Population-based estimates of the relation between breast cancer risk, tumor subtype, and family history
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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.
KeywordsBreast cancer risk Family history Population-based Tumor subtype
The authors wish to acknowledge Julia Hecht and Walter Clinton for their assistance in creating the dataset used in our analyses. Funding/Support: Design and conduct of the study; collection, management, and interpretation of the data; review and approval of the manuscript were supported by the Breast Cancer Surveillance Consortium: Breast Cancer Surveillance in a Defined Population from the National Cancer Institute (CA063731), D. Buist, Principal Investigator. Analysis of the data and manuscript preparation were supported by the UW Multidisciplinary Predoctoral Clinical Research Training Program—a Roadmap Initiative from the National Institutes of Health/National Center for Research Resources (T32 RR023256), P. Mitchell and S. Marshall, Program Directors.
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