Popular Test Underestimates Black Women’s Breast Cancer Risk

Prediction model falls short on aggressive forms of cancer. 

Posted: 02/26/2013 04:47 PM EST

An important factor in treating breast cancer in women, especially in Black women, is trying to understand what makes us more vulnerable to developing the disease.

Currently, many researchers around the country use the CARE model to assess Black women’s risk. It’s modeled after the Gail method, a prediction model based on white women’s risk. But a new report suggests that this CARE model, even with its good intentions, may not be our best bet.

Researchers from Slone Epidemiology Center (SEC) at Boston University took the CARE model and analyzed data from the Black Women’s Health Study. They found that this model poorly predicted risk for estrogen receptor (ER) negative breast cancer, a more aggressive and deadly form of cancer that Black women are more likely to be diagnosed with. They also found that the test didn’t do well with ER-positive breast cancer and underestimated younger women’s risk.

So what’s the deal?

The study noted that a lot is going on.

The CARE model is missing important prediction factors. One of which being, “How many children a woman has and how old she was when she had her first baby.” Lead researcher Dr. Deborah Boggs told BET.com that the younger you are when you have your first child and having more babies lowers your risk of ER-positive cancer.

None of this is included in the CARE model.

Boggs said that across the board, researchers just don’t know enough about ER-negative cancer, which also plays into why these models underestimate our risk.

“But here is what we know, that more accurate prediction, the better chance a woman has to be enrolled in a prevention trial. And if we are underestimating Black women’s risk, the women who need these trials the most, they won’t be included in [a prevention trial].”

This is why Boggs and her colleagues are calling for better prediction models and more research, in hopes to save more Black women’s lives.

“Perhaps by having more Black women in these trials at a sooner age, we can talk about the need for Black women to get screened earlier, like age 40, given that ER negative breast cancer hits Black women earlier than white women.”

Learn more about ER-negative cancer and other forms of breast cancer here.

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