Abstract P6-09-10: The comparison of the distribution of breast cancer risk factor between Chinese women, non-Chinese Asian and Caucasian women in the screening cohort of Athena Breast Health Network
Authors: Pan Bo , Tice Jeffrey , Sun Qiang , Kaplan Celia , Yidong Zhou , Xu Yali , Shen Songjie , Wang Changjun , Solomon Alexandra , Ryan Lauren , Kendall Paige , Henderson Timothy , Esserman Laura , Crawford Beth ,   Athena Breast Health Network, van 't Veer Laura 
Published: May 2015

Background: A major area of innovation in breast cancer (BC) is improving risk models for screening efforts. The University of California Athena Breast Health Network uses several risk models, including the Gail model [PMID: 10491430]. The Breast Cancer Surveillance Consortium (BCSC) model [PMID: 18316752] which integrated information on breast density was developed and validated by UCSF investigators and reports Asian-specific risk. The Peking Union Medical College (PUMC) model [PMID: 22662004] is developed from a case-control study in China and reports BC risk in Chinese women. Risk factors and their respective weights included in these models are different.

Methods: From December 2012 to April 2014, 2,305 women without previous history of BC and consented to research were enrolled in the UCSF Athena screening cohort. Questions asked included risk factors used in Gail, BCSC and PUMC model, such as age, age of menarche (AOM), age at first live birth, body mass index (BMI), breast biopsy, breast density, hormone replacement therapy (HRT), oral contraceptives (OCP). Women were considered high risk when: Gail &gt; 1.67% 5-year risk, BCSC &gt; 1.67% 5-year risk, PUMC score &gt; 30 (equals &gt;0.20% 1-year risk) respectively. The distribution of the risk factors and the high risk population percentage were compared between Chinese women versus non-Chinese Asian and Caucasian women.

Results: 402 Asian women comprise 17.4% of all 2,305 Athena screening cases with 234 Chinese, and 168 non-Chinese Asian (NCA). Differences in risk factor distribution were observed for the following: positive family history was observed 23% for Caucasian, 15% for Chinese and 13% for NCA (p=0.001), and previous breast biopsy was 27%, 17% and 22% respectively (p=0.002). Ever use of HRT was 36% in Caucasian, 17% in Chinese and 11% in NCA (p&lt;0.001). Ever give birth was 68% in Chinese, 65% in NCA, and 57% in Caucasian (p=0.001), while the age at first live birth &lt;30 was 35%, 33%, and 26% correspondingly (p=0.001). Breast density appeared to be higher in Asian women (p=0.095). The high risk proportions by each model are given in Table 1.

Table 1 Percentage of high risk population by ethnicity for different risk modelsRisk modelsChinese (n=234)non-Chinese Asian (n=168)Caucasian (n=1,492)P ValueRisklowhighlowhighlowhighGail137 (58.6%)97 (41.4%)107 (63.7%)61 (36.3%)884 (59.2%)608 (40.8%)0.509BCSC211 (90.2%)23 (9.8%)152 (90.5%)16 (9.5%)864 (58.0%)626 (42.0%)0.000PUMC167 (71.7%)66 (28.3%)108 (64.7%)59 (35.3%)781 (52.6%)704 (47.4%)0.000

Conclusion: Chinese and NCA women have a lower proportion of high risk by the BCSC and PUMC model compared to the Caucasian women, whereas by Gail model these proportions appear to be similar.

Citation Format: Bo Pan, Jeffrey Tice, Qiang Sun, Celia Kaplan, Zhou Yidong, Yali Xu, Songjie Shen, Changjun Wang, Alexandra Solomon, Lauren Ryan, Paige Kendall, Timothy Henderson, Laura Esserman, Beth Crawford, Athena Breast Health Network, Laura van 't Veer. The comparison of the distribution of breast cancer risk factor between Chinese women, non-Chinese Asian and Caucasian women in the screening cohort of Athena Breast Health Network [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P6-09-10.