title: Mammography screening and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers: a prospective study.
abstract: Women with a genetic predisposition to breast cancer may be at increased risk of cancer after exposure to ionizing radiation. It is unclear whether mammography screening increases the risk of breast cancer among BRCA1 and BRCA2 carriers. We identified 2,346 women with a BRCA1 (n = 1844) or BRCA2 (n = 502) mutation and no breast cancer, and we reviewed their history of mammography exposure. These women were followed for an average of 5.3 years and were observed for new breast cancer diagnoses. At study entry, 1808 women (77.1 %) reported ever having had a mammogram; of these, 204 women (11.2 %) reported having had a mammogram before age 30. We estimated the hazard ratios for the development of invasive breast cancer, conditional on the number of prior mammograms and on the age at first mammogram. Hazard ratios were estimated and stratified by gene (BRCA1 or BRCA2), relative to women with no exposure. We observed no significant association between prior mammography exposure and breast cancer risk for BRCA1 carriers (HR 0.79; 95 % CI 0.53-1.19; P = 0.26) or for BRCA2 carriers (HR 0.90; 95 % CI 0.35-2.34; P = 0.83). An early age at first mammogram (<30 years) did not increase breast cancer risk among BRCA1 carriers (HR 0.75; 95 % CI 0.41-1.37; P = 0.35) or among BRCA2 carriers (HR 0.69; 95 % CI 0.19-2.48; P = 0.57). Exposure to mammography in women with BRCA1 and BRCA2 mutations is not associated with an increased risk of breast cancer.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Vasily
authors.initials: V
authors.lastname: Giannakeas
authors.forename: Jan
authors.initials: J
authors.lastname: Lubinski
authors.forename: Jacek
authors.initials: J
authors.lastname: Gronwald
authors.forename: Pal
authors.initials: P
authors.lastname: Moller
authors.forename: Susan
authors.initials: S
authors.lastname: Armel
authors.forename: Henry T
authors.initials: HT
authors.lastname: Lynch
authors.forename: William D
authors.initials: WD
authors.lastname: Foulkes
authors.forename: Charmaine
authors.initials: C
authors.lastname: Kim-Sing
authors.forename: Christian
authors.initials: C
authors.lastname: Singer
authors.forename: Susan L
authors.initials: SL
authors.lastname: Neuhausen
authors.forename: Eitan
authors.initials: E
authors.lastname: Friedman
authors.forename: Nadine
authors.initials: N
authors.lastname: Tung
authors.forename: Leigha
authors.initials: L
authors.lastname: Senter
authors.forename: Ping
authors.initials: P
authors.lastname: Sun
authors.forename: Steven A
authors.initials: SA
authors.lastname: Narod
mesh_terms: D000328:Adult; D000368:Aged; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics; D002170:Canada / Q000453:epidemiology; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006579:Heterozygote; D006801:Humans; D015994:Incidence; D008327:Mammography; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human