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    Patent Pending

    Gail Model for Breast Cancer Risk

    Estimates risk for breast cancer based on demographic and clinical data.
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    INSTRUCTIONS

    The Gail Model is for use in women with no history of breast cancer, DCIS or LCIS. Other tools may be more appropriate for women with known mutations in BRCA1, BRCA2, or other hereditary syndromes associated with breast cancer. See the Evidence section for more information.

    When to Use
    Pearls/Pitfalls
    Why Use

    The Gail Model is one of several risk assessment models that can help determine the absolute 5 year risk and lifetime risk of developing breast cancer.

    • Other models include the Tyrer-Cuzick (also referred to as IBIS, International Breast Cancer Intervention Study) model, the Claus model, BRCAPro, and BOADICEA (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm).
    • The Gail Model for Breast Cancer risk estimates the absolute 5 year risk and lifetime risk of developing breast cancer.
    • Family history includes only first degree relatives with breast cancer, which is not enough information to estimate the risk of a patient having BRCA mutation. It also underestimates the cancer risk for patients with extensive family history.
    • The Gail Model is a good predictor of risk for populations but not for individuals.
    • It adjusts risk for race/ethnicity.
    • It may underestimate breast cancer risk in patients with atypical hyperplasia and strong family history.
    • The Gail Model was NOT designed to estimate risk for:
      • Women with a prior diagnosis of breast cancer, lobular carcinoma in situ (LCIS), or ductal carcinoma in situ (DCIS).
      • Women who have received previous radiation therapy to the chest for treatment of Hodgkin lymphoma.
      • Women with gene mutations in BRCA1 or BRCA2, or those who are known to have certain genetic syndromes that increase risk for breast cancer.
      • Women of age <35 or >85.

    It helps determine which risk-reduction options—medical (chemoprevention with tamoxifen), surgical (prophylactic mastectomy) or lifestyle changes only—are most appropriate for individual patients by weighing risks and benefits of intervention versus likelihood of developing cancer.

    years
    Unknown
    7-11 years old
    12-13 years old
    >13 years old
    Unknown
    No births
    <20 years old
    20-24 years old
    25-29 years old
    ≥30 years old
    Unknown
    0
    1
    >1
    Unknown
    0
    1
    >1
    White
    African-American
    Hispanic
    Asian-American
    American-Indian/Alaskan Native
    Unknown

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    Patients who have an increased risk of developing breast cancer, defined as calculated 5 year risk >1.7%, are candidates for chemoprevention (such as tamoxifen).

    Critical Actions

    Patients with elevated breast cancer risk (>1.7%) should be referred to a breast surgeon to discuss possible risk reduction interventions.

    Content Contributors
    • Akiko Chiba, MD
    About the Creator
    Dr. Mitchell Gail
    Are you Dr. Mitchell Gail?
    Content Contributors
    • Akiko Chiba, MD