{"id":216354,"date":"2024-03-23T11:15:58","date_gmt":"2024-03-23T11:15:58","guid":{"rendered":"https:\/\/michigandigitalnews.com\/index.php\/2024\/03\/23\/does-breast-cancer-risk-assessment-tool-bcrat-work-for-biracial-women\/"},"modified":"2025-06-25T17:20:02","modified_gmt":"2025-06-25T17:20:02","slug":"does-breast-cancer-risk-assessment-tool-bcrat-work-for-biracial-women","status":"publish","type":"post","link":"https:\/\/michigandigitalnews.com\/index.php\/2024\/03\/23\/does-breast-cancer-risk-assessment-tool-bcrat-work-for-biracial-women\/","title":{"rendered":"Does Breast Cancer Risk Assessment Tool (BCRAT) work for biracial women?"},"content":{"rendered":"<p> [ad_1]<br \/>\n<\/p>\n<p>Google searches for \u201cbreast cancer risk assessment\u201d soared last week when actress <a href=\"https:\/\/fortune.com\/well\/2024\/03\/13\/olivia-munn-breast-cancer-risk-assessment-tool\/\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Olivia Munn shared on Instagram<\/a> that her OB\/GYN had used the tool to predict her likelihood of developing the disease and \u201csaved my life.\u201d The 43-year-old was diagnosed with <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/breast-cancer\/in-depth\/breast-cancer\/art-20045654\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">luminal B breast cancer<\/a> two months after receiving a normal mammogram.<\/p>\n<div>\n<p>The <a href=\"https:\/\/bcrisktool.cancer.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Breast Cancer Risk Assessment Tool (BCRAT)<\/a> is an online calculator designed to predict a woman\u2019s risk of developing <a href=\"https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/invasive-breast-cancer\" target=\"_blank\" rel=\"noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">invasive breast cancer<\/a> in both the short term, within five years, and their lifetime, up to age 90.<\/p>\n<p>Using components of your medical history, such as your age at the time of your first menstrual period and how many of your first-degree relatives have had breast cancer, the tool is supposed to calculate your risk in about five minutes. It\u2019s available for free on the National Cancer Institute (NCI) website but is intended for health professionals. Still, if you\u2019re as curious as I am, you couldn\u2019t resist completing the quiz-like form yourself.<\/p>\n<p>Turns out it was a fool\u2019s errand\u2014the BCRAT wasn\u2019t designed for people like me. Or Munn, for that matter.<\/p>\n<p>In the demographics section, the assessment asks, \u201cWhat is the patient\u2019s race\/ethnicity?\u201d There were six options in the dropdown menu, in this order: \u201cWhite,\u201d \u201cAfrican American,\u201d \u201cHispana\/Latina,\u201d \u201cAsian American,\u201d \u201cAmerican Indian or Alaskan Native,\u201d and \u201cUnknown.\u201d None of these options alone would do\u2014and I could only pick one.<\/p>\n<p>I guarantee that if you ask someone who\u2019s bi- or multiracial what it\u2019s like to fill out a form, they\u2019ll have a story for you. I, the daughter of a Black father and a white mother, have my share. Over the decades my options have expanded to such exotic categories as \u201cOther,\u201d \u201cBiracial,\u201d \u201cMultiracial,\u201d \u201cMixed Race,\u201d \u201cSome Other Race,\u201d or \u201cTwo or More Races.\u201d Sometimes I have the luxury of picking two.<\/p>\n<p>It\u2019s disheartening, but the lack of an appropriate racial\/ethnic category on the BCRAT, however, may have serious consequences.<\/p>\n<div class=\"wp-block-image\" style=\"margin:auto;max-width:960px\"><span style=\"box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative\"><span style=\"box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.66666666666666%\"\/><img alt=\"Young African American woman prepares for a breast exam, mammogram from her gynecologist doctor at hospital or clinic.\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover;background-size:cover;background-position:0% 0%;filter:blur(20px);background-image:url(&quot;data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAYAAAAfFcSJAAAADUlEQVR42mO8fv1mPQAIHAMIsIR6agAAAABJRU5ErkJggg==&quot;)\"\/><noscript><img alt=\"Young African American woman prepares for a breast exam, mammogram from her gynecologist doctor at hospital or clinic.