Evaluating Breast Cancer Risk Projections for Hispanic Women

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Evaluating breast cancer risk projections for Hispanic women, Breast Cancer Research and Treatment

Evaluating breast cancer risk projections for Hispanic women

Matthew P. Banegas1,2,*, Mitchell H. Gail3, Andrea LaCroix2, Beti Thompson1,2, Maria Elena Martinez4, Jean Wactawski-Wende5, Esther M. John6, F. Allan Hubbell7, Shagufta Yasmeen8, Hormuzd A. Katki3,*

1School of Public Health, Department of Health Services, University of Washington, Box 357660, Seattle, WA, USA, 98195

2Public Health Sciences Division, Fred Hutchinson Cancer Research Center, PO Box 19024, M3-B232, Seattle, WA, USA, 98109

3Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 6120 Executive Blvd., EPS MSC 7244, Bethesda, MD, USA, 20892

4Arizona Cancer Center and Mel and Enid Zuckerman College of Public Health, University of Arizona, 1515 N Campbell Ave, Box245024, Tucson, AZ, USA, 85724

5School of Public Health and Health Professions, Department of Social and Preventive Medicine, University at Buffalo, Farber Hall, Rm. 270, Buffalo, NY, USA, 14214

6Cancer Prevention Institute of California, Fremont, CA, USA, StanfordUniversitySchool of Medicine and Stanford Cancer Institute, Stanford, CA, USA, 2201 Walnut Avenue, Suite 300, Fremont, California, USA, 94538

7School of Medicine, University of California Irvine, 264 Irvine Hall, 1001 Health Sciences Road
Mail Code 3950, Irvine, CA, USA, 92697

8School of Medicine, University of California, Davis, Lawrence J. Ellison Ambulatory Care Center, 4860 Y St., Suite 2500, Sacramento, California, USA, 95817

*Corresponding authors:

MPB: Fred Hutchinson Cancer Research Center, Public Health Sciences Division, P.O. Box 19024, M3-B232, Seattle, WA 98109, Phone: (206) 667-7891, Fax: (206) 667-5977, email:

HAK: Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd. Room 8014, EPS MSC 7244, Bethesda, MD 20892-7234, Phone: 301-594-7818, Fax: 301-402-0081, email:

Supplemental Table 1. Results of the BCRAT and Updated BCRAT Models*

BCRAT Updated BCRAT

No. ofNo.No.O/ENo.O/E

Gail Risk Categorywomen observed predicted ratio predictedratio

Time Period 1: Age at enrollment – Hypothetical Age at End of Main Study

Hispanics

Total6,353130110.511.18 [0.99, 1.40]120.531.08 [0.91, 1.28]

Age at baseline, years

50-593,21267 48.511.38 [1.09, 1.75]53.781.25 [0.98, 1.58]

60-692,4675347.851.11 [0.85, 1.45]51.601.03 [0.78, 1.34]

≥ 706731014.140.71 [0.38, 1.31]15.140.66 [0.35, 1.23]

Age at menarche, years

< 121,5603529.731.18 [0.85, 1.64]32.431.08 [0.77, 1.50]

12-133,0406552.791.23 [0.97, 1.57]57.551.13 [0.89, 1.44]

≥ 141,7012827.291.03 [0.71, 1.49]29.780.94 [0.65, 1.36]

Age at first live birth, years

< 201,0872117.711.19 [0.77, 1.82]19.411.08 [0.71, 1.66]

20-241,8694231.931.32 [0.97, 1.78] 34.861.20 [0.89, 1.63]

25-29/Nulliparous2,7735247.751.09 [0.83, 1.43]51.991.00 [0.76, 1.31]

≥ 304531210.751.12 [0.63, 1.97]11.691.03 [0.58, 1.81]

Number of 1st degree

relatives with breast cancer

05,3189881.501.20 [0.99, 1.47]88.881.10 [0.90, 1.34]

15292117.451.20 [0.79, 1.85]19.061.10 [0.72, 1.69]

≥ 2714 5.080.79 [0.30, 2.10]5.540.72 [0.27, 1.92]

Number of breast biopsies

04,9098179.171.02 [0.82, 1.27]85.920.94 [0.76, 1.17]

16892415.091.59 [1.07, 2.37]16.311.47 [0.99, 2.19]

≥ 2304168.821.81 [1.11, 2.96]9.531.68 [1.03, 2.74]

Age at first live birth, years

< 20

Number of FDR

09291713.471.26 [0.78, 2.03]14.751.15 [0.72, 1.85]

17732.461.22 [0.39, 3.78]2.711.11 [0.36, 3.43]

≥ 21300.80 n/a0.89n/a

20-24

Number of FDR

01,5652923.071.26 [0.87, 1.81]25.221.15 [0.80, 1.65]

1178105.871.70 [0.92, 3.17]6.401.56 [0.84, 2.91]

≥ 2212 1.461.37 [0.34, 5.49]1.591.26 [0.31, 5.03]

25-29/Nulliparous

Number of FDR

02,3213935.041.11 [0.81, 1.52]38.131.02 [0.75, 1.40]

12207 7.300.96 [0.46, 2.01]7.970.88 [0.42, 1.84]

≥ 2331 2.530.40 [0.06, 2.81]2.750.36 [0.05, 2.59]

