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Pruitt WR, Samuels B, Cunningham S. The Gail Model and Its Use in Preventive Screening: A Comparison of the Corbelli Study. Cureus 2024; 16:e56290. [PMID: 38501027 PMCID: PMC10945157 DOI: 10.7759/cureus.56290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 03/20/2024] Open
Abstract
Background This study aims to determine the usage of the Gail model in screening for breast cancer during physical examinations of women by sampling primary care physicians in two regions of Texas - Hidalgo County and Johnson County. A Gail score of 1.66% or higher indicates increased breast cancer risk. Three specialties are surveyed: internal medicine (IM), family medicine (FM), and gynecology (GYN). The null hypothesis for this study is that primary care physicians do not use the Gail model in screening for breast cancer during physical examinations of women. Methods A survey was distributed to 100 physicians with specialties in IM, FM, and GYN from May 2022 to July 2022. The survey assessed the physician's frequency of use of the Gail model and chemoprevention. Data were collected by distributing survey questionnaires to physicians in person. Descriptive statistics were used for response distributions. Fisher's exact probability test was used for comparisons across specialties. Results The response rate was 34% (34/100). Thirty-eight percent of the physicians surveyed reported using the Gail model in their practice (IM 46%, FM 23%, and GYN 31%). All 13 of the physicians using the Gail model were open to using chemoprevention. Conclusions Only 38% of the physicians surveyed responded that they use the Gail model in their practice. The study concluded that a minority of primary care physicians used the Gail model to decrease breast cancer risk. Further research would help to define better the Gail model and its use in preventing breast cancer in women. The Gail model appears to be beneficial to breast cancer risk reduction; however, risk reduction medication side effects need to be minimized.
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Affiliation(s)
| | - Beryl Samuels
- Neurosciences, Johns Hopkins University, Baltimore, USA
| | - Scott Cunningham
- Obstetrics and Gynecology, All American Institute of Medical Sciences, Black River, JAM
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Al-Shamsi HO, Abdelwahed N, Abyad A, Abu-Gheida I, Afrit M, Abu ElFuol T, Alasas R, Lababidi B, Dash P, Ahmad M, Dreier NW, ul Haq U, Joshua TLA, Otsmane S, Al-Nouri A, Al-Awadhi A, Tirmazy SH, Alterkait F, Elsabae S, Khan N, Albastaki NK, Sonawane Y, Jouda M, Perdawood F, Iqbal F, Jaafar H. Breast Cancer in the Arabian Gulf Countries. Cancers (Basel) 2023; 15:5398. [PMID: 38001658 PMCID: PMC10670541 DOI: 10.3390/cancers15225398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Breast cancer stands as the prevailing malignancy across all six Gulf Cooperation Council (GCC) nations. In this literature review, we highlighted the incidence and trend of breast cancer in the GCC. Most of the studies reported a consistent increase in breast cancer incidence over the past decades, which was particularly attributed to the adoption of a Westernized lifestyle in the region and the implications of emerging risk factors and other environmental and societal factors, the increase in screening uptake, as well as the improvement in data collection and reporting in the GCC. The data on breast cancer risk factors in the GCC were limited. In this geographic region, breast cancer frequently manifests with distinctive characteristics, including an early onset, typically occurring before the age of 50; an advanced stage at presentation; and a higher pathological grade. Additionally, it often exhibits more aggressive features such as human epidermal growth factor receptor 2 (HER2) positivity or the presence of triple-negative (TN) attributes, particularly among younger patients. Despite the growing body of literature on breast cancer in the GCC, data pertaining to survival rates are, regrettably, meager. Reports on breast cancer survival rates emanating from the GCC region are largely confined to Saudi Arabia and the United Arab Emirates (UAE). In the UAE, predictive modeling reveals 2-year and 5-year survival rates of 97% and 89%, respectively, for the same period under scrutiny. These rates, when compared to Western counterparts such as Australia (89.5%) and Canada (88.2%), fall within the expected range. Conversely, Saudi Arabia reports a notably lower 5-year survival rate, standing at 72%. This disparity in survival rates underscores the need for further research directed toward elucidating risk factors and barriers that hinder early detection and screening. Additionally, there is a pressing need for expanded data reporting on survival outcomes within the GCC. In sum, a more comprehensive and nuanced understanding of breast cancer dynamics in this region is imperative to inform effective strategies for prevention, early detection, and improved patient outcomes.