\" loading=\"lazy\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover\" sizes=\"100vw\" srcset=\"https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-1294319145-e1710975947110.jpg?w=320&amp;q=75 320w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-1294319145-e1710975947110.jpg?w=480&amp;q=75 480w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-1294319145-e1710975947110.jpg?w=576&amp;q=75 576w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-1294319145-e1710975947110.jpg?w=768&amp;q=75 768w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-1294319145-e1710975947110.jpg?w=1024&amp;q=75 1024w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-1294319145-e1710975947110.jpg?w=1280&amp;q=75 1280w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-1294319145-e1710975947110.jpg?w=1440&amp;q=75 1440w\" src=\"https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-1294319145-e1710975947110.jpg?w=1440&amp;q=75\"\/><\/noscript><\/span><figcaption>Mixed-race women are used to not fitting into one racial\/ethnic box on forms. In 2024, they\u2019re still being left out of an algorithm that may help gauge their breast cancer risk.<\/figcaption><p>Getty Images<\/p>\n<\/div>\n<h2 class=\"wp-block-heading\">Cancer epidemiologist: Lack of data on nonwhite women mars risk estimates<\/h2>\n<p>The lack of a single bi\/multiracial option makes sense; I assume my Black\/white risk would differ from that of a woman with, say, an Asian\/white background like Munn. But in the age of AI\u2014not to mention a <a href=\"https:\/\/www.census.gov\/library\/stories\/2023\/06\/nearly-a-third-reporting-two-or-more-races-under-18-in-2020.html\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">burgeoning multiracial population<\/a> in the U.S.\u2014surely the algorithm could let me choose two and calculate my risk?<\/p>\n<p>The NCI acknowledges the BCRAT\u2019s limitations, namely a lack of diverse racial and ethnic data, which can skew results. The tool may underestimate risk for Black women with previous biopsies and Hispanic women born outside the U.S., and offer inaccurate risk estimates for American Indian and Alaskan Native women.<\/p>\n<p>\u201cThe more data you can give an algorithm or a prediction tool or an AI, the better it\u2019s going to be in giving you an answer, in this case, a risk estimate,\u201d <a href=\"https:\/\/med.ucf.edu\/person\/robin-hines-ph-d-m-p-h\/\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Robin Hines, Ph.D.<\/a>, a cancer epidemiologist at the <a href=\"https:\/\/med.ucf.edu\/\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">University of Central Florida College of Medicine<\/a>, tells <em>Fortune<\/em>. \u201cIf I have 280,000 women, I\u2019m going to have much less error in my estimate than I will have if I have just over 3,000 women.\u201d<\/p>\n<p>Hines is referring to the 280,000 white women in the <a href=\"https:\/\/dceg.cancer.gov\/research\/cancer-types\/breast-cancer\/detection-demonstration-follow-up-breast-cancer\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Breast Cancer Detection Demonstration Project<\/a>. Their data, along with information from the <a href=\"https:\/\/seer.cancer.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">NCI Surveillance, Epidemiology, and End Results (SEER) Program<\/a>, were used to create the BCRAT. Risk estimates for nonwhites are based on SEER and other study data for far fewer women in these racial and ethnic groups:<\/p>\n<ul>\n<li><strong>Black:<\/strong> 3,244<\/li>\n<li><strong>Hispanic: <\/strong>2,497<\/li>\n<li><strong>Asian and Pacific Islander: <\/strong>1,563<\/li>\n<\/ul>\n<p><a href=\"https:\/\/dceg.cancer.gov\/about\/staff-directory\/gail-mitchell\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Dr. Mitchell Gail<\/a>, now a senior investigator in the <a href=\"https:\/\/dceg.cancer.gov\/about\/organization\/tdrp\/bb\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Biostatistics Branch of the NCI Division of Cancer Epidemiology and Genetics<\/a>, developed the calculator in 1989, before the <a href=\"https:\/\/www.congress.gov\/bill\/103rd-congress\/senate-bill\/1\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">National Institutes of Health Revitalization Act of 1993<\/a> called for \u201can increase in the number of women and individuals from disadvantaged backgrounds (including racial and ethnic minorities) in the fields of biomedical and behavioral research.