Family history and breast cancer risk among older women in the breast cancer surveillance consortium cohort

Breast Cancer Surveillance Consortium

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

IMPORTANCE First-degree family history is a strong risk factor for breast cancer, but controversy exists about the magnitude of the association among older women. OBJECTIVE To determine whether first-degree family history is associated with increased risk of breast cancer among older women, and identify whether the association varies by breast density. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study between 1996 and 2012 from 7 Breast Cancer Surveillance Consortium (BCSC) registries located in New Hampshire, North Carolina, San Francisco Bay area, westernWashington state, New Mexico, Colorado, and Vermont. During a mean (SD) follow-up of 6.3 (3.2) years, 10 929 invasive breast cancers were diagnosed in a cohort of 403 268 women 65 years and older with data from 472 220 mammography examinations.We estimated the 5-year cumulative incidence of invasive breast cancer by first-degree family history, breast density, and age groups. Cox proportional hazards models were fit to estimate the association of first-degree family history with risk of invasive breast cancer (after adjustment for breast density, BCSC registry, race/ethnicity, body mass index, postmenopausal hormone therapy use, and benign breast disease for age groups 65 to 74 years and 75 years and older, separately). Data analyses were performed between June 2016 and June 2017. EXPOSURE First-degree family history of breast cancer. MAIN OUTCOMES AND MEASURES Incident breast cancer. RESULTS In 403 268 women 65 years and older, first-degree family history was associated with an increased risk of breast cancer among women ages 65 to 74 years (hazard ratio [HR], 1.48; 95%CI, 1.35-1.61) and 75 years and older (HR, 1.44; 95%CI, 1.28-1.62). Estimates were similar for women 65 to 74 years with first-degree relative's diagnosis age younger than 50 years (HR, 1.47; 95%CI, 1.25-1.73) vs 50 years and older (HR, 1.33; 95%CI, 1.17-1.51) and for women ages 75 years and older with the relative's diagnosis age younger than 50 years (HR, 1.31; 95%CI, 1.05-1.63) vs 50 years and older (HR, 1.55; 95%CI, 1.33-1.81). Among women ages 65 to 74 years, the risk associated with first-degree family history was highest among those with fatty breasts (HR, 1.67; 95%CI, 1.27-2.21), whereas in women 75 years and older the risk associated with family history was highest among those with dense breasts (HR, 1.55; 95%CI, 1.29-1.87). CONCLUSIONS AND RELEVANCE First-degree family history was associated with increased risk of invasive breast cancer in all subgroups of older women irrespective of a relative's age at diagnosis.

Original languageEnglish (US)
Pages (from-to)494-501
Number of pages8
JournalJAMA Internal Medicine
Volume178
Issue number4
DOIs
StatePublished - Apr 1 2018

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Breast Neoplasms
Registries
Breast
Age Groups
Breast Diseases
San Francisco
Mammography
Proportional Hazards Models
Body Mass Index
Cohort Studies
Hormones
Prospective Studies
Incidence
Breast Density

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Family history and breast cancer risk among older women in the breast cancer surveillance consortium cohort. / Breast Cancer Surveillance Consortium.

In: JAMA Internal Medicine, Vol. 178, No. 4, 01.04.2018, p. 494-501.

