gms | German Medical Science

54. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie

07. bis 10.09.2009, Essen

Age of onset in hereditary and familial breast cancer

Meeting Abstract

  • Andreas Brandt - German Cancer Research Center (DKFZ), Heidelberg
  • Justo Lorenzo Bermejo - University of Heidelberg, Heidelberg
  • Jan Sundquist - Lund University, Lund
  • Kari Hemminki - German Cancer Research Center (DKFZ), Heidelberg

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. 54. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds). Essen, 07.-10.09.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09gmds065

DOI: 10.3205/09gmds065, URN: urn:nbn:de:0183-09gmds0654

Veröffentlicht: 2. September 2009

© 2009 Brandt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: A family history is associated with an increased risk of breast cancer. When it includes early onset or bilateral breast cancers and multiple cases of breast or ovarian cancers, it is a strong predictor of hereditary breast cancer. Hereditary breast cancer is associated with an earlier age of onset. One aim of this study was to determine how many years earlier women whose family history indicates a risk of hereditary breast cancer reach the cumulative risk of women lacking a family history. However, most women with affected relatives do not fulfil high-risk criteria. Therefore, the second aim was to derive the corresponding data for women with a mother or sister affected by breast cancer.

Materials and Methods: The nation-wide Swedish Family-Cancer Database includes 12.1 million individuals and 160,000 cases of breast cancer diagnosed from 1958-2006. Women in the Database were grouped according to seven criteria that are applied in clinical practice to identify high-risk women. Cumulative risks of breast cancer were estimated with a stratified Cox model according to the criteria. For women with a mother or sister affected, cumulative risks were calculated according to the diagnostic age of the relative.

Results: In women from high risk groups, the age to reach the same cumulative risk as women without family history at age 50 ranged from 32 to 41 years. For women with affected mother or sister, this age was decreasing with decreasing diagnostic age of mother or sister, ranging from 38 years (mother affected <40 years) to 47 years (sister affected 60–72 years).

Conclusions: Current recommendations on the earlier starting age of screening among high risk women, based on expert opinions, appear largely justified. The present data on the onset age of familial breast cancer outside high-risk groups should encourage further analysis in order to derive evidence-based recommendations.


References

1.
Hemminki K, Granström C, Sundquist J, Lorenzo Bermejo J. The updated Swedish family-cancer database used to assess familial risks of prostate cancer during rapidly increasing incidence Heredit Cancer. Clin Pract. 2006;4:186-92.
2.
Collaborative Group on Hormonal Factors in Breast Cancer. 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. 2001;358:1389-99.
3.
Hemminki K, Sundquist J, Lorenzo Bermejo J. Familial risks for cancer as the basis for evidence-based clinical referral and counseling. Oncologist. 2008;13:239-47.
4.
Hampel H, Sweet K, Westman JA, Offit K, Eng C. Referral for cancer genetics consultation: a review and compilation of risk assessment criteria. J Med Genet. 2004;41(2):81-91.
5.
McIntosh A, Shaw C, Evans G, et al. Clinical Guidelines and Evidence Review for The Classification and Care of Women at Risk of Familial Breast Cancer. London: National Collaborating Centre for Primary Care/University of Sheffield; 2004.
6.
Smith RA, Saslow D, Sawyer KA, et al. American Cancer Society guidelines for breast cancer screening: update 2003. CA Cancer J Clin 2003;53(3):141-69.