Breast Cancer Research and Treatment

, Volume 114, Issue 3, pp 549–558 | Cite as

Population-based estimates of the relation between breast cancer risk, tumor subtype, and family history

  • Megan L. Welsh
  • Diana S. M. Buist
  • Erin J. Aiello Bowles
  • Melissa L. Anderson
  • Joann G. Elmore
  • Christopher I. Li
Epidemiology

Abstract

Objective Many studies that have estimated the breast cancer risk attributable to family history have been based on data collected within family units. Use of this study design has likely overestimated risks for the general population. We provide population-based estimates of breast cancer risk and different tumor subtypes in relation to the degree, number, and age at diagnosis of affected relatives. Methods Cox Proportional Hazards to calculate risks (hazard ratios; 95% confidence interval) of breast cancer and tumor subtypes for women with a family history of breast cancer relative to women without a family history among a cohort of 75,189 women age ≥40 years of whom 1,087 were diagnosed with breast cancer from June 1, 2001–December 31, 2005 (median follow-up 3.16 years). Results Breast cancer risk was highest for women with a first-degree family history (1.54; 1.34–1.77); and did not differ substantially by the affected relative’s age at diagnosis or by number of affected first-degree relatives. A second-degree family history only was not associated with a significantly increased breast cancer risk (1.15; 0.98–1.35). There was a suggestion that a positive family history was associated with risk of triple positive (Estrogen+/Progesterone+/HER2+) and HER2-overexpressing tumors. Conclusions While a family history of breast cancer in first-degree relatives is an important risk factor for breast cancer, gathering information such as the age at diagnosis of affected relatives or information on second-degree relative history may be unnecessary in assessing personal breast cancer risk among women age ≥40 years.

