Nav: Home

Breast cancer study confirms importance of multigenerational family data to assess risk

February 21, 2019

A team of researchers led by Columbia University Mailman School of Public Health Professor Mary Beth Terry, PhD, evaluated four commonly used breast cancer prediction models and found that family-history-based models perform better than non-family-history based models, even for women at average or below-average risk of breast cancer. The study is the largest independent analysis to validate four widely used models of breast cancer risk and has the longest prospective follow-up data available to date. The findings are published online in The Lancet Oncology.

Dr. Terry and colleagues used the Breast Cancer Prospective Family Study Cohort composed of 18,856 women from Australia, Canada, and the U.S. without breast cancer, between March 1992 and June 2011. Women between the ages of 20 to 70 were selected for the study who had no previous history of bilateral prophylactic mastectomy or ovarian cancer, and whose family history of breast cancer was available. The researchers calculated 10-year risk scores for the final cohort of 15,732 women, comparing four breast cancer risk models which all vary in how they use information regarding multi-generational and genetic information as well as non-genetic information: the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm model (BOADICEA), BRCAPRO, the Breast Cancer Risk Assessment Tool (BCRAT), and the International Breast Cancer Intervention Study model (IBIS). A second analysis was conducted to compare the performance of the models after 10 years based on the mutation status of the BRCA1 or BRCA2 genes.

The results showed that the BOADICIA and IBIS models which have multigenerational family history data were more accurate in predicting breast cancer risk than the other models. This held true even for women without a family history of breast and without BRCA1 and BRCA2 mutations. The other two models BRCAPRO and BCRAT models did not perform as well overall and in women under 50 years of age. The BCRAT model was well-calibrated in women over 50 years who were not known to carry deleterious mutations in the BRCA1 and BRCA2 genes. Of the 15,732 eligible women, 4 percent were diagnosed with breast cancer during the median follow-up of 11-plus years.

"Our study, which was enriched based on family history, was large enough to evaluate model performance across the full spectrum of absolute risk, including women with the highest risk of cancer in whom accurate prediction is especially important," said Dr. Terry, who is a Professor of Epidemiology at the Columbia Mailman School, and the Herbert Irving Comprehensive Cancer Center. "Independent validation is particularly important to understand the utility of these models across different settings."

Breast cancer risk models are used to help inform decisions about primary prevention and increasingly, in screening programs, including when women should have mammographies. There are several different models to assess breast cancer risk, and they vary in how they take into account family history and genetics.

"Mathematical models can help estimate a woman's future risk of breast cancer. There are several available, but it is uncertain which models are the most appropriate ones to use. These findings might help provide better guidance to women with their decision-making on breast cancer screening strategies," says Dr. Robert MacInnis, who is a Senior Research Fellow in the Cancer Epidemiology and Intelligence Division at the Cancer Council, Victoria Australia and co-led the analyses with Dr. Terry.

"Our findings suggest that all women would benefit from risk assessment that involves collection of detailed family histories, and that risk models would be improved by inclusion of family history information including ages at diagnoses and types of cancer," said Dr. Terry.
-end-
Co-authors and their affiliated institutions can be found in the paper, "10-year Performance of Four Models of Breast Cancer Risk: A Validation Study." Here is the post-embargo link to include in articles: http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30902-1/fulltext

The study was supported by U.S. National Institutes of Health, National Cancer Institute, Breast Cancer Research Foundation, Australian National Health and Medical Research Council, Victorian Health Promotion Foundation, Victorian Breast Cancer Research Consortium, Cancer Australia, National Breast Cancer Foundation, Queensland Cancer Fund, Cancer Councils of New South Wales, Victoria, Tasmania, and South Australia, and the Cancer Foundation of Western Australia.

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit http://www.mailman.columbia.edu.

Columbia University's Mailman School of Public Health

Related Breast Cancer Articles:

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.
Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.
More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.
Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.
Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.
Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.
Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.
Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.
Does MRI plus mammography improve detection of new breast cancer after breast conservation therapy?
A new article published by JAMA Oncology compares outcomes for combined mammography and MRI or ultrasonography screenings for new breast cancers in women who have previously undergone breast conservation surgery and radiotherapy for breast cancer initially diagnosed at 50 or younger.
Blood test offers improved breast cancer detection tool to reduce use of breast biopsy
A Clinical Breast Cancer study demonstrates Videssa Breast can inform better next steps after abnormal mammogram results and potentially reduce biopsies up to 67 percent.
More Breast Cancer News and Breast Cancer Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Rethinking Anger
Anger is universal and complex: it can be quiet, festering, justified, vengeful, and destructive. This hour, TED speakers explore the many sides of anger, why we need it, and who's allowed to feel it. Guests include psychologists Ryan Martin and Russell Kolts, writer Soraya Chemaly, former talk radio host Lisa Fritsch, and business professor Dan Moshavi.
Now Playing: Science for the People

#538 Nobels and Astrophysics
This week we start with this year's physics Nobel Prize awarded to Jim Peebles, Michel Mayor, and Didier Queloz and finish with a discussion of the Nobel Prizes as a way to award and highlight important science. Are they still relevant? When science breakthroughs are built on the backs of hundreds -- and sometimes thousands -- of people's hard work, how do you pick just three to highlight? Join host Rachelle Saunders and astrophysicist, author, and science communicator Ethan Siegel for their chat about astrophysics and Nobel Prizes.