≥ 30

Number of FDR

0374118.421.31 [0.72, 2.36]9.181.20 [0.66, 2.17]

14211.450.68 [0.10, 4.89]1.580.63 [0.09, 4.49]

≥ 210 0.06n/a 0.06n/a

Observational Study3,4797159.771.19 [0.94, 1.50]65.051.09 [0.86, 1.38]

Clinical Trial2,8745950.741.16 [0.90, 1.50]55.481.06 [0.82, 1.37]

HT1,5362326.370.87 [0.58, 1.31]28.850.80 [0.53, 1.20]

E only31965.691.05 [0.47, 2.35]6.240.96 [0.43, 2.14]

E + P47058.010.62 [0.26, 1.50]8.760.57 [0.24, 1.37]

Control7471212.670.95 [0.54, 1.67]13.860.87 [0.49, 1.52]

Other CT1,3383624.371.48 [1.07, 2.05]26.621.35 [0.98, 1.88]

White women

Total128,9764,7134009.011.18 [1.14, 1.21]4787.750.98 [0.96, 1.01]

Age at baseline, years

50-5940,6481,346 1,076.491.25 [1.18, 1.32]1,305.091.03 [0.98, 1.09]

60-6958,7292,1991,914.051.15 [1.10, 1.20]2,284.620.96 [0.92, 1.00]

≥ 7029,5951,1681,018.351.15 [1.08, 1.21]1,197.890.97 [0.92, 1.03]

Age at menarche, years

< 1227,7181,077924.831.16 [1.10, 1.24]987.891.03 [0.96, 1.09]

12-1371,9532,5962,244.611.16 [1.11, 1.20]2,680.010.97 [0.93, 1.01]

≥ 1428,8481,014828.231.22 [1.15, 1.30]1,106.380.97 [0.92, 1.03]

Age at first live birth, years

< 2014,603463413.571.12 [1.02, 1.23]495.780.93 [0.85, 1.02]

20-2451,0161,6941,488.391.14 [1.09, 1.19] 1,779.380.95 [0.91, 1.00]

25-29/Nulliparous52,4362,0571,688.111.22 [1.17, 1.27]2,014.471.02 [0.98, 1.07]

≥ 309,484441383.761.15 [1.05, 1.26]456.290.97 [0.88, 1.06]

Number of 1st degree

relatives with breast cancer

0103,9793,5752,771.351.29 [1.25, 1.33]3,311.891.08 [1.04, 1.11]

116,471800875.140.91 [0.85, 0.98]1,044.280.77 [0.71, 0.82]

≥ 21,69692 181.650.50 [0.41, 0.62]215.680.43 [0.35, 0.52]

Number of breast biopsies

095,0753,1082,703.541.15 [1.11, 1.19]3,207.570.97 [0.93, 1.00]

118,955907708.641.28 [1.20, 1.37]839.411.08 [1.01, 1.15]

≥ 27,949397386.921.06 [0.93, 1.13]457.480.87 [0.79, 0.95]

Age at first live birth, years

< 20

Number of FDR

011,742362277.741.30 [1.18, 1.44]333.271.09 [0.98, 1.20]

11,8366594.780.69 [0.54, 0.88]113.570.57 [0.45, 0.73]

≥ 2190921.200.42 [0.22, 0.82]25.110.36 [0.19, 0.69]

20-24

Number of FDR

041,0041,2721,000.491.27 [1.20, 1.34]1,196.961.06 [1.01, 1.12]

16,671300350.270.86 [0.76, 0.96]418.530.72 [0.64, 0.80]

≥ 26723775.410.49 [0.36, 0.68]89.540.41 [0.30, 0.57]

25-29/Nulliparous

Number of FDR

042,4511,5791,186.811.33 [1.27, 1.40]1,417.251.11 [1.06, 1.17]

16,604352354.650.99 [0.89, 1.10]422.430.83 [0.75, 0.92]

≥ 26853571.390.49 [0.35, 0.68]84.930.41 [0.30, 0.57]

≥ 30

Number of FDR

07,639332285.991.16 [1.04, 1.29]340.190.98 [0.88, 1.09]

11,1947467.081.10 [0.87, 1.39]79.830.93 [0.74, 1.16]

≥ 21291010.940.91 [0.49, 1.70]12.890.78 [0.42, 1.44]

Observational Study73,4852,7392,296.151.19 [1.15, 1.24]2,743.161.00 [0.96, 1.04]

Clinical Trial55,4911,9741,712.871.15 [1.10, 1.20]2,044.590.96 [0.92, 1.01]

HT22,006660663.121.00 [0.92, 1.07]789.570.84 [0.77, 0.90]

E only4,00395120.890.79 [0.64, 0.96]143.970.66 [0.54, 0.81]

E + P7,136256215.961.18 [1.05, 1.34]256.961.00 [0.88, 1.13]

Control10,867309326.280.95 [0.85, 1.06]388.630.79 [0.71, 0.89]

Other CT33,4851,3141049.751.25 [1.19, 1.32]1,255.031.05 [0.99, 1.10]

*Supplemental Table 1 shows the results of the BCRAT and Updated BCRAT for all BCRAT risk factor categories and categories examined in the WHI Main study period. Note: O/E ratio = observed/expected ratio; FDR = first-degree relatives; HT = Hormone Therapy Trial; E = Estrogen; P = Progesterone; 95% CI = 95% Confidence Interval