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Rapid Responses to:
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Electronic letters published:
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif){kind=icon}
Estimating Hormone Receptor Positive Breast Cancer Risk
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Rowan T Chlebowski, MD, PhD LABioMed, Dorothy Lane, Garnet Anderson
Send rapid response to journal:
rchlebowski{at}gmail.com Rowan T Chlebowski, et al.
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We agree with the argument presented by Tice and colleagues [1] that an efficient approach to breast cancer risk stratification could start with a simple model. In separate Women’s Health Initiative cohorts, [2] we have recently developed a risk prediction model that includes only three variables and evaluated its performance for predicting development of estrogen receptor positive breast cancer in postmenopausal women. [2] Women who were 55 years or older with either a previous breast biopsy or a family history of breast cancer in first degree relatives had a five-year breast cancer risk of > 1.67%, one threshold for chemoprevention consideration. This WHI model was evaluated as being nearly as accurate as the National Cancer Institute Breast Cancer Risk Assessment tool (the Gail model). [3] Its use would facilitate rapid pre-screening for breast cancer risk in clinical settings. Since agents either approved (tamoxifen, raloxifene) [4] or under evaluation (aromatase inhibitors) [5] for breast cancer risk reduction almost exclusively target hormone receptor positive cancers, has the model of Tice and colleagues been similarly evaluated for risk prediction of hormone receptor positive breast cancers, particularly in postmenopausal women? 1. Tice JA, Cummings SR, Smith-Bindman , et al. Using clinical factors and mammmographic breast density to estimate breast cancer risk: development and validation of a new predictive model. Ann Intern Med 2008;148: 337-347. 2. Chlebowski RT, Anderson GL, Lane DS, et al. Predicting risk of breast cancer in postmenopausal women by hormone receptor status. J Natl Cancer Inst 2007; 99: 1695-705. 3. http://www.cancer.gov/bcrisktool/ (accessed March 24, 2008). 4. Vogel VG, Costantino JP, Wickerham DL, et al. Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 Trial. JAMA 2006; 295(23): 2727-41. 5. Goss PE, Richardson H, Chlebowski RT, et al. National Cancer Institute of Canada Clinical Trials Group MAP.3 Trial: evaluation of exemestane to prevent breast cancer in postmenopausal women at risk. Clin Breast Cancer 2007;7(11):895-900. Conflict of Interest:None declared |
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