NAF Testing and Risk Assessment

The Breast Cancer Risk Assessment Tool (based on the Gail model) has been established by the National Cancer Institute (NCI) and the National Surgical Adjuvant Breast and Bowel Project (NSABP) to identify women with an increased risk of breast cancer. The risk factors included in the test are: personal history of breast abnormalities, age, age at first menarche, age at first live birth, breast cancer among first-degree relatives (sisters, mother, or daughters), breast biopsies, obesity, and race. In women who have had a breast biopsy. A study of 6904 women for an average follow up of 14.6 years demonstrated that clinically, NAF may be most useful for women at highest absolute risk by the Risk Assessment Tool because modest differences in relative risk are amplified. In this group, the incidence of breast cancer by NAF cytology ranged from 5.3 to 10.3 per 1,000 women years (non-yielder to hyperplasia/atypia) for women in the highest group.