Projecting Individualized Absolute Invasive Breast Cancer Risk in African American Women

Gail, Mitchell H.; Costantino, Joseph P.; Pee, David; Bondy, Melissa L.; Newman, Lisa A.; Selvan, Mano; Anderson, Garnet L.; Malone, Kathleen E.; Marchbanks, Polly A.; McCaskill‐Stevens, Worta; Norman, Sandra A.; Simon, Michael S.; Spirtas, Robert; Ursin, Giske; Bernstein, Leslie

doi:10.1093/jnci/djm223

Cited by 290 publications

(267 citation statements)

References 15 publications

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“…In foreign-born WHI women, the HRM appeared to overestimate risk, but this discrepancy was not statistically significant. In WHI, the concordance statistics for the HRM for USborn and foreign-born Hispanic women, while modest, were similar to those obtained for other BCRAT models (2,3).…”

Section: Discussionsupporting

confidence: 73%

“…Following the previously described methods (2,3,17), we first developed nativityspecific multivariable relative risk models from the SFBCS data, including risk factors in (17). Then, we obtained baseline ageand nativity-specific breast cancer incidence rates for Hispanic women by multiplying age-and nativity-specific rates from CCR times 1 minus the nativity-specific population-attributable risk from SFBCS.…”

Section: Discussionmentioning

confidence: 99%

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Projecting Individualized Absolute Invasive Breast Cancer Risk in US Hispanic Women

Banegas

John

Slattery

et al. 2016

JNCI J Natl Cancer Inst

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Background: There is no model to estimate absolute invasive breast cancer risk for Hispanic women. Methods: The San Francisco Bay Area Breast Cancer Study (SFBCS) provided data on Hispanic breast cancer case patients (533 US-born, 553 foreign-born) and control participants (464 US-born, 947 foreign-born). These data yielded estimates of relative risk (RR) and attributable risk (AR) separately for US-born and foreign-born women. Nativity-specific absolute risks were estimated by combining RR and AR information with nativity-specific invasive breast cancer incidence and competing mortality rates from the California Cancer Registry and Surveillance, Epidemiology, and End Results program to develop the Hispanic risk model (HRM). In independent data, we assessed model calibration through observed/expected (O/E) ratios, and we estimated discriminatory accuracy with the area under the receiver operating characteristic curve (AUC) statistic. Results: The US-born HRM included age at first full-term pregnancy, biopsy for benign breast disease, and family history of breast cancer; the foreign-born HRM also included age at menarche. The HRM estimated lower risks than the National Cancer Institute's Breast Cancer Risk Assessment Tool (BCRAT) for US-born Hispanic women, but higher risks in foreign-born women. In independent data from the Women's Health Initiative, the HRM was well calibrated for US-born women (observed/expected [O/E] ratio ¼ 1.07, 95% confidence interval [CI] ¼ 0.81 to 1.40), but seemed to overestimate risk in foreign-born women (O/E ratio ¼ 0.66, 95% CI ¼ 0.41 to 1.07). The AUC was 0.564 (95% CI ¼ 0.485 to 0.644) for US-born and 0.625 (95% CI ¼ 0.487 to 0.764) for foreign-born women. Conclusions: The HRM is the first absolute risk model that is based entirely on data specific to Hispanic women by nativity. Further studies in Hispanic women are warranted to evaluate its validity.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Projecting Individualized Absolute Invasive Breast Cancer Risk in US Hispanic Women

Banegas

John

Slattery

et al. 2016

JNCI J Natl Cancer Inst

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“…27 Recently, the model was updated using data from the Contraceptive and Reproductive Experiences Study to provide more accurate determination of risk for Black women. 28 (The Gail model is not applicable to patients with a prior history of invasive breast cancer, lobular carcinoma in situ [LCIS], or ductal carcinoma in situ [DCIS]. )…”