\u201d Also known as the <a href=\"https:\/\/academic.oup.com\/jnci\/article-abstract\/81\/24\/1879\/1019887?redirectedFrom=fulltext&amp;login=false\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Gail Model<\/a>, the BCRAT algorithm was last revised in 2017 and may be updated periodically as new data become available, according to the NCI.<\/p>\n<div class=\"wp-block-image\" style=\"margin:auto;max-width:960px\"><span style=\"box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative\"><span style=\"box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:67.1875%\"\/><img alt=\"Portrait of a group of enthusiastic woman taking part in a fitness event to raise awareness for breast cancer.\" src=\"data:image\/gif;base64,R0lGODlhAQABAIAAAAAAAP\/\/\/yH5BAEAAAAALAAAAAABAAEAAAIBRAA7\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover;background-size:cover;background-position:0% 0%;filter:blur(20px);background-image:url(&quot;data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAYAAAAfFcSJAAAADUlEQVR42mO8fv1mPQAIHAMIsIR6agAAAABJRU5ErkJggg==&quot;)\"\/><noscript><img alt=\"Portrait of a group of enthusiastic woman taking part in a fitness event to raise awareness for breast cancer.\" loading=\"lazy\" decoding=\"async\" data-nimg=\"responsive\" style=\"position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover\" sizes=\"100vw\" srcset=\"https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-544600482-e1710878343308.jpg?w=320&amp;q=75 320w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-544600482-e1710878343308.jpg?w=480&amp;q=75 480w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-544600482-e1710878343308.jpg?w=576&amp;q=75 576w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-544600482-e1710878343308.jpg?w=768&amp;q=75 768w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-544600482-e1710878343308.jpg?w=1024&amp;q=75 1024w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-544600482-e1710878343308.jpg?w=1280&amp;q=75 1280w, https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-544600482-e1710878343308.jpg?w=1440&amp;q=75 1440w\" src=\"https:\/\/content.fortune.com\/wp-content\/uploads\/2024\/03\/GettyImages-544600482-e1710878343308.jpg?w=1440&amp;q=75\"\/><\/noscript><\/span><figcaption>The Breast Cancer Risk Assessment Tool (BCRAT) may underestimate risk for Black women with previous biopsies and Hispanic women born outside the U.S., and offer inaccurate risk estimates for American Indian and Alaskan Native women.<\/figcaption><p>Cecilie Arcurs\u2014Getty Images<\/p>\n<\/div>\n<h2 class=\"wp-block-heading\">Olivia Munn\u2019s OB\/GYN wants you to know your breast cancer risk<\/h2>\n<p>I took the BCRAT twice. When I input \u201cAfrican American,\u201d the tool generated a lifetime risk of 9.8%, compared to an average risk of 10.1% among 35-year-old Black women in the U.S. When I input \u201cWhite,\u201d my risk jumped to 12.4%, compared to an average of 12.6%. I don\u2019t know the nuances of the algorithm, but my biracial risk is probably more complicated than simply averaging the two scores.<\/p>\n<p>How, then, did Munn\u2019s OB\/GYN, <a href=\"https:\/\/www.draliabadi.com\/\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Dr. Tha\u00efs Aliabadi<\/a>, calculate the biracial actress\u2019s risk? Aliabadi, who\u2019s preparing to <a href=\"https:\/\/www.shemdpodcast.com\/risk-calculator\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">launch a calculator<\/a> on the website of her new podcast, <a href=\"https:\/\/www.shemdpodcast.com\/\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \"><em>SHE MD<\/em><\/a>, declined to specify which assessment tool(s)\u2014the BCRAT is <a href=\"https:\/\/my.clevelandclinic.org\/health\/diagnostics\/breast-cancer-risk-assessment\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">one of many<\/a>\u2014she used for Munn. But in her push to get every woman to understand her risk of breast cancer, Aliabadi tells <em>Fortune<\/em> the lack of racially and ethnically diverse tools is an issue.