title: Is family history related to preventive health behaviors and medical management in breast cancer patients?
abstract: BACKGROUND
  Women diagnosed with breast cancer who also have a family history of the disease are at increased risk of developing additional primary breast or ovarian cancers. We investigated whether a relationship exists between family history and health behaviors in a cross-sectional study of breast cancer survivors.
  
  
  METHODS
  Participants in the Women's Healthy Eating and Living (WHEL) Study (a randomized trial designed to test the effect of a plant-based diet on breast cancer recurrence) completed baseline questionnaires about their family history and health behaviors. Medical records and self-reports provided treatment data. Participants were defined as having a family history (FH+) if they met specific family history criteria (n=195), and were compared with women having no family history (FH-) of breast cancer (n=1736).
  
  
  RESULTS
  The mean age of breast cancer diagnosis was 51.2 years for both groups, but FH+ women were more likely to be diagnosed before age 40. FH+ and FH- women had similar dietary patterns, alcohol intake, exercise patterns, body mass index and smoking histories. However, FH+ women were more likely to have undergone prophylactic contralateral mastectomy (OR=3.6, 95% CI=2.2 - 6.2) and bilateral oophorectomy (OR=1.6; 95% CI=1.0 - 2.3) following diagnosis, adjusted for age and time since diagnosis. The FH+ and FH- groups had similar patterns of use of anti-estrogen medications and frequency of medical follow-up.
  
  
  CONCLUSIONS
  Breast cancer survivors with a strong family history of breast cancer are more likely to undergo surgical preventive measures to reduce their risk of additional cancer, but do not report undertaking more preventive lifestyle behaviors compared to breast cancer survivors without a family history.
authors.affiliation: Cancer Prevention and Control, Rebecca and John Moores UCSD Cancer Center, University of California, SanDiego, 95000 Gilman Drive, San Diego, California 92093-0901, USA. Imadlensky@ucsd.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: Madlensky
authors.forename: Shirley W
authors.initials: SW
authors.lastname: Flatt
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Bardwell
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Rock
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008408:Mastectomy / Q000706:statistics & numerical data; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000235:genetics / Q000517:prevention & control*; D010051:Ovarian Neoplasms / Q000235:genetics / Q000517:prevention & control*; D010052:Ovariectomy / Q000706:statistics & numerical data; D014481:United States