in the CARE model were usually 1.5-times higher for women younger than 45 years and ranged from 2.0 to 2.4 times higher for women between 45 and 79 years old.

Using data from the Women's Health Initiative, the CARE model predicted well overall in most categories, the investigators say, though the CARE model underestimated the risk among women with a history of benign breast biopsy examinations.

The Breast Cancer Risk Assessment Tool of the NCI is available at http://www.cancer.gov/bcrisktool/.

"When the CARE model is incorporated into NCI's Breast Cancer Risk Assessment Tool, the user will not see any difference in the questions asked," Dr. Gail said.

"As for other breast cancer risk projection tools, it is best to use risk projections from this model in conjunction with a health care provider who is knowledgeable about breast cancer risk," Dr. Gail explained.

"Such a person can provide perspective on the risk estimates and would be aware of special circumstances, such as a woman who is known to carry a disease-producing mutation of BRCA1 or BRCA2, for whom other methods for projecting risk might be more appropriate."

J Natl Cancer Inst 2007;99:1782-1792.

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