Assessment of the Gail Model in Estimating the Risk of Breast Cancer: Effect of Cancer Worry and Risk in Healthy Women

Abstract

Background: There has been substantial interest in developing methods to predict the risk of breast cancer.<br />The Gail model is one the first model have been widely used to identify women at higher risk of breast cancer. Aim: This<br />study aimed to determine the 5-year and the general life-time risk of breast cancer and also to determine breast cancer<br />predictors in women using the Gail model. Methods: We used the Gail model to estimate the risk of breast cancer<br />in female Turkish outpatients aged above 35 years in this cross-sectional study. Age, life-style habits, breast-feeding<br />duration, family history of breast cancer, and body mass index were compared between high and low-risk subjects.<br />We have performed the Patient Health Questionnaire 9-item (PHQ-9) and the Generalized Anxiety Disorder 7-item<br />(GAD-7) tools on patients regarding depression and anxiety. We also assessed the association of these covariates with<br />the estimated risk of breast cancer in multivariate linear regression analysis. Results: We enrolled 1065 subjects with<br />a mean age of 52.9 ± 8.4 years. The mean of the five-year risk for breast cancer was 1.33%±0.6. Meanwhile, the mean of<br />lifetime risks for breast cancer was 10.15%±3.18, respectively. Nearly one-third of the participants had one child,<br />55.9% had breast-fed their children more than six months. Meanwhile, 18.5% of the subjects had a high depression<br />score, 15.2% had a high anxiety score. Higher age, age at first birth, and parity; lower age at menarche; presence of<br />menopause and family history of breast cancer were higher in the high-risk group. Higher age, and age at first birth;<br />lower age at menarche; family history of breast cancer, presence of menopause, and parity were independently associated<br />with higher breast cancer risk. Conclusion: We identified certain risk factors for breast cancer in our study population<br />and Gail model is a reliable and useful breast cancer risk prediction model for clinical decision-making. This study<br />contributes to the body of evidence in order to facilitate early detection and better plan for possible malignancies in<br />Turkish population.