New Model Offers Better Breast Cancer Risk Estimate for Black Women

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Right now, most doctors use some form of the Gail model, a standard breast cancer risk assessment tool, to calculate breast cancer risk. The Gail model assesses 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 Gail model ask about alcohol use, menopausal status, and body mass index. The result is a Gail score, which estimates the risk of developing invasive breast cancer in the next 5 years.

Still, while the Gail model is widely used, it’s known to underestimate breast cancer risk in black women. Black women are more likely than white women to be diagnosed with breast cancer when they’re younger than 40 and are more likely to die from breast cancer than white women.

So while younger black women seem to have a higher risk of breast cancer than younger white women, black women have historically been underrepresented in breast cancer prevention studies.

The Gail model underestimating risk in black women may be the reason that fewer black women are in prevention studies. Many prevention studies invite women at high risk of breast cancer to participate; if the Gail model underestimates a black woman’s risk of breast cancer, then she wouldn’t be eligible for the study.

Researchers at Boston University announced they’ve developed a new breast cancer risk prediction model for black women that is more accurate than the Gail model.

The research was published online on Jan. 26, 2015 by the Journal of Clinical Oncology. Read the abstract of “Prospective Approach to Breast Cancer Risk Prediction in African American Women: The Black Women’s Health Study Model.”

The researchers used prospective information from 55,000 black women who were 30 to 69 years old in the Boston University Black Women’s Health Study to develop the model. Prospective information means the researchers collected information from the women before they developed any breast cancer.

To develop the model, the researchers used information on the women’s:

  • family history of breast cancer
  • history of benign breast disease
  • age at first period
  • age when a woman gave birth her to first child
  • birth control pill use
  • hormone replacement therapy use
  • body mass index at age 18
  • adult height
  • whether a woman’s ovaries had been removed or not

After 5 years, the model predicted that 486 women would be diagnosed with breast cancer; 506 women actually were diagnosed with breast cancer.

The model was most accurate for women younger than 50.

The model predicted that 14.6% of the women would be considered at high risk for breast cancer, a much higher percentage than predicted by the Gail model. This means that many more black women could be eligible for breast cancer prevention studies.

If you’re a black woman, you may want to talk to your doctor about this study and what your true risk of breast cancer is. 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

To learn more about breast cancer risk and other options to keep your risk as low as it can be, visit the Lower Your Risk section.

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