Gail Model Underestimates Breast Cancer Risk in Thai Population

Document Type : Research Articles


1 Division of Head Neck and Breast Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

2 Minimally Invasive and Endocrine Surgery Division, Department of Surgery, Police General Hospital, Bangkok, Thailand.


Background: The Gail model is the most widely used method for breast cancer risk estimation. This model has
been studied and verified for its validity in many groups but there has yet to be a study to validate the Gail model in a
Thai population. This study aims to evaluate whether the Gail model can accurately calculate the risk of breast cancer
among Thai women. Methods: The subjects were recruited from the Division of Head, Neck, and Breast Surgery,
Department of Surgery, Siriraj Hospital. The patients attending the division were asked to enroll in the study and
complete questionnaires. Gail model scores were then calculated. Relationships between parameters were examined
using the Pearson’s chi-square test, Fisher’s exact test, and independent-samples t-test. Results: There were 514
women recruited. Age, parity, age at first-live birth, and history of atypical ductal hyperplasia (ADH) were significant
risk factors for breast cancer. The 5-year and lifetime risk score for breast cancer calculated by the Gail model were
not significantly different between the patient and the control subjects. The proportions of the subjects with lifetime
risk ≥20% were significantly higher in breast cancer patients (p=0.049). Conclusion: The Gail model underestimated
the risk of breast cancer in Thai women. Calibration of the model is still required before adoption in Thai population.


Main Subjects