Estimating Breast Cancer Risk: Questions and Answers

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4. Why are some other risk factors left out of the Tool?

Other risk factors for breast cancer have been identified or proposed but are not included in the Breast Cancer Risk Assessment Tool for several reasons: because evidence that these factors contribute to breast cancer risk is not conclusive, because researchers cannot determine whether these factors add useful information to factors already in the model, or because data on other risk factors was not available in the research data used to develop the model. Such risk factors include: age at menopause, use of birth control pills, high body mass index, a high-fat diet, alcohol, radiation exposure, and environmental pollutants. Recently published research indicates that breast tissue density, measured from mammograms, can add useful information, but risk models with breast tissue density measurement still need to be validated with additional independent studies. Research also indicates that other risk factors, such as use of hormone therapy, might improve the tool.

5. Is the Breast Cancer Risk Assessment Tool useful for all women?

The Breast Cancer Risk Assessment Tool was developed for women in the United States population age 35 years or older. It should not be used for women with a previous diagnosis of breast cancer, women exposed to breast radiation for treatment of Hodgkin lymphoma, or women who reside in, or recently migrated from, regions with low breast cancer risk, such as rural China or Japan. More accurate methods to project risk may be available for women with certain rare identified mutations, such as alterations in the breast cancer susceptibility genes BRCA1 and BRCA2. The Breast Cancer Risk Assessment Tool was developed and has been validated in populations consisting mainly of non-Hispanic white women. More research is needed to validate or refine the model for other racial and ethnic groups.

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