Pilot of Computerized Breast Cancer Risk Assessment Tool Begins, Health Professionals Targeted

National Cancer Institute
Tuesday, 29 September 1998

A computer-based tool that allows health professionals to project a woman's individualized estimate of breast cancer risk is now available from the National Cancer Institute (NCI).

The Breast Cancer Risk Assessment Tool was developed after the Breast Cancer Prevention Trial (BCPT) showed that women at increased risk of breast cancer who were randomly assigned to take a daily dose of tamoxifen for five years had approximately 49 percent fewer diagnoses of invasive breast cancer than women who were assigned to a placebo. Tamoxifen offered a prevention benefit along with no increased risk of serious side effects for younger women (ages 35 to 49) compared to the placebo, but the prevention benefit for women ages 50 and older came with a risk of serious side effects.

The tool is designed to help health care providers discuss the option of tamoxifen with women who seek the drug as a preventive measure. With answers to a few questions about her medical and personal history, a woman's risk of developing breast cancer in the next five years and over her lifetime (to age 90) can be estimated. The questions include whether a woman has been previously diagnosed with ductal carcinoma in situ or lobular carcinoma in situ, her current age, age at first menstrual period, age at first live birth, number of first-degree relatives (mother, sisters, daughters) diagnosed with breast cancer, whether or not she has had any breast biopsies, and her race.

The disk includes information about breast cancer risk factors in general, as well as information about tamoxifen and its benefits and risks, including the rare, but serious side effects of endometrial cancer, deep vein thrombosis, and pulmonary embolism. Researchers from NCI and the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Pittsburgh-based research network who conducted the BCPT, developed the tool.

The program uses statistical methods applied to data from the Breast Cancer Detection Demonstration Project, a mammography screening project conducted in the 1970s.

While the tool helps health care providers advise women at increased risk of breast cancer, NCI and NSABP encourage postmenopausal women at increased risk for breast cancer to consider participating in the Study of Tamoxifen and Raloxifene (STAR). The study will be run by NSABP, and will compare tamoxifen with raloxifene, an osteoporosis drug which preliminary studies suggest also has breast cancer prevention effects. STAR will enroll 22,000 high-risk, postmenopausal women ages 35 and older and is scheduled to begin at centers across the United States and in Canada in early 1999. Women who wish to be put on a mailing list for information about STAR can do so by Internet on the NSABP homepage (http://www.nsabp.pitt.edu), by mail to NSABP, Box 21, Pittsburgh, PA 15261, or by fax to NSABP at (412) 330-4660.

The Breast Cancer Risk Assessment Tool has been sent to every physician who participated in the BCPT and to anyone who has signed up via NCI's cancerTrials Web site. Everyone who receives the tool is asked to provide feedback as to its usefulness, as refinements and changes are expected. The disk is available in personal computer (PC) and Macintosh computer formats. To order the assessment tool, call the NCI's Cancer Information Service at 1-800-4-CANCER or visit NCI's cancerTrials Web site at http://cancertrials.nci.nih.gov.

For more information, or to contact National Cancer Institute, see their website at: www.cancer.gov