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Affiliation(s)
- Humaid O. Al-Shamsi
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
- Department of Clinical Sciences, College of Medicine, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Nadia Abdelwahed
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Amin Abyad
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Ibrahim Abu-Gheida
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Mehdi Afrit
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Tasneem Abu ElFuol
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Ryad Alasas
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Bilal Lababidi
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Prasanta Dash
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Mudhasir Ahmad
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Norbert W. Dreier
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Urfan ul Haq
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Thanda Lucy Ann Joshua
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Sonia Otsmane
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Anwar Al-Nouri
- Kuwait Cancer Control Center, Kuwait City, Kuwait; (A.A.-N.); (F.A.)
| | - Aydah Al-Awadhi
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | | | - Faisal Alterkait
- Kuwait Cancer Control Center, Kuwait City, Kuwait; (A.A.-N.); (F.A.)
| | - Shimaa Elsabae
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Nyla Khan
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Nehad Kazim Albastaki
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Yoginee Sonawane
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
| | - Mohammed Jouda
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Frea Perdawood
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Faryal Iqbal
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
| | - Hassan Jaafar
- Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
- Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
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Hashim HT, Ramadhan MA, Theban KM, Bchara J, El-Abed-El-Rassoul A, Shah J. Assessment of breast cancer risk among Iraqi women in 2019. BMC Womens Health 2021; 21:412. [PMID: 34911515 PMCID: PMC8672597 DOI: 10.1186/s12905-021-01557-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 12/01/2021] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer is one of the most common cancers among women worldwide and the leading cause of death among Iraqi women. Breast cancer cases in Iraq were found to have increased from 26.6/100,000 in 2000 to 31.5/100,000 in 2009. The present study aims to assess the established risk factors of breast cancer among Iraqi women and to highlight strategies that can aid in reducing the incidence. Methods 1093 Iraqi females were enrolled in this cross-sectional study by purposive sampling methods. Data collection occurred from July 2019 to September 2019. 1500 women participated in the study, and 407 women were ultimately excluded. The questionnaire was conducted as a self-administrated form in an online survey. Ethical approval was obtained from the College of Medicine in the University of Baghdad. The Gail Model risk was calculated for each woman by the Breast Cancer Risk Assessment Tool (BCRAT), an interactive model developed by Mitchell Gail that was designed to estimate a woman’s absolute risk of developing breast cancer in the upcoming five years of her life and in her lifetime. Results The ages of the participants ranged from 35 to 84 years old. The mean 5–year risk of breast cancer was found to be 1.3, with 75.3% of women at low risk and 24.7% of women at high risk. The mean lifetime risk of breast cancer was found to be 13.4, with 64.7% of women at low risk, 30.3% at moderate risk, and 5.0% at high risk. The results show that geographically Baghdad presented the highest 5-year risk, followed by Dhi Qar, Maysan, and Nineveh. However, the highest lifetime risk was found in Najaf, followed by Dhi Qar, Baghdad, and Nineveh, successively. Conclusion Breast cancer is a wide-spreading problem in the world and particularly in Iraq, with Gail Model estimations of high risk in several governorates. Prevention programs need to be implemented and awareness campaigns organized in order to highlight the importance of early detection and treatment.
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Saleh B, Elhawary MA, Mohamed ME, Ali IN, El Zayat MS, Mohamed H. Gail model utilization in predicting breast cancer risk in Egyptian women: a cross-sectional study. Breast Cancer Res Treat 2021; 188:749-758. [PMID: 33852122 DOI: 10.1007/s10549-021-06200-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/16/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE Herein, our purpose was to calculate the 5-year and lifetime risk of breast cancer and to assess new breast cancer potential contributors among Egyptian women utilizing the modified Gail model, while presenting a global comparison of risk assessment. METHODS This study included 7009 women from both urban and rural areas scattered across 40% of the Egyptian provinces. The 5-year risk categories were defined as low risk (≤ 1.66%) or high risk (> 1.66%), whereas the lifetime risk categories were defined as low risk (≤ 20%) or high risk (> 20%). Pearson's Chi-squared test was performed to determine the association between participants' characteristics and distinct risk categories. Binary logistic regression was carried out for correlation analysis. RESULTS The mean estimated risk for developing invasive breast cancer over 5 years was 0.86 (± 0.67), whereas the mean lifetime breast cancer risk score was 11.26 (± 5.7). Accordingly, only 614 (8.75%) and 470 (6.7%) women were categorized as individuals with high risk of breast cancer incidence in 5-year and lifetime, respectively. Only 192 participants (2.7%) conferred both high 5-year and high lifetime risk scores. Marital status, method of feeding, physical activity behavior, contraceptive use, menopause and number of children were found to have a statistically significant association with both 5-year and lifetime breast cancer risk categories. CONCLUSION We revealed that modified Gail model had a well-fitting and discrimination accuracy in Egyptian women when compared with other countries.
