Breast cancer risk assessment models: applicability to African-American women.

BACKGROUND. Mortality rates are higher among African-American women with breast cancer than they are among white women. This population subset can benefit from available risk reduction strategies. Optimal public health gains from chemoprevention strategies depend on the ability to assess accurately the risk for the individual. However, it is not known if existing breast cancer prediction models are accurate predictors of the disease among African-American women. METHODS. Literature was reviewed for breast cancer risk prediction models and their validation studies. Reported data were also reviewed regarding the strength of established breast cancer risk factors for African-American women. RESULTS. The two currently accepted breast cancer risk assessment models, the Gail Model and the Clans Model, were designed primarily to provide risk assessments for white women. Neither model has been validated in African-American women. Reported data are inconsistent regarding the prevalence and strength of risk factors included in these models. CONCLUSIONS. Efforts should be made to validate existing risk assessment models in African-American women and future research should be directed at the identification of more reliable risk assessment features. Cancer 2003;97(1 Suppl):230-5.