Doctors use risk assessment tools to calculate breast cancer risk. Two of the most well-known are the Gail model and the Breast Cancer Surveillance Consortium (BCSC) Risk Calculator.
Both models assess breast cancer risk based on a series of personal health questions that women and their doctors answer together. The questions ask about risk factors such as age, child-bearing history, family history of breast cancer, and breast biopsy results. Some more recent versions of the models ask about alcohol use, menopausal status, and body mass index. The BCSC Risk Calculator is the only risk assessment tool that includes breast density information when calculating risk. The tools offer risk scores, which estimate the risk of developing invasive breast cancer in the next 5 years.
Still, because these tools were developed from data that came mostly from non-Hispanic white women, they may underestimate risk in women of other ethnicities.
Researchers have now developed a breast cancer risk prediction model based entirely on information from Hispanic women, including whether a woman was born inside or outside of the United States. A study found this new model was more accurate in assessing risk in Hispanic women than existing models.
The research was presented at the Eighth American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved on Nov. 13, 2015. Read the abstract of “Projecting Individualized Absolute Invasive Breast Cancer Risk in Hispanic Women.”
To develop the model, the researchers used information from two studies: the San Francisco Bay Area Breast Cancer Study and the 4-Corners Breast Cancer Study.
Information from 1,086 Hispanic women diagnosed with breast cancer:
- 533 were born in the United States
- 553 were born outside the United States
and 1,411 Hispanic women who hadn’t been diagnosed with breast cancer:
- 464 were born in the United States
- 947 were born outside the United States
was used to estimate risk separately for women born in the United States and women born outside the United States.
Factors in the new model include:
- woman’s age at first full-term pregnancy
- woman’s age at first menstrual period
- information on any biopsies for benign breast disease
- family history of breast cancer in first-degree relatives (mother, father, sister, brother, children)
Part of the validation process included comparing risk assessments developed by the new tool to information from Hispanic women in the Women’s Health Initiative trial. The researchers found the model was very accurate for Hispanic women born in the United States, but overestimated risk for Hispanic women born outside the United States. Other research has shown that Hispanic women born outside the United States have about half the breast cancer risk of U.S.-born Hispanic women.
"The goal of our work is to enable Hispanic women to better understand their risk of developing invasive breast cancer,” said Matthew Banegas, Ph.D., M.P.H., investigator with Kaiser Permanente Center for Health Research and lead author of the study. “They will be able to discuss this information with their physician and what it means for them specifically.”
Since the model was developed using information from women in the San Francisco Bay area, it will be most applicable to women in that region, said Dr. Banegas. As researchers collect more information from Hispanic women in other parts of the United States and from Hispanic women born outside the country, that information will be incorporated into the model to increase its accuracy.
The new model isn’t available online yet.
If you’re a Hispanic woman, you may want to talk to your doctor about this study. Ask your doctor if you can use this new model to determine your risk. If you learn that your risk is higher than average, there are steps you can take, including possibly taking medicine to lower that risk.
It makes good sense to do all that you can to keep your risk of breast cancer as low as it can be. Some lifestyle choices you may want to consider are:
- maintaining a healthy weight
- exercising every day
- limiting or avoiding alcohol
- eating a healthy diet that’s low in processed foods, sugar, and trans fats
- not smoking
- breastfeeding, if you have the option to do so
To learn more about breast cancer risk and other options to keep your risk as low as it can be, visit the Breastcancer.org Lower Your Risk section.