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Affiliation(s)
- Basem Saleh
- Medical Oncology Department, Tanta Cancer Center, Ministry of Health, Tanta, Gharbiah, Egypt.,Medical Oncology Department, Aswan Oncology Center, Ministry of Health, Aswân, Egypt
| | - Mohamed A Elhawary
- International Society of Pharmacovigilance - Egypt Chapter, Cairo, Egypt.,Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Moataz E Mohamed
- Department of Pharmacy Practice, Faculty of Pharmacy, Helwan University, Cairo, Egypt
| | - Islam N Ali
- Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.,University of Glasgow, Glasgow, Scotland, UK
| | - Menna S El Zayat
- Diagnostic Radiology Department, Al Helal Hospital - Specialized Medical Centers, Cairo, Egypt
| | - Hadeer Mohamed
- Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. .,Department of Clinical Oncology, Ain Shams University Hospitals, Cairo, Egypt.
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Rostami S, Rafei A, Damghanian M, Khakbazan Z, Maleki F, Zendehdel K. Discriminatory Accuracy of the Gail Model for Breast Cancer Risk Assessment among Iranian Women. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 49:2205-2213. [PMID: 33708742 PMCID: PMC7917489 DOI: 10.18502/ijph.v49i11.4739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: The Gail model is the most well-known tool for breast cancer risk assessment worldwide. Although it was validated in various Western populations, inconsistent results were reported from Asian populations. We used data from a large case-control study and evaluated the discriminatory accuracy of the Gail model for breast cancer risk assessment among the Iranian female population. Methods: We used data from 942 breast cancer patients and 975 healthy controls at the Cancer Institute of Iran, Tehran, Iran, in 2016. We refitted the Gail model to our case-control data (the IR-Gail model). We compared the discriminatory power of the IR-Gail with the original Gail model, using ROC curve analyses and estimation of the area under the ROC curve (AUC). Results: Except for the history of biopsies that showed an extremely high relative risk (OR=9.1), the observed ORs were similar to the estimates observed in Gail’s study. Incidence rates of breast cancer were extremely lower in Iran than in the USA, leading to a lower average absolute risk among the Iranian population (2.78, ±SD 2.45). The AUC was significantly improved after refitting the model, but it remained modest (0.636 vs. 0.627, ΔAUC = 0.009, bootstrapped P=0.008). We reported that the cut-point of 1.67 suggested in the Gail study did not discriminate between breast cancer patients and controls among the Iranian female population. Conclusion: Although the coefficients from the local study improved the discriminatory accuracy of the model, it remained modest. Cohort studies are warranted to evaluate the validity of the model for Iranian women.
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Affiliation(s)
- Sahar Rostami
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rafei
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Damghanian
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Khakbazan
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Maleki
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.,Breast Disease Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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Tanner LTA, Cheung KL. Correlation between breast cancer and lifestyle within the Gulf Cooperation Council countries: A systematic review. World J Clin Oncol 2020; 11:217-242. [PMID: 32355643 PMCID: PMC7186238 DOI: 10.5306/wjco.v11.i4.217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/12/2020] [Accepted: 03/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the six Gulf Cooperation Council countries (GCCCs), Bahrain, Saudi Arabia, Kuwait, Oman, Qatar and the United Arab Emirates, breast cancer (BC) is the greatest cause of cancer incidence and mortality. Obesity and physical inactivity are established risk factors for BC globally and appear to be more of a problem in high income countries like the GCCCs.
AIM To determine whether obesity and physical inactivity are associated with BC incidence in the GCCCs using the United Kingdom as a comparator.
METHODS This systematic review was carried out according to PRISMA guidelines. A cancer registry and a statistical data search was done to identify the BC incidence over the past two decades and the prevalence of obesity and physical inactivity in the GCCCs. Additionally, a systematic search of the databases, MEDLINE, Web of Science, and PubMed between 1999 and 2019 was performed to determine whether obesity and physical inactivity are risk factors for BC in the GCCCs. All papers were critically appraised according to their research methods and were assessed for quality and risk of bias.
