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A woman is at risk for breast cancer just because she's a woman. However, doctors have a new tool that can help predict how great her risk really is of developing invasive breast cancer.
Researchers from the National Surgical Adjuvant Breast and Bowel Project (NSABP) in Pittsburgh tested a breast cancer risk assessment model that estimates risk based on a series of factors including current age, age at first menstruation, age at delivery of first child, number of previous breast biopsies and number of first-degree relatives with breast cancer.
"The model can determine a woman's risk of cancer throughout her lifetime," says lead researcher Joseph P. Costantino, associate director of prevention at the NSABP's Biostatistic Center and an associate professor of biostatistics at the Graduate School of Public Health at the University of Pittsburgh.
A positive response to any of the questions (except age) equals an elevated risk of breast cancer. Then the model calculates how many times higher a woman's risk is compared to women in the general population with no risk factors, according to Costantino.
Using the model, that number is multiplied by the number of breast cancers expected in women of the same age and race with no known risk factors, Costantino says. This method was reported in the Journal of the National Cancer Institute. The original model to assess breast cancer risk was designed in 1989. This model was modified by the NSABP so that it gauges risk for invasive breast cancer, cancer that has spread to involve nearby tissues.
Doctors now can use the revised model, accessible on a computer disc by the National Cancer Institute, to help calculate a patient's risk of developing breast cancer. The results can either help alleviate a woman's fears, or if it indicates a risk, allow doctor and patient to move forward with preventative strategies and treatment.
"Experience and research has shown that women dramatically overestimate their breast cancer risk. So for the majority of women, when they find out their true risk, it greatly reduces their anxiety," Costantino says. "If a woman finds out she is at high risk for breast cancer, there are steps she can take to greatly reduce her risk." For example, a woman might have prophylactic mastectomy (surgical removal of a healthy breast) or take the drug tamoxifen for five years, which studies have shown can reduce the incidence of breast cancer by 45 percent in women considered at high risk. Recent studies show after five years of tamoxifen, another five years of letrozole further reduces the risk of recurrent breast cancer.
Breast cancer is the second-leading cause of cancer in women, surpassed only by lung cancer. While there are some risk factors a woman has no control over -- such as advancing age, the age she started menstruating or begins menopause -- there are some lifestyle changes she can make to reduce her risk.
Avoiding or minimizing alcohol consumption, eating a diet high in colorful fruits and vegetables and low in fat, maintaining a healthy weight, and exercising have been shown to reduce a woman's risk of developing the disease.
Also, just because a woman has known risk factors does not mean she will get breast cancer. More than 70 percent of women diagnosed with breast cancer have no identifiable risk factors.
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External Sources
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Dollinger M, Rosenbaum, EH, Tempero M., et al. Everyone's Guide to Cancer Therapy, Fourth Edition, Kansas City, Missouri: Andrews McMeel Publishing, 2002.
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National Cancer Institute
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This article was reviewed and updated June 2007.
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