Section: Quantitative Breast Cancer Risk Assessmentmentioning

confidence: 99%

Opportunities and Strategies for Breast Cancer Prevention Through Risk Reduction

Mahoney

Bevers

Linos

et al. 2008

CA: A Cancer Journal for Clinicians

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Due to the high incidence of breast cancer among US females, risk-reduction strategies are essential. Before considering approaches to breast cancer risk reduction, it is important for clinicians to complete individualized qualitative and quantitative assessments of risk for their patients in order to inform physicians' clinical decision making and management and to engage patients collaboratively in a thorough discussion of risks and benefits. This review will summarize information on potential pharmacologic, nutritional, surgical, and behavioral approaches to reducing breast cancer risk.While there is no clear evidence that specific dietary components can effectively reduce breast cancer risk, weight gain and obesity in adulthood are risk factors for the development of postmenopausal breast cancer. Alcohol consumption, even at moderate levels, increases breast cancer risk, although some of the detrimental effects may be reduced by sufficient folate intake. Women at increased risk of breast cancer can opt to reduce their breast cancer risk through the use of tamoxifen or raloxifene; other chemopreventive agents remain under investigation. Surgical approaches to risk reductions are restricted to those patients with a substantially increased risk of developing breast cancer. Patients should be encouraged to maintain a healthy lifestyle for their overall well-being and to remain up to date with recommendations for screening and surveillance. (CA Cancer

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“…Knowledge of gene expression changes in these tissues could generate novel tools to integrate into existing riskassessment models (e.g. the Gail model (Gail et al, 1989(Gail et al, , 2007) to improve their accuracy. Some evidence already exists suggesting that alterations could have clinical significance (Yang et al, 2005;Chen et al, 2009).…”

mentioning

confidence: 99%

Gene expression in histologically normal epithelium from breast cancer patients and from cancer-free prophylactic mastectomy patients shares a similar profile

et al. 2010

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INTRODUCTION:We hypothesised that gene expression in histologically normal (HN) epithelium (NlEpi) would differ between breast cancer patients and usual-risk controls undergoing reduction mammoplasty (RM), and that gene expression in NlEpi from cancer-free prophylactic mastectomy (PM) samples from high-risk women would resemble HN gene expression. METHODS: We analysed gene expression in 73 NlEpi samples microdissected from frozen tissue. In 42 samples, we used microarrays to compare gene expression between 18 RM patients and 18 age-matched HN (9 oestrogen receptor (ER) þ , 9 ERÀ) and 6 PM patients. Data were analysed using a Bayesian approach (BADGE), and validated with quantitative real-time PCR (qPCR) in 31 independent NlEpi samples from 8 RM, 17 HN, and 6 PM patients. RESULTS: A total of 98 probe sets (86 genes) were differentially expressed between RM and HN samples. Performing hierarchical analysis with these 98 probe sets, PM and HN samples clustered together, away from RM samples. qPCR validation of independent samples was high (84%) and uniform in RM compared with HN patients, and lower (58%), but more heterogeneous, in RM compared with PM patients. The 86 genes were implicated in many processes including transcription and the MAPK pathway. CONCLUSION: Gene expression differs between the NlEpi of breast cancer cases and controls. The profile of cancer cases can be discerned in high-risk NlEpi from cancer-free breasts. This suggests that the profile is not an effect of the tumour, but may mark increased risk and reveal the earliest genomic changes of breast cancer.

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Projecting Individualized Absolute Invasive Breast Cancer Risk in African American Women

Abstract: The CARE model usually gave higher risk estimates for African American women than the Breast Cancer Risk Assessment Tool and is recommended for counseling African American women regarding their risk of breast cancer.

Cited by 290 publications

References 15 publications

Projecting Individualized Absolute Invasive Breast Cancer Risk in US Hispanic Women

Projecting Individualized Absolute Invasive Breast Cancer Risk in US Hispanic Women

Opportunities and Strategies for Breast Cancer Prevention Through Risk Reduction

Gene expression in histologically normal epithelium from breast cancer patients and from cancer-free prophylactic mastectomy patients shares a similar profile

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