RESULTS BC was the top malignancy in each GCC country. Women tended to be diagnosed with BC at a younger age than women in the United Kingdom. The greatest 10-year increase in BC incidence was seen in Saudi Arabia (54.2%), approximately seven times the rate of increase seen in the United Kingdom (7.6%). The prevalence of obesity and physical inactivity was greater in all the GCCCs in comparison to the United Kingdom. A total of 155 full studies were reviewed of which 17 were included. Of those, eight looked at the prevalence of obesity and physical inactivity in the Gulf States and nine looked at these as risk factors for BC. Only one study found an association between BC and obesity (odds ratio = 2.29). No studies looked solely at the link between physical inactivity and BC.
CONCLUSION The prevalence of obesity and physical inactivity was high within the GCCCs, but the majority of the included studies found no positive correlation between obesity or physical inactivity and BC. A high proportion of women in this study were pre-menopausal which could contribute to the negative findings.
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Affiliation(s)
| | - Kwok Leung Cheung
- School of Medicine, University of Nottingham, Derby DE22 3DT, United Kingdom
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Solikhah S, Nurdjannah S. Assessment of the risk of developing breast cancer using the Gail model in Asian females: A systematic review. Heliyon 2020; 6:e03794. [PMID: 32346636 PMCID: PMC7182726 DOI: 10.1016/j.heliyon.2020.e03794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 02/25/2020] [Accepted: 04/14/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Currently, the Breast Cancer Risk Assessment Tool (BCRAT), also known as the Gail model (GM) has been widely recognized and adapted for to study disparity in racial and ethnic groups in America including Asian and Pacific Islander American females. However, its applicability outside America remains uncertain due to diversity in epidemiology and risk factors of breast cancer in populations especially in Asian females. We sought to evaluate the performance of the GM to predict breast cancer risk in Asian countries. Material and methods This study identified articles published from 2010 by searching PubMed, MEDLINE, Scopus, Web of Science, Google Scholar and gray literature. The initial search terms were breast cancer, mammary, carcinoma, tumor, neoplasm, risk assessment tool, BCRAT, breast cancer prediction, Gail model, Asia, and Asian. Results The search yielded 20 articles, with 7 articles addressing the AUC and/or the expected (E) to observed (O) ratio of predicted breast cancer risk, representing the accuracy of the GM in the Asian population. One publication reported the sensitivity and specificity but no AUC. None of the studies were accepted as the standard for reporting prognostic models. Several studies reported good prognostic testing and likely developed a new model modifying the items in the instrument. Conclusion The results are not strong enough to develop breast cancer risk in the setting of Asian countries. Involving the breast cancer risk of the Asian population in developing a prognostic model with good statistical understanding is particularly important and can reduce flawed or biased models. Identifying the best methods to achieve well-suited prognostic models in the Asian population should be a priority.
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Affiliation(s)
- Solikhah Solikhah
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, 55166, Indonesia.,Dynamic Social Study Center, Universitas Ahmad Dahlan, Yogyakarta, 55166, Indonesia
| | - Sitti Nurdjannah
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, 55166, Indonesia
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8
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The Application of Gail Model to Predict the Risk of Developing Breast Cancer among Jordanian Women. JOURNAL OF ONCOLOGY 2020; 2020:9608910. [PMID: 32148498 PMCID: PMC7053471 DOI: 10.1155/2020/9608910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/30/2019] [Accepted: 02/03/2020] [Indexed: 11/30/2022]
Abstract
Background and Objectives. Breast cancer has been the most common cancer affecting women in Jordan. In the process of implementing breast cancer prevention and early detection programs, individualized risk assessment can add to the cost-effectiveness of such interventions. Gail model is a widely used tool to stratify patients into different risk categories. However, concerns about its applicability across different ethnic groups do exist. In this study, we report our experience with the application of a modified version of this model among Jordanian women.
