Skip to main content

Advertisement

SpringerLink
Log in

Population-based estimates of the relation between breast cancer risk, tumor subtype, and family history

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Objective Many studies that have estimated the breast cancer risk attributable to family history have been based on data collected within family units. Use of this study design has likely overestimated risks for the general population. We provide population-based estimates of breast cancer risk and different tumor subtypes in relation to the degree, number, and age at diagnosis of affected relatives. Methods Cox Proportional Hazards to calculate risks (hazard ratios; 95% confidence interval) of breast cancer and tumor subtypes for women with a family history of breast cancer relative to women without a family history among a cohort of 75,189 women age ≥40 years of whom 1,087 were diagnosed with breast cancer from June 1, 2001–December 31, 2005 (median follow-up 3.16 years). Results Breast cancer risk was highest for women with a first-degree family history (1.54; 1.34–1.77); and did not differ substantially by the affected relative’s age at diagnosis or by number of affected first-degree relatives. A second-degree family history only was not associated with a significantly increased breast cancer risk (1.15; 0.98–1.35). There was a suggestion that a positive family history was associated with risk of triple positive (Estrogen+/Progesterone+/HER2+) and HER2-overexpressing tumors. Conclusions While a family history of breast cancer in first-degree relatives is an important risk factor for breast cancer, gathering information such as the age at diagnosis of affected relatives or information on second-degree relative history may be unnecessary in assessing personal breast cancer risk among women age ≥40 years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sattin RW, Rubin GL, Webster LA et al (1985) Family history and the risk of breast cancer. JAMA 253(13):1908–1913

    Article  PubMed  CAS  Google Scholar 

  2. Colditz GA, Willett WC, Hunter DJ et al (1993) Family history, age and risk of breast cancer: prospective data from the nurses’ health study. JAMA 270(3):338–343

    Article  PubMed  CAS  Google Scholar 

  3. Parazzini F, La Vecchia C, Negri E et al (1993) Family history of breast, ovarian and endometrial cancer and risk of breast cancer. Int J Epidemiol 22(4):614–618

    Article  PubMed  CAS  Google Scholar 

  4. Muhonen T, Eerola H, Vehmanen P et al (1997) Breast cancer risk estimation in families with history of breast cancer. Br J Cancer 76(9):1228–1231

    PubMed  CAS  Google Scholar 

  5. Negri E, Braga C, La Vecchia C et al (1997) Family history of cancer and risk of breast cancer. Int J Cancer 72(5):735–738

    Article  PubMed  CAS  Google Scholar 

  6. Pharoah PDP, Day NE, Duffy S et al (1997) Family history and the risk of breast cancer: a systematic review and meta-analysis. Int J Cancer 71(5):800–809

    Article  PubMed  CAS  Google Scholar 

  7. Anderson H, Bladström A, Olsson H et al (2000) Familial breast and ovarian cancer: a Swedish population-based register study. Am J Epidemiol 152(12):1154–1163

    Article  PubMed  CAS  Google Scholar 

  8. Dumitrescu RG, Cotarla I (2005) Understanding breast cancer risk—where do we stand in 2005? J Cell Mol Med 9(1):208–221

    Article  PubMed  CAS  Google Scholar 

  9. Hopper JL, Bishop DT, Easton DF (2005) Population-based family studies in genetic epidemiology. Lancet 366(9494):1397–1406

    Article  PubMed  Google Scholar 

  10. Crest AB, Aiello EJ, Anderson ML et al (2006) Varying levels of family history of breast cancer in relation to mammographic breast density (United States). Cancer Causes Control 17(6):843–850

    Article  PubMed  Google Scholar 

  11. Lehrer S, Lee P, Tartter P et al (1995) Breast cancer and family history: a multivariate analysis of levels of tumor HER2 protein and family history of cancer in women who have breast cancer. Mt Sinai J Med 62(6):415–418

