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May 27, 2019  
FIBROIDS1 NEWS: Feature Story

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  • New Model Accurately Predicts Breast Cancer Risk

    New Model Accurately Predicts Breast Cancer Risk in African American Women


    May 14, 2008


    By: Danae Roumis for Fibroids1

    An improved model, called the CARE model, for predicting the risk of breast cancer in African American women aged 45 and older has been developed by a team of researchers led by Mitchell Gail, MD, PhD at the National Cancer Institute (NCI) in Bethesda, Maryland. The results of their study were published in November 2007 in the online Journal of the National Cancer Institute. According to the NCI, African Americans have higher mortality rates from breast cancer than any other racial or ethnic group in the United States, and a surge of recent research from academic and medical institutions around the country has highlighted increasing disparities in incidence and treatment. Clearly, the development of the CARE model could have very positive public health implications. It will be able to more accurately predict which African American women are at risk, and which are eligible for breast cancer prevention trials.
    Take Action
    Information to Help Reduce Your Breast Cancer Risk:
  • Breast cancer is the leading, non-skin cancer cause of death of women in the United States. If you are at risk for breast cancer, contact your physician to ask about your options for screening and prevention.
  • If you are a middle-aged, African American woman, ask your healthcare provider about the CARE model. Your provider is your resource and is there to provide you with reliable information.
  • If you have a relative or friend possibly at risk for breast cancer, share with them the news about the CARE model.
  • Stay diligent when it comes to regular screening methods, as early detection can make all the difference, as early tissue abnormalities are easiest to treat, and the least likely to have spread.


  • The Breast Cancer Risk Assessment Tool (BCRAT) has been widely used to predict cancer risk, but since the data used to develop this model was collected mostly from white women, its application to other groups has been questioned. The researchers conducted the Women’s Contraceptive and Reproductive Experiences study (Women’s CARE) to gather more appropriate information about the incidence of breast cancer in African American women, using this new information to revise the prediction model. National Cancer Institute Director, John E. Niederhuber, MD, said that “The development of the CARE model highlights the need to develop targeted tools to assess an individual woman's risk, and those tools must be based on many factors that also assure that the tool can be used in a non-discriminatory manner.” The hope of the NCI is to have the new CARE model integrated into the present system by the spring of 2008.

    The researchers combined data from the CARE study with that from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program, as well as with national mortality data, to calculate a figure of absolute risk. The researchers tested the accuracy of the CARE model against breast cancer incidence from the Women’s Health Initiative, and the new model successfully approximated the observed data. Gail and his colleagues used the Study of Tamoxifen and Raloxifene (STAR) trial to determine whether the CARE model would categorize women differently in terms of eligibility for preventive treatments. According to the study, the CARE model estimated that 30 percent of African American women would have been eligible for participation in the STAR trial, whereas the original BCRAT model’s estimate of eligibility was only14.5 percent. So, the CARE model is better at both approximating a woman’s risk of breast cancer, as well as more inclusive when it comes to prevention.

    The CARE model, at this point in time, can only be used for women without a previous history of breast cancer, and there is a possibility that it may understate the breast cancer risk in certain other women, including those who have previously received radiation to the chest, or those who carry a mutation in the BRCA1 or BRCA2 genes, which are commonly associated with increased breast cancer risk. The researchers have recommended that healthcare professionals use the CARE model when counseling African American women regarding their risk of breast cancer. Don’t hesitate to consult with your physician about the CARE model, your risks, and possible prevention options. This is especially important if you already suspect that you are at risk for breast cancer.

    Last updated: 14-May-08

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