Predicting Breast Cancer Risk in Black Women

Virginia Kaklamani, MD, DSc reviewing Boggs DA et al. J Clin Oncol 2015 Jan 26.

A new prediction model has been developed using prospective data from the Black Women's Health Study.

The commonly used Breast Cancer Risk Assessment Tool (formally known as the Gail model) was developed and validated in mostly white women. Data suggest that this model underestimates breast cancer risk in black women.

Investigators have now developed and validated a breast cancer risk prediction model for black women using prospective data from the Black Women's Health Study, which included 55,879 women, of whom 896 were diagnosed with invasive breast cancer.

Factors associated with increased risk for breast cancer were history of breast cancer in a first-degree relative under the age of 50, history of benign breast disease or biopsy, lower body-mass index at age 18, earlier age at menarche, later age at first birth, longer duration or more recent use of oral contraceptives, no history of bilateral oophorectomy, longer duration of estrogen plus progestin use, and greater height.

The model was found to have a discriminatory accuracy of 0.59 for patients of all ages and a discriminatory accuracy of 0.62 for women younger than 50. A discriminatory accuracy of 0.5 denotes a model with no discriminatory ability, whereas a perfect model would have a discriminatory accuracy of 1.

Citation(s):

Boggs DA et al. Prospective approach to breast cancer risk prediction in African American women: The Black Women's Health Study model. J Clin Oncol 2015 Jan 26; [e-pub ahead of print].