    PubMed  CAS  Google Scholar 

  12. Tutera AM, Sellers TA, Potter JD et al (1996) Association between family history of cancer and breast cancer defined by estrogen and progesterone receptor status. Genet Epidemiol 13(2):207–221

    Article  PubMed  CAS  Google Scholar 

  13. Huang WY, Newman B, Millikan RC et al (2000) Risk of breast cancer according to the status of HER-2/neu oncogene amplification. Cancer Epidemiol Biomarkers Prev 9(1):65–71

    PubMed  CAS  Google Scholar 

  14. Gavrilov I, Nacheva M, Tzingilev D (2002) Familial breast cancer. Part II: relationships with histology, staging, steroid receptors and serum tumor markers. J BUON 7(1):61–65

    PubMed  CAS  Google Scholar 

  15. Yang XR, Sherman ME, Rimm DL et al (2007) Differences in risk factors for breast cancer molecular subtypes in a population-based study. Cancer Epidemiol Biomarkers Prev 16(3):439–443

    Article  PubMed  CAS  Google Scholar 

  16. Althuis MD, Fergenbaum JH, Garcia-Closas M et al (2004) Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomarkers Prev 13(10):1558–1568

    PubMed  CAS  Google Scholar 

  17. Sørlie T, Perou CM, Tibshirani R et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci U S A 98(19):10869–10874

    Article  PubMed  Google Scholar 

  18. Carey LA, Perou CM, Livasy CA et al (2006) Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA 295(21):2492–2502

    Article  PubMed  CAS  Google Scholar 

  19. Taplin SH, Thompson RS, Schnitzer F et al (1990) Revisions in the risk-based Breast Cancer Screening Program at Group Health Cooperative. Cancer 66(4):812–818

    Article  PubMed  CAS  Google Scholar 

  20. Taplin SH, Mandelson MT, Anderman C et al (1997) Mammography diffusion and trends in late-state breast cancer: evaluating outcomes in a population. Cancer Epidemiol Biomarkers Prev 6(8):625–631

    PubMed  CAS  Google Scholar 

  21. Taplin SH, Ichikawa L, Buist DS et al (2004) Evaluating organized breast cancer screening implementation: the prevention of late-state disease? Cancer Epidemiol Biomarkers Prev 13(2):225–234

    Article  PubMed  Google Scholar 

  22. Group Health Cooperative Breast Cancer Screening Schedule (1992) Available via: http://www.centerforhealthstudies.org/surveillanceproject/overview/screening-schedule.html. Cited 9 April 2008

  23. Cox DR, Oakes D (1984) Analysis of survival data. Chapman & Hall, London

    Google Scholar 

  24. Perou CM, Sørlie T, Elsen MB et al (2000) Molecular portraits of human breast tumours. Nature 406(6797):747–752

    Article  PubMed  CAS  Google Scholar 

  25. Sørlie T, Tibshirani R, Parker J et al (2003) Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci U S A 100(14):8418–8423

    Article  PubMed  CAS  Google Scholar 

  26. American College of Radiology (2003) Breast imaging reporting and data system (BI-RADS™), 4th edn. American College of Radiology, Reston, VA

    Google Scholar 

  27. Hosmer DW, Lemeshow S (1999) Applied Survival analysis: regression modeling of time to event data. John Wiley, Inc., New York

    Google Scholar 

  28. StataCorp (2005) Stata statistical software: release 9. StataCorp LP, College Station, TX

    Google Scholar 

  29. Collaborative Group on Hormonal Factors in Breast Cancer (2001) Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease. Lancet 358(9291):1389–1399

    Article  Google Scholar 

  30. Calle EE, Martin LM, Thun MJ et al (1993) Family history, age, and risk of fatal breast cancer. Am J Epidemiol 138(9):675–681

    PubMed  CAS  Google Scholar 

  31. Ziogas A, Anton-Culver H (2003) Validation of family history data in cancer family registries. Am J Prev Med 24(2):190–198

