Improving risk prediction for breast cancer: Does nipple aspirate fluid cytology enhance the Gail model?
Jeffrey A. Tice, Rei Miike, Kelly Adduci, Nicholas L. Petrakis and Margaret R. Wrensch University of California, San Francisco, San Francisco, CA Background: The Gail model is used by physicians to decide whether a woman s risk for breast cancer is high enough to warrant chemopreventive therapy. The model is accurate for prediction of population risk, but is limited by poor discriminatory ability for individuals. Women with abnormal cytology in breast fluid obtained by nipple aspiration (NAF) have an increased risk of breast cancer. Utilization of this information may improve the discriminatory ability of the Gail model. Methods: NAF was collected from women in the San Francisco Bay Area from 1972 through 1991. Breast cancer cases were identified through follow-up with the women, linkage to regional and state cancer registries, and mortality records. Incidence rates were calculated per 1000 women-years of follow-up. Proportional hazards modeling was used to recalculate the coefficients
