The Gail model predicts breast cancer in women with suspicious radiographic lesions

Background We sought to evaluate whether a woman’s 5-year Gail risk adds to the predictive value of the Breast Imaging Reporting and Data System (BI-RADS) classification for the detection of breast cancer. Methods We performed a retrospective review of the BI-RADS classifications and pathology results for all image-guided needle breast biopsy examinations over a 3-year period at our institution. The 5-year Gail risk was calculated for eligible patients. Chi-square analysis was used to compare rates of malignancy based on Gail and BI-RADS scores. Results A total of 632 image-guided needle biopsy examinations were performed in 609 women. A total of 414 women had suspicious (BI-RADS 4) lesions and underwent 424 biopsy examinations. For this subset, women with a Gail risk of less than 1.7% had 21% malignant results, whereas those with a Gail risk of 1.7% or greater had 42% malignant results (relative risk, 1.94; 95% confidence interval, 1.45–2.66). Conclusions The Gail model can stratify further the risk for breast cancer in women with suspicious breast imaging reports.