Family History and Breast Cancer Risk Among Older Women in the Breast Cancer Surveillance Consortium Cohort

Abstract

IMPORTANCE First-degree family history is a strong risk factor for breast cancer, but controversy exists about the magnitude of the association among older women.OBJECTIVE To determine whether first-degree family history is associated with increased risk of breast cancer among older women, and identify whether the association varies by breast density.DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study between 1996 and 2012 from 7 Breast Cancer Surveillance Consortium (BCSC) registries located in New Hampshire, North Carolina, San Francisco Bay area, western Washington state, New Mexico, Colorado, and Vermont. During a mean (SD) follow-up of 6.3 (3.2) years, 10 929 invasive breast cancers were diagnosed in a cohort of 403 268 women 65 years and older with data from 472 220 mammography examinations. We estimated the 5-year cumulative incidence of invasive breast cancer by first-degree family history, breast density, and age groups. Cox proportional hazards models were fit to estimate the association of first-degree family history with risk of invasive breast cancer (after adjustment for breast density, BCSC registry, race/ethnicity, body mass index, postmenopausal hormone therapy use, and benign breast disease for age groups 65 to 74 years and 75 years and older, separately). Data analyses were performed between June 2016 and June 2017.EXPOSURE First-degree family history of breast cancer. MAIN OUTCOMES AND MEASURES Incident breast cancer.RESULTS In 403 268 women 65 years and older, first-degree family history was associated with an increased risk of breast cancer among women ages 65 to 74 years (hazard ratio [HR], 1.48; 95% CI, 1.35-1.61) and 75 years and older (HR, 1.44; 95% CI, 1.28-1.62). Estimates were similar for women 65 to 74 years with first-degree relative's diagnosis age younger than 50 years (HR, 1.47; 95% CI, 1.25-1.73) vs 50 years and older (HR, 1.33; 95% CI, 1.17-1.51) and for women ages 75 years and older with the relative's diagnosis age younger than 50 years (HR, 1.31; 95% CI, 1.05-1.63) vs 50 years and older (HR, 1.55; 95% CI, 1.33-1.81). Among women ages 65 to 74 years, the risk associated with first-degree family history was highest among those with fatty breasts (HR, 1.67; 95% CI, 1.27-2.21), whereas in women 75 years and older the risk associated with family history was highest among those with dense breasts (HR, 1.55; 95% CI, 1.29-1.87).CONCLUSIONS AND RELEVANCE First-degree family history was associated with increased risk of invasive breast cancer in all subgroups of older women irrespective of a relative's age at diagnosis.

Endogenous interaction profiling identifies DDX5 as an oncogenic coactivator of transcription factor Fra-1

“…As breast cancer has a genetic component, family history is another important risk factor. The risk of women to develop breast cancer increases with the number of affected relatives, particularly with the first-degree relatives [13,14]. The hereditary breast cancer characterized with the mutations in high-penetrance genes, such as BRCA1 and BRCA2, constitutes 3-6% of all breast cancers [15].…”

Study of Known Risk Factors in Breast Cancer Patients in the Regional Population

“…15 In a study published in the JAMA Internal Medicine, first-degree family history was associated with an increased risk of breast cancer among women ages 65 to 74 years (hazard ratio [HR], 1.48; 95% CI, 1.35-1.61) and 75 years and older (HR, 1.44; 95% CI, 1.28-1.62). 16 In our study, only one case which is 1%, diagnosed at 43 years of age, had a first degree relative, her mother, with breast cancer. None of the cases had any second-degree relative suffering from breast or ovarian cancer.…”

A Retrospective, Observational Study to Determine the Patient and Tumor Characteristics of HER2-Positive Breast Cancer Patients Treated at Five Main Public Cancer Centers in Malaysia

“…A study conducted among ~400,000 women aged 65 years and older reported that first-degree family history was associated with an increased risk of invasive breast cancer among all subgroups. 29 It was observed that the 5-year risk increased by 23% for women with a family history of breast cancer. 29 Another study of 113,000 women in the United Kingdom reported a significant increase in the breast cancer risk in patients with family history.…”

“…29 It was observed that the 5-year risk increased by 23% for women with a family history of breast cancer. 29 Another study of 113,000 women in the United Kingdom reported a significant increase in the breast cancer risk in patients with family history. Women who had two or more relatives with breast cancer had a 2.5-fold increased risk of developing breast cancer.…”