Keywords

Breast cancer risk Family history Population-based Tumor subtype 

References

  1. 1.
    Sattin RW, Rubin GL, Webster LA et al (1985) Family history and the risk of breast cancer. JAMA 253(13):1908–1913PubMedCrossRefGoogle Scholar
  2. 2.
    Colditz GA, Willett WC, Hunter DJ et al (1993) Family history, age and risk of breast cancer: prospective data from the nurses’ health study. JAMA 270(3):338–343PubMedCrossRefGoogle Scholar
  3. 3.
    Parazzini F, La Vecchia C, Negri E et al (1993) Family history of breast, ovarian and endometrial cancer and risk of breast cancer. Int J Epidemiol 22(4):614–618PubMedCrossRefGoogle Scholar
  4. 4.
    Muhonen T, Eerola H, Vehmanen P et al (1997) Breast cancer risk estimation in families with history of breast cancer. Br J Cancer 76(9):1228–1231PubMedGoogle Scholar
  5. 5.
    Negri E, Braga C, La Vecchia C et al (1997) Family history of cancer and risk of breast cancer. Int J Cancer 72(5):735–738PubMedCrossRefGoogle Scholar
  6. 6.
    Pharoah PDP, Day NE, Duffy S et al (1997) Family history and the risk of breast cancer: a systematic review and meta-analysis. Int J Cancer 71(5):800–809PubMedCrossRefGoogle Scholar
  7. 7.
    Anderson H, Bladström A, Olsson H et al (2000) Familial breast and ovarian cancer: a Swedish population-based register study. Am J Epidemiol 152(12):1154–1163PubMedCrossRefGoogle Scholar
  8. 8.
    Dumitrescu RG, Cotarla I (2005) Understanding breast cancer risk—where do we stand in 2005? J Cell Mol Med 9(1):208–221PubMedCrossRefGoogle Scholar
  9. 9.
    Hopper JL, Bishop DT, Easton DF (2005) Population-based family studies in genetic epidemiology. Lancet 366(9494):1397–1406PubMedCrossRefGoogle Scholar
  10. 10.
    Crest AB, Aiello EJ, Anderson ML et al (2006) Varying levels of family history of breast cancer in relation to mammographic breast density (United States). Cancer Causes Control 17(6):843–850PubMedCrossRefGoogle Scholar
  11. 11.
    Lehrer S, Lee P, Tartter P et al (1995) Breast cancer and family history: a multivariate analysis of levels of tumor HER2 protein and family history of cancer in women who have breast cancer. Mt Sinai J Med 62(6):415–418PubMedGoogle Scholar
  12. 12.
    Tutera AM, Sellers TA, Potter JD et al (1996) Association between family history of cancer and breast cancer defined by estrogen and progesterone receptor status. Genet Epidemiol 13(2):207–221PubMedCrossRefGoogle Scholar
  13. 13.
    Huang WY, Newman B, Millikan RC et al (2000) Risk of breast cancer according to the status of HER-2/neu oncogene amplification. Cancer Epidemiol Biomarkers Prev 9(1):65–71PubMedGoogle Scholar
  14. 14.
    Gavrilov I, Nacheva M, Tzingilev D (2002) Familial breast cancer. Part II: relationships with histology, staging, steroid receptors and serum tumor markers. J BUON 7(1):61–65PubMedGoogle Scholar
  15. 15.
    Yang XR, Sherman ME, Rimm DL et al (2007) Differences in risk factors for breast cancer molecular subtypes in a population-based study. Cancer Epidemiol Biomarkers Prev 16(3):439–443PubMedCrossRefGoogle Scholar
  16. 16.
    Althuis MD, Fergenbaum JH, Garcia-Closas M et al (2004) Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomarkers Prev 13(10):1558–1568PubMedGoogle Scholar
  17. 17.
    Sørlie T, Perou CM, Tibshirani R et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci U S A 98(19):10869–10874PubMedCrossRefGoogle Scholar
  18. 18.
    Carey LA, Perou CM, Livasy CA et al (2006) Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA 295(21):2492–2502PubMedCrossRefGoogle Scholar
  19. 19.
    Taplin SH, Thompson RS, Schnitzer F et al (1990) Revisions in the risk-based Breast Cancer Screening Program at Group Health Cooperative. Cancer 66(4):812–818PubMedCrossRefGoogle Scholar
  20. 20.
    Taplin SH, Mandelson MT, Anderman C et al (1997) Mammography diffusion and trends in late-state breast cancer: evaluating outcomes in a population. Cancer Epidemiol Biomarkers Prev 6(8):625–631PubMedGoogle Scholar
  21. 21.
    Taplin SH, Ichikawa L, Buist DS et al (2004) Evaluating organized breast cancer screening implementation: the prevention of late-state disease? Cancer Epidemiol Biomarkers Prev 13(2):225–234PubMedCrossRefGoogle Scholar
  22. 22.
    Group Health Cooperative Breast Cancer Screening Schedule (1992) Available via: http://www.centerforhealthstudies.org/surveillanceproject/overview/screening-schedule.html. Cited 9 April 2008
  23. 23.
    Cox DR, Oakes D (1984) Analysis of survival data. Chapman & Hall, LondonGoogle Scholar
  24. 24.
    Perou CM, Sørlie T, Elsen MB et al (2000) Molecular portraits of human breast tumours. Nature 406(6797):747–752PubMedCrossRefGoogle Scholar
  25. 25.
    Sørlie T, Tibshirani R, Parker J et al (2003) Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci U S A 100(14):8418–8423PubMedCrossRefGoogle Scholar
  26. 26.
    American College of Radiology (2003) Breast imaging reporting and data system (BI-RADS™), 4th edn. American College of Radiology, Reston, VAGoogle Scholar
  27. 27.
    Hosmer DW, Lemeshow S (1999) Applied Survival analysis: regression modeling of time to event data. John Wiley, Inc., New YorkGoogle Scholar
  28. 28.
    StataCorp (2005) Stata statistical software: release 9. StataCorp LP, College Station, TXGoogle Scholar
  29. 29.
    Collaborative Group on Hormonal Factors in Breast Cancer (2001) Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease. Lancet 358(9291):1389–1399CrossRefGoogle Scholar
  30. 30.
    Calle EE, Martin LM, Thun MJ et al (1993) Family history, age, and risk of fatal breast cancer. Am J Epidemiol 138(9):675–681PubMedGoogle Scholar
  31. 31.
    Ziogas A, Anton-Culver H (2003) Validation of family history data in cancer family registries. Am J Prev Med 24(2):190–198PubMedCrossRefGoogle Scholar
  32. 32.
    Murff HJ, Spigel DR, Syngal S (2004) Does this patient have a family history of cancer? An evidence-based analysis of the accuracy of family cancer history. JAMA 292(12):1480–1489PubMedCrossRefGoogle Scholar
  33. 33.
    Coliditz GA, Rosner BA, Chen WY et al (2004) Risk factors for breast cancer according to estrogen and progesterone receptor status. J Natl Cancer Inst 96(3):218–228CrossRefGoogle Scholar
  34. 34.
    Swede H, Moysich KB, Freudenheim JL et al (2001) Breast cancer risk factors and HER2 over-expression in tumors. Cancer Detect Prev 25(6):511–519PubMedGoogle Scholar
  35. 35.
    Cooper JA, Rohan TE, Cant EL et al (1989) Risk factors for breast cancer by oestrogen receptor status: a population-based case–control study. Br J Cancer 59(1):119–125PubMedGoogle Scholar
  36. 36.
    Lakhani SR, Van De Vijver MJ, Jacquemier J et al (2002) The pathology of familial breast cancer: predictive value of immunohistochemical markers estrogen receptor, progesterone receptor, HER-2, and p53 in patients with mutations in BRCA1 and BRCA2. J Clin Oncol 20(9):2310–2318PubMedCrossRefGoogle Scholar
  37. 37.
    Sellers TA, Kushi LH, Potter JD et al (1993) Effect of family history, body-fat distribution, and reproductive factors on the risk of postmenopausal breast cancer. N Engl J Med 326(20):1323–1329Google Scholar
  38. 38.
    Yankaskas BC (2005–2006) Epidemiology of breast cancer in young women. Breast Dis 23(1):3–8Google Scholar
  39. 39.
    Ries LAG, Melbert D, Krapcho M et al. (2007) SEER cancer statistics review, 1975–2004. National Cancer Institute, Bethesda, MD. http://seer.cancer.gov/csr/1975_2004/, based on November 2006 SEER data submission, posted to the SEER web site
  40. 40.
    Hall IJ, Burke W, Coughlin S et al (2001) Population-based estimates of the prevalence of family history of cancer among women. Community Genet 4(3):134–142PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Megan L. Welsh
    • 1
    • 2
  • Diana S. M. Buist
    • 1
    • 2
    • 3
  • Erin J. Aiello Bowles
    • 3
  • Melissa L. Anderson
    • 3
  • Joann G. Elmore
    • 1
    • 4
  • Christopher I. Li
    • 1
    • 2
  1. 1.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  2. 2.Fred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.Group Health Center for Health StudiesSeattleUSA
  4. 4.Department of Internal MedicineUniversity of WashingtonSeattleUSA

Personalised recommendations