Evidence map›Paper›PMID 39254768›Full record

ArticleBreast cancer research and treatment2025

Breast Cancer Risk Assessment Tool (BCRAT) and long-term breast cancer mortality in the Women's Health Initiative.

Rebecca A Nelson, Rowan T Chlebowski, Kathy Pan, Thomas E Rohan, Joanne Mortimer, Jean Wactawski-Wende, Dorothy S Lane, Laura Kruper

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Article in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Rebecca A NelsonDivision of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
Rowan T ChlebowskiThe Lundquist Institute, 1124 W. Carson Street, Torrance, CA, 90502, USA. rowanchlebowski@gmail.com.ORCID http://orcid.org/0000-0002-4212-6184
Kathy PanKaiser Permanente Southern California, Downey, CA, USA.
Thomas E RohanDepartment of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Joanne MortimerDivision of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
Jean Wactawski-WendeDepartment of Epidemiology & Population Health, University at Buffalo, Buffalo, NY, USA.
Dorothy S LaneDepartment of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY, USA.
Laura KruperDivision of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

Funding

Breast Cancer Research Foundation BCRF-23-140
6 · The paper itself

Abstract

backgroundWhile the Breast Cancer Risk Assessment Tool (BCRAT) predicts breast cancer incidence, the model's performance, re-purposed to predict breast cancer mortality, is uncertain. Therefore, we examined whether the BCRAT model predicts breast cancer mortality in postmenopausal women in the Women's Health Initiative (WHI).

methodsBCRAT 5-year breast cancer incidence risk estimates were calculated for 145,408 women (aged 50-79 years) enrolled in the WHI at 40 US clinical centers to examine associations of BCRAT risk groups (< 1%, 1-< 3%, ≥ 3%) with breast cancer mortality using Cox proportional regression modeling in all participants and in those with incident breast cancer.

resultsWomen with BCRAT ≥ 3% risk, compared to women with BCRAT < 1% risk, were older (age 70-79 years: 38.3% versus 5.3%), less commonly Black (1.1% versus 40.2%), and had stronger breast cancer family history. With 20-years follow-up, considering all participants, with 8,849 breast cancers and 1,076 breast cancer deaths, breast cancer mortality in BCRAT group ≥ 3% was not higher versus BCRAT group < 1% (Hazard Ratio [HR] 1.06 95% Confidence Interval [CI] 0.80-1.40): percent without 20-year breast cancer mortality; 99.4% [group < 1%] and 98.8% [group ≥ 3%]. Considering women with incident breast cancer, breast cancer mortality was also not higher in BCRAT group ≥ 3% versus BCRAT group < 1% (HR 1.07 95% CI 0.79-1.45).

conclusionsThe BCRAT model, at ≥ 3% 5-year incidence risk (US guideline threshold for chemoprevention), does not identify women with higher breast cancer mortality risk, with implications for breast cancer prevention strategies.

Indexed as

Breast NeoplasmsAgedFemaleHumansIncidenceMiddle AgedPostmenopauseProportional Hazards ModelsRisk AssessmentRisk FactorsUnited StatesWomen's HealthBreast cancer mortalityBreast Cancer Risk Assessment Tool (BCRAT)Women’s Health Initiative

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.