Breast cancer incidence among women with a family history of breast cancer by relative's age at diagnosis

Abstract

BACKGROUND:Women with a first-degree family history of breast cancer are often advised to begin screening when they are 10 years younger than the age at which their relative was diagnosed. Evidence is lacking to determine how much earlier they should begin. METHODS: Using Breast Cancer Surveillance Consortium data on screening mammograms from 1996 to 2016, the authors constructed a cohort of 306,147 women 30-59 years of age with information on first-degree family history of breast cancer and relative's age at diagnosis. The authors compared cumulative 5-year breast cancer incidence among women with and without a first-degree family history of breast by relative's age at diagnosis and by screening age. RESULTS: Among 306,147 women included in the study, approximately 11% reported a first-degree family history of breast cancer with 3885 breast cancer cases identified. Women reporting a relative diagnosed between 40 and 49 years and undergoing screening between ages 30 and 39 or 40 and 49 had similar 5-year cumulative incidences of breast cancer (respectively, 18.6/1000; 95% confidence interval [CI], 12.1, 25.7; 18.4/1000; 95% CI, 13.7, 23.5) as women without a family history undergoing screening between 50-59 years of age (18.0/1000; 95% CI, 17.0, 19.1). For relative's diagnosis age from 35 to 45 years of age, initiating screening 5-8 years before diagnosis age resulted in a 5-year cumulative incidence of breast cancer of 15.2/1000, that of an average 50-year-old woman. CONCLUSION: Women with a relative diagnosed at or before age 45 may wish to consider, in consultation with their provider, initiating screening 5-8 years earlier than their relative's diagnosis age. Cancer 2022;128:4232-4240.

What if the age at which a woman started regular mammographic screening depended on her risk, not age?

“…The relationship is not a constant, and it is not linear. Figure 1 clearly shows that the data presented by Durham and colleagues 1 do not support approach 2, whereby a fixed age difference applies regardless of the age at diagnosis of the relative. In particular, the difference of 10 years applies only if the relative was diagnosed at the age of 40 years.…”

“…Durham and colleagues 1 focused on women with a relative diagnosed at or before the age of 45 years, and they suggest that these women might want to consider initiating screening 5–8 years earlier than their relative’s age at diagnosis. On the basis of the data that they have presented, we think their conclusion that the screening age be younger by a particular amount for women with a particular family history can be widened to cover all women who have a first‐degree relative diagnosed before the age of 70 years, except that the age difference depends on the age at diagnosis of the relative (see Figure 1).…”

“…Some national agencies, such as the National Institute for Health and Care Excellence in the United Kingdom, 2 recommend such an approach; we call this approach 1. In the United States, some agencies apparently recommend that regular screening commence for women at a fixed interval of 10 years earlier than the age at which their relative was diagnosed (see references 12 and 13 in Durham et al 1 ). We call this approach 2.…”

Whole exome sequencing and replication for breast cancer among Hispanic/Latino women identifiesFANCMas a susceptibility gene for estrogen-receptor-negative breast cancer

“…Breast cancer is the most common cancer in women, 1 and is influenced by hormonal, environmental, and genetic factors. 2 Approximately 11% of screening age women have a first-degree relative diagnosed with breast cancer, 3 and these women have ∼2-fold higher risk of being diagnosed with breast cancer.4 Germline pathogenic variants found in high-penetrance genes such as BRCA1 5 , BRCA2 , 6 PALB2 , 7 TP53 8,9 and others 10 are associated with high risk of breast cancer and underlie familial cancer syndromes. Several intermediate-penetrance genes including CHEK2 11 and ATM 12 also have been identified.…”

Exploring the Radioprotective Indium (III) Oxide Screens for Mammography Scans Using a Three-Layer Heterogeneous Breast Phantom and MCNPX: A Comparative Study Using Clinical Findings

“…Although many types of cancer do not differentiate based on gender [ 3 ], it is well known that some types of cancer are more prevalent in men and some in women [ 4 ]. On the other hand, breast cancer is a kind of cancer that is often found in women [ 5 ]. Although there is no unique cause for breast cancer, genetic factors, daily habits, and several other variables might be seen as potential triggers for its growth [ 6 ] Fortunately, early detection of breast cancer allows for a high probability of controlling and effectively treating this form of cancer [ 7 ].…”