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.
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Acknowledgments
The authors would like to thank the thousands of women and their families who participated in this research. We also thank Enid Satariano and Jocelyn Koo (Northern California Cancer Center), Gordon Glendon and Elaine Maloney (Cancer Care Ontario), and Maggie Angelakos (University of Melbourne) for their assistance. The Breast Cancer Family Registry (Breast CFR) was supported by the National Cancer Institute, National Institutes of Health under RFA CA-95-011 and CA-06-503, and through cooperative agreements with members of the Breast CFR and P.I.s. The three Breast CFRs contributing data to this analysis were supported by U01 CA69417 (Northern California Cancer Center), U01 CA69467 (Cancer Care Ontario), and U01 CA69638 (University of Melbourne). The content of this manuscript does not necessarily reflect the views or policies of the National Cancer Institute or any of the collaborating centers in the Breast CFR, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government or the Breast CFR.
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Chang, E.T., Milne, R.L., Phillips, KA. et al. Family history of breast cancer and all-cause mortality after breast cancer diagnosis in the Breast Cancer Family Registry. Breast Cancer Res Treat 117, 167–176 (2009). https://doi.org/10.1007/s10549-008-0255-3
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DOI: https://doi.org/10.1007/s10549-008-0255-3