Breast Cancer Research and Treatment

, Volume 117, Issue 1, pp 167–176

Family history of breast cancer and all-cause mortality after breast cancer diagnosis in the Breast Cancer Family Registry

  • Ellen T. Chang
  • Roger L. Milne
  • Kelly-Anne Phillips
  • Jane C. Figueiredo
  • Meera Sangaramoorthy
  • Theresa H. M. Keegan
  • Irene L. Andrulis
  • John L. Hopper
  • Pamela J. Goodwin
  • Frances P. O’Malley
  • Nayana Weerasooriya
  • Carmel Apicella
  • Melissa C. Southey
  • Michael L. Friedlander
  • Graham G. Giles
  • Alice S. Whittemore
  • Dee W. West
  • Esther M. John
Epidemiology

Abstract

Although having a family history of breast cancer is a well established breast cancer risk factor, it is not known whether it influences mortality after breast cancer diagnosis. We studied 4,153 women with first primary incident invasive breast cancer diagnosed between 1991 and 2000, and enrolled in the Breast Cancer Family Registry through population-based sampling in Northern California, USA; Ontario, Canada; and Melbourne and Sydney, Australia. Cases were oversampled for younger age at diagnosis and/or family history of breast cancer. Carriers of germline mutations in BRCA1 or BRCA2 were excluded. Cases and their relatives completed structured questionnaires assessing breast cancer risk factors and family history of cancer. Cases were followed for a median of 6.5 years, during which 725 deaths occurred. Cox proportional hazards regression was used to evaluate associations between family history of breast cancer at the time of diagnosis and risk of all-cause mortality after breast cancer diagnosis, adjusting for established prognostic factors. The hazard ratios for all-cause mortality were 0.98 (95% confidence interval [CI] = 0.84–1.15) for having at least one first- or second-degree relative with breast cancer, and 0.85 (95% CI = 0.70–1.02) for having at least one first-degree relative with breast cancer, compared with having no such family history. Estimates did not vary appreciably when stratified by case or tumor characteristics. In conclusion, family history of breast cancer is not associated with all-cause mortality after breast cancer diagnosis for women without a known germline mutation in BRCA1 or BRCA2. Therefore, clinical management should not depend on family history of breast cancer.

Keywords

Breast cancer Survival Mortality Family history 

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Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Ellen T. Chang
    • 1
    • 2
  • Roger L. Milne
    • 3
    • 4
  • Kelly-Anne Phillips
    • 5
    • 6
  • Jane C. Figueiredo
    • 7
    • 8
  • Meera Sangaramoorthy
    • 1
  • Theresa H. M. Keegan
    • 1
    • 2
  • Irene L. Andrulis
    • 7
    • 9
    • 10
  • John L. Hopper
    • 4
  • Pamela J. Goodwin
    • 7
    • 11
    • 12
  • Frances P. O’Malley
    • 9
  • Nayana Weerasooriya
    • 10
  • Carmel Apicella
    • 4
  • Melissa C. Southey
    • 13
  • Michael L. Friedlander
    • 14
  • Graham G. Giles
    • 15
  • Alice S. Whittemore
    • 2
  • Dee W. West
    • 1
    • 2
  • Esther M. John
    • 1
    • 2
  1. 1.Northern California Cancer CenterFremontUSA
  2. 2.Division of Epidemiology, Department of Health Research and PolicyStanford University School of MedicineStanfordUSA
  3. 3.Genetic and Molecular Epidemiology Group, Human Cancer Genetics ProgramSpanish National Cancer Center (CNIO)MadridSpain
  4. 4.Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population HealthThe University of MelbourneMelbourneAustralia
  5. 5.Division of Haematology and Medical OncologyPeter MacCallum Cancer CentreEast MelbourneAustralia
  6. 6.Department of Medicine, St. Vincent’s HospitalThe University of MelbourneMelbourneAustralia
  7. 7.Samuel Lunenfeld Research Institute, Mount Sinai HospitalUniversity of TorontoTorontoCanada
  8. 8.Department of Preventive Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  9. 9.Department of Pathology and Laboratory Medicine, Mount Sinai HospitalUniversity of TorontoTorontoCanada
  10. 10.Ontario Cancer Genetics Network, Cancer Care OntarioTorontoCanada
  11. 11.Faculty of Medicine, Department of MedicineUniversity of TorontoTorontoCanada
  12. 12.Faculty of Medicine, Department of Public Health SciencesUniversity of TorontoTorontoCanada
  13. 13.Department of PathologyThe University of MelbourneMelbourneAustralia
  14. 14.Prince of Wales HospitalRandwickAustralia
  15. 15.Cancer Epidemiology CentreThe Cancer Council VictoriaCarltonAustralia

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