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9
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Correlation of MLH1 polymorphisms, survival statistics, in silico assessment and gene downregulation with clinical outcomes among breast cancer cases. Mol Biol Rep 2019; 47:683-692. [DOI: 10.1007/s11033-019-05175-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 10/30/2019] [Indexed: 02/07/2023]
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10
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Bener A, Barışık CC, Acar A, Özdenkaya Y. Assessment of the Gail Model in Estimating the Risk of Breast Cancer: Effect of Cancer Worry and Risk in Healthy Women. Asian Pac J Cancer Prev 2019; 20:1765-1771. [PMID: 31244298 PMCID: PMC7021593 DOI: 10.31557/apjcp.2019.20.6.1765] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Indexed: 11/25/2022] Open
Abstract
Background: There has been substantial interest in developing methods to predict the risk of breast cancer.
The Gail model is one the first model have been widely used to identify women at higher risk of breast cancer. Aim: This
study aimed to determine the 5-year and the general life-time risk of breast cancer and also to determine breast cancer
predictors in women using the Gail model. Methods: We used the Gail model to estimate the risk of breast cancer
in female Turkish outpatients aged above 35 years in this cross-sectional study. Age, life-style habits, breast-feeding
duration, family history of breast cancer, and body mass index were compared between high and low-risk subjects.
We have performed the Patient Health Questionnaire 9-item (PHQ-9) and the Generalized Anxiety Disorder 7-item
(GAD-7) tools on patients regarding depression and anxiety. We also assessed the association of these covariates with
the estimated risk of breast cancer in multivariate linear regression analysis. Results: We enrolled 1065 subjects with
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
lifetime risks for breast cancer was 10.15%±3.18, respectively. Nearly one-third of the participants had one child,
55.9% had breast-fed their children more than six months. Meanwhile, 18.5% of the subjects had a high depression
score, 15.2% had a high anxiety score. Higher age, age at first birth, and parity; lower age at menarche; presence of
menopause and family history of breast cancer were higher in the high-risk group. Higher age, and age at first birth;
lower age at menarche; family history of breast cancer, presence of menopause, and parity were independently associated
with higher breast cancer risk. Conclusion: We identified certain risk factors for breast cancer in our study population
and Gail model is a reliable and useful breast cancer risk prediction model for clinical decision-making. This study
contributes to the body of evidence in order to facilitate early detection and better plan for possible malignancies in
Turkish population.
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Affiliation(s)
- Abdulbari Bener
- Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine Istanbul University, Istanbul, Turkey. ,Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK.,Istanbul Medipol University, International School of Medicine, Istanbul, Turkey
| | - Cem Cahit Barışık
- Department of Radiology and Pathology, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ahmet Acar
- Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine Istanbul University, Istanbul, Turkey.
| | - Yaşar Özdenkaya
- Department of Surgery, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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11
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Genetic Testing to Guide Risk-Stratified Screens for Breast Cancer. J Pers Med 2019; 9:jpm9010015. [PMID: 30832243 PMCID: PMC6462925 DOI: 10.3390/jpm9010015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/18/2019] [Accepted: 02/22/2019] [Indexed: 12/14/2022] Open
Abstract
Breast cancer screening modalities and guidelines continue to evolve and are increasingly based on risk factors, including genetic risk and a personal or family history of cancer. Here, we review genetic testing of high-penetrance hereditary breast and ovarian cancer genes, including BRCA1 and BRCA2, for the purpose of identifying high-risk individuals who would benefit from earlier screening and more sensitive methods such as magnetic resonance imaging. We also consider risk-based screening in the general population, including whether every woman should be genetically tested for high-risk genes and the potential use of polygenic risk scores. In addition to enabling early detection, the results of genetic screens of breast cancer susceptibility genes can be utilized to guide decision-making about when to elect prophylactic surgeries that reduce cancer risk and the choice of therapeutic options. Variants of uncertain significance, especially missense variants, are being identified during panel testing for hereditary breast and ovarian cancer. A finding of a variant of uncertain significance does not provide a basis for increased cancer surveillance or prophylactic procedures. Given that variant classification is often challenging, we also consider the role of multifactorial statistical analyses by large consortia and functional tests for this purpose.
