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Family History of Breast Cancer, Breast Density, and Breast Cancer Risk in a U.S. Breast Cancer Screening Population.
Cancer Epidemiol Biomarkers Prev. 2017 06; 26(6):938-944.CE

Abstract

Background:

The utility of incorporating detailed family history into breast cancer risk prediction hinges on its independent contribution to breast cancer risk. We evaluated associations between detailed family history and breast cancer risk while accounting for breast density.

Methods:

We followed 222,019 participants ages 35 to 74 in the Breast Cancer Surveillance Consortium, of whom 2,456 developed invasive breast cancer. We calculated standardized breast cancer risks within joint strata of breast density and simple (1st-degree female relative) or detailed (first-degree, second-degree, or first- and second-degree female relative) breast cancer family history. We fit log-binomial models to estimate age-specific breast cancer associations for simple and detailed family history, accounting for breast density.

Results:

Simple first-degree family history was associated with increased breast cancer risk compared with no first-degree history [Risk ratio (RR), 1.5; 95% confidence interval (CI), 1.0-2.1 at age 40; RR, 1.5; 95% CI, 1.3-1.7 at age 50; RR, 1.4; 95% CI, 1.2-1.6 at age 60; RR, 1.3; 95% CI, 1.1-1.5 at age 70). Breast cancer associations with detailed family history were strongest for women with first- and second-degree family history compared with no history (RR, 1.9; 95% CI, 1.1-3.2 at age 40); this association weakened in higher age groups (RR, 1.2; 95% CI, 0.88-1.5 at age 70). Associations did not change substantially when adjusted for breast density.

Conclusions:

Even with adjustment for breast density, a history of breast cancer in both first- and second-degree relatives is more strongly associated with breast cancer than simple first-degree family history.Impact: Future efforts to improve breast cancer risk prediction models should evaluate detailed family history as a risk factor. Cancer Epidemiol Biomarkers Prev; 26(6); 938-44. ©2017 AACR.

Authors+Show Affiliations

Department of Surgery, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, Vermont. thomas.ahern@med.uvm.edu.Department of Surgery, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, Vermont.Graduate Group in Epidemiology, University of California, Davis, Davis, California.Graduate Group in Epidemiology, University of California, Davis, Davis, California. Group Health Research Institute, Seattle, Washington.Group Health Research Institute, Seattle, Washington.Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California. Department of Medicine, University of California, San Francisco, San Francisco, California.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28096200

Citation

Ahern, Thomas P., et al. "Family History of Breast Cancer, Breast Density, and Breast Cancer Risk in a U.S. Breast Cancer Screening Population." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 26, no. 6, 2017, pp. 938-944.
Ahern TP, Sprague BL, Bissell MCS, et al. Family History of Breast Cancer, Breast Density, and Breast Cancer Risk in a U.S. Breast Cancer Screening Population. Cancer Epidemiol Biomarkers Prev. 2017;26(6):938-944.
Ahern, T. P., Sprague, B. L., Bissell, M. C. S., Miglioretti, D. L., Buist, D. S. M., Braithwaite, D., & Kerlikowske, K. (2017). Family History of Breast Cancer, Breast Density, and Breast Cancer Risk in a U.S. Breast Cancer Screening Population. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 26(6), 938-944. https://doi.org/10.1158/1055-9965.EPI-16-0801
Ahern TP, et al. Family History of Breast Cancer, Breast Density, and Breast Cancer Risk in a U.S. Breast Cancer Screening Population. Cancer Epidemiol Biomarkers Prev. 2017;26(6):938-944. PubMed PMID: 28096200.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Family History of Breast Cancer, Breast Density, and Breast Cancer Risk in a U.S. Breast Cancer Screening Population. AU - Ahern,Thomas P, AU - Sprague,Brian L, AU - Bissell,Michael C S, AU - Miglioretti,Diana L, AU - Buist,Diana S M, AU - Braithwaite,Dejana, AU - Kerlikowske,Karla, Y1 - 2017/01/17/ PY - 2016/10/10/received PY - 2016/12/19/revised PY - 2017/01/05/accepted PY - 2017/1/18/pubmed PY - 2018/3/10/medline PY - 2017/1/19/entrez SP - 938 EP - 944 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 26 IS - 6 N2 - Background: The utility of incorporating detailed family history into breast cancer risk prediction hinges on its independent contribution to breast cancer risk. We evaluated associations between detailed family history and breast cancer risk while accounting for breast density.Methods: We followed 222,019 participants ages 35 to 74 in the Breast Cancer Surveillance Consortium, of whom 2,456 developed invasive breast cancer. We calculated standardized breast cancer risks within joint strata of breast density and simple (1st-degree female relative) or detailed (first-degree, second-degree, or first- and second-degree female relative) breast cancer family history. We fit log-binomial models to estimate age-specific breast cancer associations for simple and detailed family history, accounting for breast density.Results: Simple first-degree family history was associated with increased breast cancer risk compared with no first-degree history [Risk ratio (RR), 1.5; 95% confidence interval (CI), 1.0-2.1 at age 40; RR, 1.5; 95% CI, 1.3-1.7 at age 50; RR, 1.4; 95% CI, 1.2-1.6 at age 60; RR, 1.3; 95% CI, 1.1-1.5 at age 70). Breast cancer associations with detailed family history were strongest for women with first- and second-degree family history compared with no history (RR, 1.9; 95% CI, 1.1-3.2 at age 40); this association weakened in higher age groups (RR, 1.2; 95% CI, 0.88-1.5 at age 70). Associations did not change substantially when adjusted for breast density.Conclusions: Even with adjustment for breast density, a history of breast cancer in both first- and second-degree relatives is more strongly associated with breast cancer than simple first-degree family history.Impact: Future efforts to improve breast cancer risk prediction models should evaluate detailed family history as a risk factor. Cancer Epidemiol Biomarkers Prev; 26(6); 938-44. ©2017 AACR. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/28096200/Family_History_of_Breast_Cancer_Breast_Density_and_Breast_Cancer_Risk_in_a_U_S__Breast_Cancer_Screening_Population_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=28096200 DB - PRIME DP - Unbound Medicine ER -