Simple Model Proposed to Predict Breast Cancer Risk in Postmenopausal Women

Behind the Cancer Headlines®

November 19, 2007 

According to a study published in the Journal of the National Cancer Institute, a new, simpler model for predicting estrogen receptor-positive breast cancer risk in postmenopausal women appears to perform almost as well as the standard model. This new model could be used to identify postmenopausal women at high risk of estrogen receptor-positive breast cancer who may benefit from risk reduction strategies.  

Many women must be screened to identify the minority who would benefit from taking a chemoprevention drug to reduce their breast cancer risk. A faster method of identifying these women is needed.  

Rowan Chlebowski, M.D., Ph.D., of Harbor-UCLA Medical Center in Torrance, Calif., and colleagues used data from the Women’s Health Initiative to compare estimates of breast cancer risk using several different risk prediction models, including the widely used Gail model.

The Gail model underestimated 5-year breast cancer incidence by almost 20 percent, but it performed better when predicting estrogen receptor-positive breast cancer than estrogen receptor-negative breast cancer. The simpler model that used only three factors for calculating risk—age, family history of breast cancer, and previous breast biopsy—was almost as accurate as the Gail model for predicting estrogen receptor-positive breast cancer. 

The simpler model “would be more accessible for routine and rapid prescreening in the prevention or routine care setting,” the authors write.  

In an accompanying editorial, Mitchell Gail, M.D., Ph.D., of the National Cancer Institute in Bethesda, Md., after whom the Gail model is named, and colleagues write that many of Chlebowski’s results were consistent with epidemiologic literature. But they also note that breast cancer incidence in this study was higher than in the general U.S. population and that the risk from family history for estrogen receptor-negative breast cancer was much smaller than in many other studies. 

“Chlebowski [and colleagues] have presented useful and important results that illustrate the promise and difficulty of estimating absolute risk in subtypes of breast cancer,” the editorialists write. 

SOURCE: 

Journal of the National Cancer Institute, November 13, 2007