This information was published in the Journal of the National Cancer Institute.

Identifying women at high risk of developing breast cancer can help guide breast cancer screening and risk reduction strategies. Women at high risk, for example, may benefit from additional screening approaches such as magnetic resonance imaging (MRI) and/or use of drugs such as tamoxifen (Nolvadex®) or Evista® (raloxifene) for breast cancer risk reduction.

The National Cancer Institute (NCI) Breast Cancer Risk Assessment Tool was developed to assess a woman’s risk of breast cancer based on factors such as age, reproductive history, family history, and history of breast biopsies. This tool, however, was based largely on information from White women. The performance of the tool among African-American women has been uncertain.

To develop a tool for assessing breast cancer risk among African-American women, researchers evaluated information from a study known as the Women’s Contraceptive and Reproductive Experiences (CARE) study. The study included 1,607 African-American women with invasive breast cancer and 1,647 African-American women without breast cancer.

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The researchers used information from the study to predict risk of breast cancer among African-American women based on age, age at first menstrual period, having a mother or sister(s) with breast cancer, and number of previous benign breast biopsies. The risk estimate obtained from this model was compared to the risk estimate that would have been obtained using the Breast Cancer Risk Assessment Tool.

  • The CARE model appeared to accurately predict breast cancer risk in African-American women.
  • Among African-American women age 45 or older, risk estimates tended to be higher using the CARE model than using the Breast Cancer Risk Assessment Tool. The percent of women with a five-year risk of breast cancer of at least 1.66% (the risk level required to enter the STAR trial-a study of breast cancer risk reduction) was 30.3% using CARE and 14.5% using the Breast Cancer Risk Assessment Tool.

The researchers conclude: “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.”

Reference: Gail MH, Costantino JP, Pee D et al. Projecting individualized absolute invasive breast cancer risk in African American women. Journal of the National Cancer Institute. 2007;99:1782-92.