The effect of family history on screening procedures and prognosis in breast cancer patients - Results of a large population-based case-control study.

Autor: Seiffert K; University Medical Center Hamburg-Eppendorf, Department of Gynecology, Martinistraße 52, 20246, Hamburg, Germany. Electronic address: k.seiffert@uke.de., Thoene K; Department of Cancer Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany., Eulenburg CZ; University Medical Center Hamburg-Eppendorf, Department of Medical Biometry and Epidemiology, Martinistraße 52, 20246, Hamburg, Germany; University of Groningen, University Medical Center Groningen, Epidemiology, Groningen, the Netherlands., Behrens S; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Schmalfeldt B; University Medical Center Hamburg-Eppendorf, Department of Gynecology, Martinistraße 52, 20246, Hamburg, Germany., Becher H; Department of Cancer Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany., Chang-Claude J; Department of Cancer Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Witzel I; University Medical Center Hamburg-Eppendorf, Department of Gynecology, Martinistraße 52, 20246, Hamburg, Germany.
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2021 Feb; Vol. 55, pp. 98-104. Date of Electronic Publication: 2020 Dec 24.
DOI: 10.1016/j.breast.2020.12.008
Abstrakt: Background: The potential benefit of additional breast cancer screening examinations in moderate risk patients (patients with a history of breast cancer in one or two family members) remains unclear.
Methods: A large population-based case-control study on breast cancer in postmenopausal women in Germany recruited 2002-2005 (3813 cases and 7341 age-matched controls) was used to assess the association of family history with breast cancer risk. Analysis of family history, participation in screening procedures, and tumor size regarding prognosis in patients was based on follow-up data until 2015.
Results: A first degree family history of breast cancer was associated with higher breast cancer risk (OR 1.39, p < 0.001). Patients with a first degree family history of breast cancer were more likely to have had >10 mammograms (MG) (42.7% vs. 24.9%, p < 0.001) and showed a higher rate of imaging-detected tumors (MG or ultrasound) (45.8% vs. 31.9%, p < 0.001). A smaller tumor size at initial diagnosis (below 2 cm) was more likely in patients with a positive family history (OR 1.45, p < 0.001) and a higher number of MG (≥10 MG: OR 2.29). After accounting for tumor characteristics, mammogram regularity (HR 0.72, p < 0.001) and imaging-assisted tumor detection (HR 0.66, p < 0.001) were associated with better overall survival but not with a positive family history.
Discussion: Patients with a positive family history had a higher rate of imaging detected tumors with smaller size at initial diagnosis compared to patients without affected family members. Screening was associated with improved survival after a breast cancer diagnosis, irrespective of a positive family history.
Competing Interests: Declaration of competing interest All authors declare that they have no conflict of interest.
(Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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