Family history of breast cancer and all-cause mortality after breast cancer diagnosis in the Breast Cancer Family Registry.
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.
Chang
Ellen T
ET
Northern California Cancer Center, Fremont, 94538, USA. ellen@nccc.org
Milne
Roger L
RL
Phillips
Kelly-Anne
KA
Figueiredo
Jane C
JC
Sangaramoorthy
Meera
M
Keegan
Theresa H M
TH
Andrulis
Irene L
IL
Hopper
John L
JL
Goodwin
Pamela J
PJ
O'Malley
Frances P
FP
Weerasooriya
Nayana
N
Apicella
Carmel
C
Southey
Melissa C
MC
Friedlander
Michael L
ML
Giles
Graham G
GG
Whittemore
Alice S
AS
West
Dee W
DW
John
Esther M
EM
D000328:Adult; D001315:Australia; D001943:Breast Neoplasms / Q000235:genetics* / Q000401:mortality*; D004252:DNA Mutational Analysis; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D009864:Ontario; D010375:Pedigree; D016016:Proportional Hazards Models; D012042:Registries; D018426:SEER Program; D014481:United States