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This profiler calculates 5-year and lifetime risk of developing invasive breast cancer and also categorizes these risk factors as either High, Moderate, or Low risk:
This profiler is intended only for women-specifically women who have NOT already been diagnosed with breast cancer, ductal carcinoma in situ (DCIS), or lobular carcinoma in situ (LCIS), or a BRCA1 or BRCA2 gene mutation. The results of this profiler are based on widely accepted research but are only accurate for the intended audience.
The breast cancer risk estimates are calculated using a woman's own age, ethnicity, personal medical history, reproductive history and the history of breast cancer in her immediate family. In general, breast cancer risk increases with age and with a longer lifetime exposure to the hormone estrogen. This profiler uses a statistical model known as the "Gail model," which is named after Dr. Mitchell Gail, Senior Investigator in the Biostatistics Branch of NCI's Division of Cancer Epidemiology and Genetics.
The Gail model has been tested in large populations of white women and has been shown to provide accurate estimates of breast cancer risk. In other words, the model has been "validated" for white women. It has also been tested in data from the Women's Health Initiative for African American women, and the model performs well, but may underestimate risk in African American women with previous biopsies. The model has been validated for Asian and Pacific Islander women. Researchers are conducting additional studies, including studies with minority populations, to gather more data and to test and improve the model.
The NCI Breast Cancer Risk Assessment Calculator may be updated periodically as new data or research becomes available. The algorithm was last updated in 2011. http://www.cancer.gov/bcrisktool/about-tool.aspx
The FDA has approved certain medications for the prevention of invasive breast cancer for women with an increased 5-year risk of breast cancer. Women at risk are defined as those with a 5-year breast cancer risk of 1.66% or higher (according to the Breast Cancer Prevention Trial sponsored by the National Cancer Institute). Because breast cancer risk increases with age, most women above the age of 60 have a 5-year risk of breast cancer that is higher than 1.66%.
Drugs used to lower the risk of breast cancer have possible side effects including hot flashes and increased risks of uterine cancer cataracts, and blood clots. In 2013, Guidelines from the United States Preventive Services Task Force (USPSTF) state that women who have a 5-year risk of 3% or higher for invasive breast cancer would have the most benefit and given the risks of the medication's side effects.
Recommendations vary as to how often to have a mammogram. In general, mammograms are suggested every 1 to 2 years starting at age 40 or 50. The American Cancer Society recommends that women who have a high lifetime risk of invasive breast cancer should talk to their health care providers about when to start breast cancer screening and if they would benefit by other imaging tests in addition to routine mammograms.