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12
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Fatima F, Hameed A, Haider G, Zehra S, Azhar A, Saleem S. Association and implications in triple negative and triple positive breast cancer: Relationship with sociodemographic and reproductive factors in Pakistan. Pak J Med Sci 2018; 34:1468-1472. [PMID: 30559805 PMCID: PMC6290238 DOI: 10.12669/pjms.346.15763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background & Objectives Triple negative and triple positive breast cancer have adverse effects than other types of breast cancer. However, triple negative has poor prognosis with short survival as compared with triple positive breast cancer. Good prognosis is one of the key factors for successful treatment trial. This study aimed to find out the association of sociodemographic and reproductive features like parity, menopause, number of child bearing as risk factors in the development and prognosis of triple negative and triple positive breast cancer. Methods This study is a part of an ongoing project which is being conducted in Karachi from 2013 to 2020. Informed consent from triple negative breast cancer (n=134) and triple positive breast cancer (n=87) patients were taken prior to their recruitment into the study. Demographic, anthropometric, reproductive and disease history of patients were recorded. Means, frequency distribution, data classification and association analyses were done by SPSS version 17.0. Results Statistical analyses revealed that delayed first child bearing age and lower number of children are associated with the development of triple negative breast cancer. However, no significant effect of these parameters has been observed on the outcomes of triple positive breast cancer. Conclusions Reproductive factors have more pathological implications than sociodemographic factors in both triple positive and triple negative breast cancer development. These findings might prove to be beneficial for effective and better breast cancer management.
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Affiliation(s)
- Faria Fatima
- Faria Fatima, Research Fellow, The Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan
| | - Abdul Hameed
- Abdul Hameed, Ph.D. Institute of Biomedical and Genetic Engineering (IB&GE), Islamabad, Pakistan
| | - Ghulam Haider
- Ghulam Haider, MBBS, FCPS (Medicine), FCPS (Oncology) Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan
| | - Sitwat Zehra
- Sitwat Zehra, Ph.D. The Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan
| | - Abid Azhar
- Abid Azhar, Ph.D., D.Sc. The Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan
| | - Saima Saleem
- Saima Saleem, Ph.D. The Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, Karachi, Pakistan
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Malik SS, Mubarik S, Masood N, Khadim MT. An insight into clinical outcome of XPG polymorphisms in breast cancer. Mol Biol Rep 2018; 45:2369-2375. [PMID: 30255276 DOI: 10.1007/s11033-018-4401-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 09/21/2018] [Indexed: 12/16/2022]
Abstract
XPG polymorphisms are associated with varied clinical outcomes in different cancers but up-till now no study has been reported on breast cancer. Therefore, current study was aimed to explore the association of breast cancer risk factors and XPG polymorphisms (rs2296147 and rs1047768). It also investigated impact of XPG variants on overall survival and progression free survival among breast cancer cases. A total of 493 histopathologically identified breast cancer cases and 387 healthy females were genotyped by ARMS-PCR. Relationship between general characteristics, XPG polymorphisms and breast cancer risk was accessed by conditional logistic regression and illustrated by OR and 95% CI. Kaplan Meier test was applied to estimate survival distributions whereas log rank test demonstrated survival differences. Association of XPG variants with OS and PFS in breast cancer was illustrated by HR and 95% CI. Early onset of menopause, consanguinity and family history contributed (P < 0.05) towards breast cancer development. Both rs2296147 and rs1047768 SNPs were found to be associated (P < 0.05) with the risk of breast cancer. XPG rs1047768 was significantly associated with decreased PFS (HR 1.72; 95% CI 1.0-2.8) in breast cancer cases (P = 0.013) which was demonstrated by median time of 26 months for T > C variant when compared with median time of 37 months for TT genotype. No association was found between XPG rs2296147 polymorphism and survival analysis among breast cancer cases. XPG (rs1047768 T > C) variant may play a significant role in terms of decreased PFS and could be used as a predictor of unfavourable prognosis among breast cancer.
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Affiliation(s)
- Saima Shakil Malik
- Fatima Jinnah Women University, The Mall, Rawalpindi, 46000, Pakistan.
- Armed Forces Institute of Pathology, Rawalpindi, Pakistan.
