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Family history, age, and risk of breast cancer. Prospective data from the Nurses' Health Study.

Abstract

OBJECTIVE

To examine prospectively the risk of breast cancer as influenced by a maternal history of breast cancer, the mother's age at diagnosis, or a sister's history of breast cancer.

DESIGN

Prospective cohort study with biennial follow-up.

SETTING/PARTICIPANTS

117,988 women in the Nurses' Health Study aged 30 to 55 years in 1976, followed up through 1988 (1.3 million person-years of follow-up).

RESULTS

We identified 2389 incident cases of invasive breast cancer. Compared with women without a maternal history of breast cancer, the age-adjusted relative risk (RR) of breast cancer was highest among women whose mother was diagnosed before the age of 40 years (RR, 2.1 [95% confidence interval, 1.6 to 2.8]). The RR decreased with advancing maternal age at time of diagnosis to 1.5 (95% confidence interval, 1.1 to 2.2) for maternal diagnosis after the age of 70 years. Having a sister with a history of breast cancer also was related to increased risk; for women with one sister with breast cancer compared with those with one sister without such a history, the age-adjusted RR was 2.3 (95% confidence interval, 1.6 to 3.4). Women whose mother and sister both had a history of breast cancer had an RR of 2.5 (95% confidence interval, 1.5 to 4.2) compared with those without a family history. These associations did not differ appreciably when stratified by age; menopausal status; history of benign breast disease; body mass index; age at menarche; or parity or age at first birth of the women at risk. The results remained unchanged when we controlled for these risk factors in multivariate models. Despite slightly greater mammography surveillance and earlier detection of tumors among women with a family history of breast cancer, detection bias is unlikely to account for more than a small part of the observed association.

CONCLUSIONS

Risk of breast cancer is approximately doubled among women whose mother had breast cancer diagnosed before the age of 40 years or who have a sister with breast cancer, and remains elevated even for those whose mothers were diagnosed with breast cancer at the age of 70 years or older. However, the risk associated with a mother or sister history of breast cancer is smaller than suggested by earlier retrospective studies. Overall, within this population of middle-aged women, only 2.5% of breast cancer cases are attributable to a positive family history.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Medicine, Brigham and Women's Hospital, Boston, MA.

    , , , , ,

    Source

    JAMA 270:3 1993 Jul 21 pg 338-43

    MeSH

    Adult
    Age Factors
    Breast Neoplasms
    Family
    Female
    Follow-Up Studies
    Humans
    Incidence
    Medical History Taking
    Middle Aged
    Population Surveillance
    Prospective Studies
    Risk Factors
    United States

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    8123079

    Citation

    Colditz, G A., et al. "Family History, Age, and Risk of Breast Cancer. Prospective Data From the Nurses' Health Study." JAMA, vol. 270, no. 3, 1993, pp. 338-43.
    Colditz GA, Willett WC, Hunter DJ, et al. Family history, age, and risk of breast cancer. Prospective data from the Nurses' Health Study. JAMA. 1993;270(3):338-43.
    Colditz, G. A., Willett, W. C., Hunter, D. J., Stampfer, M. J., Manson, J. E., Hennekens, C. H., & Rosner, B. A. (1993). Family history, age, and risk of breast cancer. Prospective data from the Nurses' Health Study. JAMA, 270(3), pp. 338-43.
    Colditz GA, et al. Family History, Age, and Risk of Breast Cancer. Prospective Data From the Nurses' Health Study. JAMA. 1993 Jul 21;270(3):338-43. PubMed PMID: 8123079.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Family history, age, and risk of breast cancer. Prospective data from the Nurses' Health Study. AU - Colditz,G A, AU - Willett,W C, AU - Hunter,D J, AU - Stampfer,M J, AU - Manson,J E, AU - Hennekens,C H, AU - Rosner,B A, PY - 1993/7/21/pubmed PY - 1993/7/21/medline PY - 1993/7/21/entrez SP - 338 EP - 43 JF - JAMA JO - JAMA VL - 270 IS - 3 N2 - OBJECTIVE: To examine prospectively the risk of breast cancer as influenced by a maternal history of breast cancer, the mother's age at diagnosis, or a sister's history of breast cancer. DESIGN: Prospective cohort study with biennial follow-up. SETTING/PARTICIPANTS: 117,988 women in the Nurses' Health Study aged 30 to 55 years in 1976, followed up through 1988 (1.3 million person-years of follow-up). RESULTS: We identified 2389 incident cases of invasive breast cancer. Compared with women without a maternal history of breast cancer, the age-adjusted relative risk (RR) of breast cancer was highest among women whose mother was diagnosed before the age of 40 years (RR, 2.1 [95% confidence interval, 1.6 to 2.8]). The RR decreased with advancing maternal age at time of diagnosis to 1.5 (95% confidence interval, 1.1 to 2.2) for maternal diagnosis after the age of 70 years. Having a sister with a history of breast cancer also was related to increased risk; for women with one sister with breast cancer compared with those with one sister without such a history, the age-adjusted RR was 2.3 (95% confidence interval, 1.6 to 3.4). Women whose mother and sister both had a history of breast cancer had an RR of 2.5 (95% confidence interval, 1.5 to 4.2) compared with those without a family history. These associations did not differ appreciably when stratified by age; menopausal status; history of benign breast disease; body mass index; age at menarche; or parity or age at first birth of the women at risk. The results remained unchanged when we controlled for these risk factors in multivariate models. Despite slightly greater mammography surveillance and earlier detection of tumors among women with a family history of breast cancer, detection bias is unlikely to account for more than a small part of the observed association. CONCLUSIONS: Risk of breast cancer is approximately doubled among women whose mother had breast cancer diagnosed before the age of 40 years or who have a sister with breast cancer, and remains elevated even for those whose mothers were diagnosed with breast cancer at the age of 70 years or older. However, the risk associated with a mother or sister history of breast cancer is smaller than suggested by earlier retrospective studies. Overall, within this population of middle-aged women, only 2.5% of breast cancer cases are attributable to a positive family history. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/8123079/Family_history_age_and_risk_of_breast_cancer__Prospective_data_from_the_Nurses'_Health_Study_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/270/pg/338 DB - PRIME DP - Unbound Medicine ER -