How online tools can play a role in maintaining breast health
What if an online tool could help determine your risk of developing breast cancer?
Called Breast Cancer Risk Assessment models, these tools use a quick series of questions regarding age, race, medical history and more to determine the general likelihood that someone will develop breast cancer at some point in their lives. The results can help both patients and their doctors determine the best approach to monitoring future breast health and what proactive measures should be taken.
“There’s a lot of potential benefit from these models,” says Sarasota Memorial Genetic Counselor Katherine Zimmerman, MSPH, LCGC. “Especially when taken with consultation with your doctor.”
Importantly, these models are not 100% accurate and should never be used instead of talking to a healthcare professional or scheduling regular mammograms.
How Does the Breast Cancer Risk Assessment Test Work?
There are actually many different models available, though all take into account accepted breast cancer risk factors. These include:
- Age – As with many cancers, risk of breast cancer increases with age
- Family History – Cancer can be hereditary, so a family history of cancer increases risk
- Race/Ethnicity – Ethnic groups can have different cancer risks, and this can play a role in individual risk
- Genetic Mutation – Certain mutations, such as the BRCA1 and BRCA2 gene, are known to increase risk of breast cancer
- Breast Density – Denser breast tissue increases risk
- Childbirth History – Women who have not given birth have increased risk of developing breast cancer
- Menstrual History – Starting menstruation at a young age and experiencing menopause late can both increase risk of breast cancer
Not all risk factors are weighted the same and not all models include every risk factor, but all are based on an assessment of some combination of these factors.
BRCA1, BRCA2 and Other Genetic Risks for Breast Cancer
When functioning properly, the BRCA1/2 genes repair DNA and keep cells healthy. But when damaged by mutation, they greatly increase an individual’s risk of developing breast cancer and ovarian or prostate cancer. This makes the BRCA1/2 mutation a definitive factor in breast cancer risk.
“If you have a genetic risk for breast cancer such as a BRCA1/2 mutation,” says Zimmerman, “your lifetime risk is based on those genes.”
To learn more about BRCA1/2 mutations and genetic cancer risk, click here.
The Gail Model and the Tyrer-Cuzick Model
Two of the most common Breast Cancer Risk Assessment models are the Gail Model and the Tyrer-Cuzick Model.
The Gail Model, or the Breast Cancer Risk Assessment Tool (BCRAT), helps physicians determine a woman’s risk of developing breast cancer over the next five years and throughout the rest of her life. The test takes about five minutes to complete and can be found online here.
Note: The National Cancer Institute has warned that the Gail Model may underestimate risk in Black women with previous biopsies and Hispanic women born outside the United States. More data is also needed to further validate the model for American Indian/Alaska Native women.
The Tyrer-Cuzick model, also known as the IBIS tool, helps determine a woman’s risk of developing breast cancer over the next 10 years and throughout the rest of her life. One notable difference between this model and the Gail Model is that the Tyrer-Cuzick model includes breast density as a factor in the model. The test takes only a few minutes to complete and can be found online here.
Both models are used by healthcare professionals when assessing patient risk and whether they qualify for special screenings or specific preventative medication.
How To Read Your Score
A woman’s average risk of developing cancer in her lifetime is roughly 1 in 8, or around 13%.
Someone is considered at high risk of developing breast cancer if the model returns a risk assessment of 20% or higher.
Talking Breast Cancer Risk With Your Doctor
While Breast Cancer Risk Assessment models are readily available, it’s important that their use never replace regular mammograms or regular check-ups and self-examinations. To accurately determine your risk of developing breast cancer, you should always consult with a healthcare professional.
“I never discourage my patients from researching and staying informed on their health,” says Zimmerman. “But it’s also important to allow your healthcare provider to do their job, to run these models with you and talk through the results with you to determine what your risks are.”
To talk with a genetic counselor at Sarasota Memorial, click here or call Sarasota Memorial’s Genetic Education program at (941) 262-7570.
Learn More
To learn more about genetic testing for breast cancer risk at Sarasota Memorial, click here.
To learn more about breast cancer care at the Brian D. Jellison Cancer Institute of Sarasota Memorial, click here.
Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, KY.