Table 1. Characteristics of the Gail and Claus Modelsa
| Gail Model (Breast Cancer Risk Assessment Tool)b | Claus Model | |
| Data derived from | Breast Cancer Detection Demonstration Project Study | Cancer and Steroid Hormone Study |
| Study population | 2,852 cases, aged ≥35 y | 4,730 cases, aged 20–54 y |
| In situ and invasive cancer | Invasive cancer | |
| 3,146 controls | 4,688 controls | |
| Caucasian | Caucasian | |
| Annual breast screening | Not routinely screened | |
| Family history characteristics | FDRs with breast cancer | FDRs or SDRs with breast cancer |
| Age of onset in relatives | ||
| Other characteristics | Current age | Current age |
| Age at menarche | ||
| Age at first live birth | ||
| Number of breast biopsies | ||
| Atypical hyperplasia in breast biopsy | ||
| Race (included in the most current version of the Gail model) | ||
| Strengths | Incorporates: | Incorporates: |
| Risk factors other than family history | Paternal and maternal history | |
| Age at onset of breast cancer | ||
| Family history of ovarian cancer | ||
| Limitations | Underestimates risk in hereditary families | May underestimate risk in hereditary families |
| Number of breast biopsies without atypical hyperplasia may cause inflated risk estimates | May not be applicable to all combinations of affected relatives | |
| Does not include risk factors other than family history | ||
| Does not incorporate: | ||
| Paternal family history of breast cancer or any family history of ovarian cancer | ||
| Age at onset of breast cancer in relatives | ||
| All known risk factors for breast cancer [89] | ||
| Best application | For individuals with no family history of breast cancer or one FDR with breast cancer, aged ≥50 y | For individuals with no more than two FDRs or SDRs with breast cancer |
| For determining eligibility for chemoprevention studies |
| FDR = First-degree relative; SDR = second-degree relative. | ||
| aAdapted from Domchek et al.,[87] Rubenstein et al.,[88] and Rhodes.[89] | ||
| bModified based on periodic updates.[90,91] |
References
- Domchek SM, Eisen A, Calzone K, et al.: Application of breast cancer risk prediction models in clinical practice. J Clin Oncol 21 (4): 593-601, 2003. [PUBMED Abstract]
- Rubinstein WS, O'Neill SM, Peters JA, et al.: Mathematical modeling for breast cancer risk assessment. State of the art and role in medicine. Oncology (Huntingt) 16 (8): 1082-94; discussion 1094, 1097-9, 2002. [PUBMED Abstract]
- Rhodes DJ: Identifying and counseling women at increased risk for breast cancer. Mayo Clin Proc 77 (4): 355-60; quiz 360-1, 2002. [PUBMED Abstract]
- Gail MH, Costantino JP, Pee D, et al.: Projecting individualized absolute invasive breast cancer risk in African American women. J Natl Cancer Inst 99 (23): 1782-92, 2007. [PUBMED Abstract]
- Schonfeld SJ, Pee D, Greenlee RT, et al.: Effect of changing breast cancer incidence rates on the calibration of the Gail model. J Clin Oncol 28 (14): 2411-7, 2010. [PUBMED Abstract]
