title: Family history of breast cancer and its association with disease severity and mortality.
abstract: A family history (FH) of breast cancer (BC) is known to increase an individual's risk of disease onset. However, its role in disease severity and mortality is less clear. We aimed to ascertain associations between FH of BC, severity and BC-specific mortality in a hospital-based cohort of 5354 women with prospective information on FH. We included women diagnosed at Guy's and St Thomas' NHS Foundation Trust between 1975 and 2012 (n = 5354). BC severity was defined and categorized as good, moderate, and poor prognosis. Data on BC-specific mortality was obtained from the National Cancer Registry and medical records. Associations between FH and disease severity or BC-specific mortality were evaluated using proportional odds models and Cox proportional hazard regression models, respectively. Available data allowed adjustment for potential confounders (e.g., treatment, socioeconomic status, and ethnicity). FH of any degree was not associated with disease severity at time of diagnosis (adjusted proportional OR: 1.00 [95% CI: 0.85 to 1.17]), which remained true also after stratification by period of diagnosis. FH of BC was not associated with BC-mortality HR: 0.99 (95% CI: 0.93 to 1.05). We did not find evidence to support an association between FH of BC and severity and BC-specific mortality. Our results indicate that clinical management should not differ between women with and without FH, when the underlying mutation is unknown.
authors.affiliation: Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Melvin
authors.affiliation: Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom.
authors.forename: Wahyu
authors.initials: W
authors.lastname: Wulaningsih
authors.affiliation: Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom.
authors.forename: Zac
authors.initials: Z
authors.lastname: Hana
authors.affiliation: Faculty of Life Sciences and Medicine, Division of Cancer Studies, Section of Research Oncology, King's College London, London, United Kingdom.|Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Arnie D
authors.initials: AD
authors.lastname: Purushotham
authors.affiliation: Faculty of Life Sciences and Medicine, Division of Cancer Studies, Section of Research Oncology, King's College London, London, United Kingdom.|Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Pinder
authors.affiliation: Regional Cancer Centre, Uppsala/Orebro, Uppsala, Sweden.
authors.forename: Ian
authors.initials: I
authors.lastname: Fentiman
authors.affiliation: Faculty of Life Sciences and Medicine, Division of Cancer Studies, Section of Research Oncology, King's College London, London, United Kingdom.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Gillett
authors.affiliation: Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom.
authors.forename: Anca
authors.initials: A
authors.lastname: Mera
authors.affiliation: Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom.|Research Oncology, Guy's Hospital, London, United Kingdom.|Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.affiliation: Faculty of Life Sciences and Medicine, Division of Cancer Studies, Cancer Epidemiology Group, King's College London, London, United Kingdom.
authors.forename: Mieke
authors.initials: M
authors.lastname: Van Hemelrijck
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008131:London / Q000453:epidemiology; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Family history; breast cancer; mortality; severity