<\/p>\n<p>\u201cWe have good tools to use for the general population but, obviously, we need to have more studies and focus more on different ethnicities,\u201d she says. \u201cHopefully, by collecting a lot of data\u2014and artificial intelligence\u2014we\u2019ll be able to put all this data together and come out with a better test.\u201d<\/p>\n<p>Progress is already being made. The <a href=\"https:\/\/www.bu.edu\/slone\/bwhs-brcarisk-calculator\/\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Black Women\u2019s Health Study Breast Cancer Risk Calculator<\/a> launched in 2021 and <a href=\"https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2021\/breast-cancer-risk-calculator-us-black-women\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">estimates short-term risk<\/a> for women between the ages of 30 and 70. It gave me a 10-year risk of 0.8%, compared to an average of 0.9%.<\/p>\n<p>President Joe Biden on Monday signed the <a href=\"https:\/\/www.whitehouse.gov\/briefing-room\/presidential-actions\/2024\/03\/18\/executive-order-on-advancing-womens-health-research-and-innovation\/\" target=\"_blank\" rel=\"noreferrer noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \">Executive Order on Advancing Women\u2019s Health Research and Innovation<\/a>, which concedes \u201cwe know far too little about women\u2019s health across women\u2019s lifespans, and those gaps are even more prominent for women of color, older women, and women with disabilities.\u201d It calls for the investment of federal dollars in closing that gap.<\/p>\n<p>For now, Aliabadi\u2019s biggest concern is that not enough women\u2014regardless of their race or ethnicity\u2014are even aware of their ballpark risk, myself included. That I\u2019m 35 and had never heard of a breast cancer risk assessment until Munn\u2019s Instagram announcement is \u201cexactly the problem,\u201d she says. While I\u2019m dissatisfied that most existing tools don\u2019t, or can\u2019t, account for biracial women, I do feel empowered with at least an idea of my risk. And though my estimates are relatively low, they\u2019ve prompted questions I want to ask my doctor.<\/p>\n<p>\u201cI want to change that and make that standard of care for all women\u2014not just high-risk women, all women,\u201d Aliabadi tells <em>Fortune<\/em>. \u201cIt takes two minutes. Look at how much time we spend doing other things in life. What\u2019s two minutes to calculate your lifetime risk of breast cancer?\u201d\u00a0<\/p>\n<p><strong>For more on breast cancer risk and prevention:<\/strong><\/p>\n<\/div>\n<div data-cy=\"subscriptionPlea\">\n<p><span style=\"font-weight:400\">Subscribe to Well Adjusted, our newsletter full of simple strategies to work smarter and live better, from the Fortune Well team. <\/span><a href=\"https:\/\/www.fortune.com\/newsletters\/well-adjusted?&amp;itm_source=fortune&amp;itm_medium=article_tout&amp;itm_campaign=well_adjusted\" target=\"_blank\" rel=\"noopener\" class=\"sc-47dba8f0-0 iRbseu styledLinkColor \"><span style=\"font-weight:400\">Sign up<\/span><\/a><span style=\"font-weight:400\"> for free today.<\/span><\/p>\n<\/div>\n<p>[ad_2]<br \/>\n<br \/><a href=\"https:\/\/fortune.com\/well\/article\/breast-cancer-risk-assessment-tool-race-ethnicity\/\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>[ad_1] Google searches for \u201cbreast cancer risk assessment\u201d soared last week when actress Olivia Munn shared on Instagram that her OB\/GYN had used the tool<\/p>\n","protected":false},"author":1,"featured_media":216355,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[149],"tags":[],"_links":{"self":[{"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/posts\/216354"}],"collection":[{"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/comments?post=216354"}],"version-history":[{"count":1,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/posts\/216354\/revisions"}],"predecessor-version":[{"id":334766,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/posts\/216354\/revisions\/334766"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/media\/216355"}],"wp:attachment":[{"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/media?parent=216354"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/categories?post=216354"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/michigandigitalnews.com\/index.php\/wp-json\/wp\/v2\/tags?post=216354"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}