Specialized Risk Calculator May Reduce Disparities for Black Patients With Breast Cancer
A new risk model tailored for Black patients predicts their risk of developing breast cancer as accurately as current models for White patients, researchers reported (https://ascopubs.org/doi/10.1200/JCO.21.01236) in the Journal of Clinical Oncology. Because Black patients are more likely to be younger at diagnosis, present with aggressive or advanced cancer, and die from the disease than other racial and ethnic groups, using the new model to personalize prevention and screening recommendations may reduce those disparities.
Most existing breast cancer risk calculators were developed and tested using data largely from White patients and are less accurate for Black patients, who are more likely to have triple-negative or inflammatory breast cancer and be diagnosed at ages younger than 40, which is the typical recommendation to begin screening. The new risk calculator accounts for those differences, and its accuracy was highest for patients younger than 40.
To develop the model, researchers estimated breast cancer relative risks and attributable risks using data from Black women in three U.S. case-control studies involving 3,468 patients with breast cancer cases and 3,578 controls combined with Surveillance, Epidemiology, and End Results database age- and race-specific incidence rates. They also created a prediction model for estrogen–receptor relative risks and attributable risks.
They tested and validated the models using prospective data from 51,798 participants in the Black Women’s Health Study, including 1,515 who developed invasive breast cancer, and found that both models estimated breast cancer risk for Black patients as accurately as the current models do for White patients.
Beyond its benefits in guiding screening recommendations, the researchers said the model could identify (https://ascopubs.org/doi/10.1200/JCO.21.01236) whether to refer Black patients to genetic counseling or clinical trials. Visit the breast cancer risk calculator (https://www.bu.edu/slone/bwhs-brcarisk-calculator/) to use the risk model with your patients.