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Nosheen Masood
- Fatima Jinnah Women University, The Mall, Rawalpindi, 46000, Pakistan
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Al-Sulaiman RJ, Bener A, Doodson L, Bujassoum Al Bader S, Ghuloum S, Lemaux A, Bugrein H, Alassam R, Karim A. Exploring the effectiveness of crisis counseling and psychoeducation in relation to improving mental well-being, quality of life and treatment compliance of breast cancer patients in Qatar. Int J Womens Health 2018; 10:285-298. [PMID: 29922098 PMCID: PMC5995281 DOI: 10.2147/ijwh.s161840] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background An insufficient number of studies have been carried out in the Middle East to evaluate the role of structured psychotherapeutic interventions in enhancing breast cancer patients’ psychological well-being, quality of life and treatment compliance. This study has been designed to address this limitation by exploring the benefit of two structured psychotherapeutic interventions, crisis counseling and psychoeducation, in enhancing breast cancer patients’ psychological well-being, quality of life and treatment compliance in Qatar. Methods A total of 201 women with early-stage breast cancer from the state of Qatar were recruited and randomized into either the control group or one of the treatment groups (crisis counseling or psychoeducation). Each of the two treatment interventions consisted of a total of six 60- to 90-minute sessions, which were provided over a period of 12 weeks. The short- and long-term benefits of the crisis counseling and psychoeducation interventions were evaluated in terms of improving patients’ psychological well-being, quality of life and treatment compliance by asking all the patients to complete the Depression, Anxiety and Stress Scale, 21 item version (DASS-21) and European Organization for Research and Treatment of Cancer Quality of Life scale (QLQ-C30) instruments at different points in time and by monitoring their compliance to chemotherapy and radiotherapy treatment. Results This study revealed that both of the study interventions, crisis counseling and psychoeducation, were effective in improving women’s psychological well-being and quality of life over time in comparison to the control group, but had no significant impact on patients’ compliance with treatment. In addition, the study showed that psychoeducation conferred a greater advantage than did the crisis counseling model, especially in improving women’s psychological well-being over time. Conclusion This study is considered the first of its kind in Qatar to provide evidence on the benefit of crisis counseling and psychoeducation interventions in improving the psychological well-being and quality of life of women with early-stage breast cancer in Qatar. In addition, this study has provided innovative research that can be used as evidence to propose changes to the psychotherapy services for breast cancer patients in Qatar. This research study aims to provide a first step toward further research in the future, which will hopefully lead to a better health care system for cancer patients in Qatar.
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Affiliation(s)
- Reem Jawad Al-Sulaiman
- Department of Medical Oncology, National Center of Cancer Care and Research, Doha, Qatar
| | - Abdulbari Bener
- Istanbul Medipol University, International School of Medicine, Istanbul, Turkey.,Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Lisa Doodson
- Department of Psychotherapy and Counseling Studies, Regent's University London, London, UK
| | | | - Suhaila Ghuloum
- Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
| | - Alain Lemaux
- Department of Medical Oncology, National Center of Cancer Care and Research, Doha, Qatar
| | - Hekmat Bugrein
- Department of Medical Oncology, National Center of Cancer Care and Research, Doha, Qatar
| | - Reena Alassam
- Department of Medical Oncology, National Center of Cancer Care and Research, Doha, Qatar
| | - Aisha Karim
- Department of Medical Oncology, National Center of Cancer Care and Research, Doha, Qatar
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15
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Al Otaibi HH. Breast Cancer Risk Assessment Using the Gail Model and It’s Predictors in Saudi Women. Asian Pac J Cancer Prev 2017; 18:2971-2975. [PMID: 29172267 PMCID: PMC5773779 DOI: 10.22034/apjcp.2017.18.11.2971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background: The Gail Model has been widely implemented in developed and developing countries and is considered to be the best available instrument to estimate breast cancer (BC) risk for early prevention. Objective: The goals of the study were to determine five-year and lifetime BC risks and to assess BC predictors among female Saudi teachers using the Gail model. Methods: A cross sectional study with convenience sampling was conducted among 180 female Saudi secondary school teachers. The Gail model was used to evaluate the five-year and lifetime risks of developing BC. Included were a one-day 24-hour recall to assess daily serving sizes and food groups for food intake and questions regarding daily exercise, BMI, and demographic data. Result: The mean age of the teachers was 41±7.2 years, with a 0.87±0.93 mean for the five-year risk and a 9.6±5.4 mean lifetime risk of developing BC. According to the general linear model, the BC risk predictors were age, age at menarche, age at first pregnancy, family history, BMI, fruit and vegetable intake, and meat intake. Conclusion: The present study provided new information regarding the potential factors for five-year and lifetime invasive BC risk among Saudi women. Moreover, we could confirm that the Gail model is an appropriate BC risk assessment tool for Saudi women for early prevention, particularly among women at high risk of BC.
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Affiliation(s)
- Hala Hazam Al Otaibi
- Department of Food Sciences and Nutrition, College of Agriculture and Food Science, King Faisal University, Saudi Arabia.
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