Summary
Background. Several mathematical models have been developed for predicting individual breast cancer risk. Such models can help clinicians to choose appropriate preventive and therapeutic interventions for each patient. Unfortunately, the validity of these models has not been tested outside the USA.
Methods. The authors describe a case–control study in the Czech Republic with a similar design to that of the US Breast Cancer Detection and Demonstration Project (BCDDP). The main objective of the study was to evaluate the validity of the Gail model in the Czech female population, and to develop a local model using the same statistical approach as the Gail model. Between November 2000 and May 2004, 14,566 questionnaires containing case history data from both healthy women (control group) and women with breast cancer were collected. Case–control age-matched pairs (n = 4598) have subsequently been matched and analyzed.
Results. Our results show that the original Gail model was not able to properly distinguish between controls and breast cancer cases in the Czech female population. Based on paired data, the mean 5-year and life-time breast cancer risk was 1.379 ± 0.668 and 7.990 ± 3.184 in the control group and 1.375 ± 0.692 and 8.028 ± 3.506 in the patients with breast cancer group. The original Gail model was also not able to properly describe age-specific baseline risk of breast cancer development in the Czech population. In response the authors developed two variants of modified/locally adjusted models.
Conclusion. The original Gail model is not an accurate breast cancer risk assessment tool for the Czech female population.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Levi F, Lucchini F, Negri E, Boyle P, La Vecchia C, 2003 Mortality from major cancer sites in the European Union, 1955–1998 Ann Oncol 14: 490–495
Freedman AN, Graubard BI, Rao SR, McCaskill-Stevens W, Ballard-Barbash R, Gail MH, 2003 Estimates of the number of US women who could benefit from tamoxifen for breast cancer chemoprevention J Natl Cancer Inst 95: 526–532
Armstrong K, Eisen A, Weber B, 2000 Assessing the risk of breast cancer N Engl J Med 342: 564–571
Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, et al. 1989 Projecting individualized probabilities of developing breast cancer for white females who are being examined annually J Natl Cancer Inst 81: 1879–1886
Newman LA, Gail MH, Selvan M, Bondy M, Rockhill B, Colditz G, et al. 2003 Proposed revision of the Gail breast cancer (BC) risk assessment model Proc Am Soc Clin Oncol 22: 845 abstract 3396
Constantino JP, Gail MH, Pee D, Anderson S, Redmond CK, Benichou J, et al. 1999 Validation studies for models projecting the risk of invasive and total breast cancer incidence J Natl Cancer Inst 91: 1541–1548
Domchek SM, Eisen A, Calzone K, Stopfer J, Blackwood A, Weber BL, 2003 Application of breast cancer risk prediction models in clinical practice J Clin Oncol 21: 593–601
Cuzick J, Powles T, Veronesi U, Forbes J, Edwards R, Ashley S, et al. 2003 Overview of the main outcomes in breast-cancer prevention trials Lancet 361: 296–300
Fisher B, Constantino JP, Wickerham DL, Redmond CK, Kavanah M, Cronin WM, et al. 1998 Tamoxifen for prevention of breast cancer: a report of the National Surgical Adjuvant Breast Bowel Project P-1 J Natl Cancer Inst 90: 1371–1388
Wickerham DL, 2003 Tamoxifen’s impact as a preventive agent in clinical practice and an update on the STAR trial Recent Results Cancer Res. 163: 87–95
Cancer Incidence, Mortality and Prevalence Worldwide, 2001 IARC CancerBase No. 5 Lyon IARC Press
Acknowledgement
The study was supported by grants from the Czech Ministry of Education (No. MSM 0021620808) and from the Terry Fox Foundation and by an unrestricted grant from Johnson & Johnson.
Author information
Authors and Affiliations
Corresponding author
Additional information
Addressfor offprints and correspondence: Jan Novotny, MD, PhD, Department of Oncology, General Teaching Hospital, U nemocnice 2, Prague 2, 128 08, Czech Republic; E-mail: onkologie@seznam.cz
Rights and permissions
About this article
Cite this article
Novotny, J., Pecen, L., Petruzelka, L. et al. Breast cancer risk assessment in the Czech female population – an adjustment of the original Gail model. Breast Cancer Res Treat 95, 29–35 (2006). https://doi.org/10.1007/s10549-005-9027-5
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10549-005-9027-5