10.1186/1471-2407-12-529BMC Cancer12-BCMA

A Decarli

A Kwong

A Seow

B Rockhill

Chien-Hui Goh

CS Wong

CY Tam

D Spiegelman

David B Matchar

David Machin

EH Ng

EW Steyerberg

F Gao

Fei Gao

HR Shin

J Chen

J Novotny

JP Costantino

JS Kaur

Kee-Seng Chia

KG Yeoh

Khuan-Yew Chow

KS Chia

MH Gail

ML Bondy

NF Boyd

P Boyle

RK Matsuno

RL Bennett

RT Chlebowski

RW Jakes

Singapore Department of Statistics

SJ Schonfeld

Stephen W Duffy

WE Barlow

WHO expert consultation

Yu-Fan Sim

PubMed

Springer - Publisher Connector

Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study)

Abstract Background Gail and others developed a model (GAIL) using age-at-menarche, age-at-birth of first live child, number of previous benign breast biopsy examinations, and number of first-degree-relatives with breast cancer as well as baseline age-specific breast cancer risks for predicting the 5-year risk of invasive breast cancer for Caucasian women. However, the validity of the model for projecting risk in South-East Asian women is uncertain. We evaluated GAIL and attempted to improve its performance for Singapore women of Chinese, Malay and Indian origins. Methods Data from the Singapore Breast Screening Programme (SBSP) are used. Motivated by lower breast cancer incidence in many Asian countries, we utilised race-specific invasive breast cancer and other cause mortality rates for Singapore women to produce GAIL-SBSP. By using risk factor information from a nested case-control study within SBSP, alternative models incorporating fewer then additional risk factors were determined. Their accuracy was assessed by comparing the expected cases (E) with the observed (O) by the ratio (E/O) and 95% confidence interval (CI) and the respective concordance statistics estimated. Results From 28,883 women, GAIL-SBSP predicted 241.83 cases during the 5-year follow-up while 241 were reported (E/O=1.00, CI=0.88 to 1.14). Except for women who had two or more first-degree-relatives with breast cancer, satisfactory prediction was present in almost all risk categories. This agreement was reflected in Chinese and Malay, but not in Indian women. We also found that a simplified model (S-GAIL-SBSP) including only age-at-menarche, age-at-birth of first live child and number of first-degree-relatives performed similarly with associated concordance statistics of 0.5997. Taking account of body mass index and parity did not improve the calibration of S-GAIL-SBSP. Conclusions GAIL can be refined by using national race-specific invasive breast cancer rates and mortality rates for causes other than breast cancer. A revised model containing only three variables (S-GAIL-SBSP) provides a simpler approach for projecting absolute risk of invasive breast cancer in South-East Asia women. Nevertheless its role in counseling the individual women regarding their risk of breast cancer remains problematical and needs to be validated in independent data.</p

Gao Fei

Machin David

Chow Khuan-Yew

Sim Yu-Fan

Duffy Stephen W

Matchar David B

Goh Chien-Hui

Chia Kee-Seng

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http://dx.doi.org/10.1186/1471-2407-12-529

Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study)

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