    Article  PubMed  Google Scholar 

  32. Murff HJ, Spigel DR, Syngal S (2004) Does this patient have a family history of cancer? An evidence-based analysis of the accuracy of family cancer history. JAMA 292(12):1480–1489

    Article  PubMed  CAS  Google Scholar 

  33. Coliditz GA, Rosner BA, Chen WY et al (2004) Risk factors for breast cancer according to estrogen and progesterone receptor status. J Natl Cancer Inst 96(3):218–228

    Article  Google Scholar 

  34. Swede H, Moysich KB, Freudenheim JL et al (2001) Breast cancer risk factors and HER2 over-expression in tumors. Cancer Detect Prev 25(6):511–519

    PubMed  CAS  Google Scholar 

  35. Cooper JA, Rohan TE, Cant EL et al (1989) Risk factors for breast cancer by oestrogen receptor status: a population-based case–control study. Br J Cancer 59(1):119–125

    PubMed  CAS  Google Scholar 

  36. Lakhani SR, Van De Vijver MJ, Jacquemier J et al (2002) The pathology of familial breast cancer: predictive value of immunohistochemical markers estrogen receptor, progesterone receptor, HER-2, and p53 in patients with mutations in BRCA1 and BRCA2. J Clin Oncol 20(9):2310–2318

    Article  PubMed  CAS  Google Scholar 

  37. Sellers TA, Kushi LH, Potter JD et al (1993) Effect of family history, body-fat distribution, and reproductive factors on the risk of postmenopausal breast cancer. N Engl J Med 326(20):1323–1329

    Google Scholar 

  38. Yankaskas BC (2005–2006) Epidemiology of breast cancer in young women. Breast Dis 23(1):3–8

    Google Scholar 

  39. Ries LAG, Melbert D, Krapcho M et al. (2007) SEER cancer statistics review, 1975–2004. National Cancer Institute, Bethesda, MD. http://seer.cancer.gov/csr/1975_2004/, based on November 2006 SEER data submission, posted to the SEER web site

  40. Hall IJ, Burke W, Coughlin S et al (2001) Population-based estimates of the prevalence of family history of cancer among women. Community Genet 4(3):134–142

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors wish to acknowledge Julia Hecht and Walter Clinton for their assistance in creating the dataset used in our analyses. Funding/Support: Design and conduct of the study; collection, management, and interpretation of the data; review and approval of the manuscript were supported by the Breast Cancer Surveillance Consortium: Breast Cancer Surveillance in a Defined Population from the National Cancer Institute (CA063731), D. Buist, Principal Investigator. Analysis of the data and manuscript preparation were supported by the UW Multidisciplinary Predoctoral Clinical Research Training Program—a Roadmap Initiative from the National Institutes of Health/National Center for Research Resources (T32 RR023256), P. Mitchell and S. Marshall, Program Directors.

Author information

Authors and Affiliations

  1. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Megan L. Welsh, Diana S. M. Buist, Joann G. Elmore & Christopher I. Li

  2. Fred Hutchinson Cancer Research Center, Mailstop: D1-100, 1100 Fairview Avenue North, Seattle, WA, 98109, USA

    Megan L. Welsh, Diana S. M. Buist & Christopher I. Li

  3. Group Health Center for Health Studies, Seattle, WA, USA

    Diana S. M. Buist, Erin J. Aiello Bowles & Melissa L. Anderson

  4. Department of Internal Medicine, University of Washington, Seattle, WA, USA

    Joann G. Elmore

Authors
  1. Megan L. Welsh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Diana S. M. Buist
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erin J. Aiello Bowles
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Melissa L. Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joann G. Elmore
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christopher I. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Megan L. Welsh.

Appendices

Appendices

Appendix A Description of family history classification for study subjects
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Welsh, M.L., Buist, D.S.M., Aiello Bowles, E.J. et al. Population-based estimates of the relation between breast cancer risk, tumor subtype, and family history. Breast Cancer Res Treat 114, 549–558 (2009). https://doi.org/10.1007/s10549-008-0026-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-008-0026-1

Keywords

Search

Navigation