Research output: Contribution to journalReview article

@article{76d97bb4977243b8a41da49958e10f4e,
title = "Family history and breast cancer risk among older women in the breast cancer surveillance consortium cohort",
abstract = "IMPORTANCE First-degree family history is a strong risk factor for breast cancer, but controversy exists about the magnitude of the association among older women. OBJECTIVE To determine whether first-degree family history is associated with increased risk of breast cancer among older women, and identify whether the association varies by breast density. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study between 1996 and 2012 from 7 Breast Cancer Surveillance Consortium (BCSC) registries located in New Hampshire, North Carolina, San Francisco Bay area, westernWashington state, New Mexico, Colorado, and Vermont. During a mean (SD) follow-up of 6.3 (3.2) years, 10 929 invasive breast cancers were diagnosed in a cohort of 403 268 women 65 years and older with data from 472 220 mammography examinations.We estimated the 5-year cumulative incidence of invasive breast cancer by first-degree family history, breast density, and age groups. Cox proportional hazards models were fit to estimate the association of first-degree family history with risk of invasive breast cancer (after adjustment for breast density, BCSC registry, race/ethnicity, body mass index, postmenopausal hormone therapy use, and benign breast disease for age groups 65 to 74 years and 75 years and older, separately). Data analyses were performed between June 2016 and June 2017. EXPOSURE First-degree family history of breast cancer. MAIN OUTCOMES AND MEASURES Incident breast cancer. RESULTS In 403 268 women 65 years and older, first-degree family history was associated with an increased risk of breast cancer among women ages 65 to 74 years (hazard ratio [HR], 1.48; 95{\%}CI, 1.35-1.61) and 75 years and older (HR, 1.44; 95{\%}CI, 1.28-1.62). Estimates were similar for women 65 to 74 years with first-degree relative's diagnosis age younger than 50 years (HR, 1.47; 95{\%}CI, 1.25-1.73) vs 50 years and older (HR, 1.33; 95{\%}CI, 1.17-1.51) and for women ages 75 years and older with the relative's diagnosis age younger than 50 years (HR, 1.31; 95{\%}CI, 1.05-1.63) vs 50 years and older (HR, 1.55; 95{\%}CI, 1.33-1.81). Among women ages 65 to 74 years, the risk associated with first-degree family history was highest among those with fatty breasts (HR, 1.67; 95{\%}CI, 1.27-2.21), whereas in women 75 years and older the risk associated with family history was highest among those with dense breasts (HR, 1.55; 95{\%}CI, 1.29-1.87). CONCLUSIONS AND RELEVANCE First-degree family history was associated with increased risk of invasive breast cancer in all subgroups of older women irrespective of a relative's age at diagnosis.",
author = "{Breast Cancer Surveillance Consortium} and Dejana Braithwaite and Miglioretti, {Diana L} and Weiwei Zhu and Joshua Demb and Amy Trentham-Dietz and Brian Sprague and Tice, {Jeffrey A.} and Tracy Onega and Henderson, {Louise M.} and Buist, {Diana S.M.} and Elad Ziv and Walter, {Louise C.} and Karla Kerlikowske and Andrew Avins and Thad Benefield and Bowles, {Erin Aiello} and Mark Bowman and David Burian and Mike Butler and Elyse Chiapello and Rachael Chicoine and Firas Dabbous and {De Bie}, Evan and Tammy Dodd and Therese Dolecek and Scottie Eliassen and Kevin Filocamo and Pete Frawley and Hongyuan Gao and Charlotte Gard and Berta Geller and Martha Goodrich and Greenwood-Hickman, {Mikael Anne} and Cindy Groseclose and Sally Herschorn and Michael Hofmann and Alejandro Hughes and Rebecca Hubbard and Tiffany Hoots and Kathleen Howe and Laura Ichikawa and Bonnie Joe and Doug Kane and Gabe Knop and Casey Luce and Lin Ma and Terry Macarol and John Mace and Jennifer Maeser and Kathy Malvin",
year = "2018",
month = "4",
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language = "English (US)",
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pages = "494--501",
journal = "JAMA Internal Medicine",
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TY - JOUR

T1 - Family history and breast cancer risk among older women in the breast cancer surveillance consortium cohort

AU - Breast Cancer Surveillance Consortium

AU - Braithwaite, Dejana

AU - Miglioretti, Diana L

AU - Zhu, Weiwei

AU - Demb, Joshua

AU - Trentham-Dietz, Amy

AU - Sprague, Brian

AU - Tice, Jeffrey A.

AU - Onega, Tracy

AU - Henderson, Louise M.

AU - Buist, Diana S.M.

AU - Ziv, Elad

AU - Walter, Louise C.

AU - Kerlikowske, Karla

AU - Avins, Andrew

AU - Benefield, Thad

AU - Bowles, Erin Aiello

AU - Bowman, Mark

AU - Burian, David

AU - Butler, Mike

AU - Chiapello, Elyse

AU - Chicoine, Rachael

AU - Dabbous, Firas

AU - De Bie, Evan

AU - Dodd, Tammy

AU - Dolecek, Therese

AU - Eliassen, Scottie

AU - Filocamo, Kevin

AU - Frawley, Pete

AU - Gao, Hongyuan

AU - Gard, Charlotte

AU - Geller, Berta

AU - Goodrich, Martha

AU - Greenwood-Hickman, Mikael Anne

AU - Groseclose, Cindy

AU - Herschorn, Sally

AU - Hofmann, Michael

AU - Hughes, Alejandro

AU - Hubbard, Rebecca

AU - Hoots, Tiffany

AU - Howe, Kathleen

AU - Ichikawa, Laura

AU - Joe, Bonnie

AU - Kane, Doug

AU - Knop, Gabe

AU - Luce, Casey

AU - Ma, Lin

AU - Macarol, Terry

AU - Mace, John

AU - Maeser, Jennifer

AU - Malvin, Kathy

PY - 2018/4/1

Y1 - 2018/4/1

N2 - IMPORTANCE First-degree family history is a strong risk factor for breast cancer, but controversy exists about the magnitude of the association among older women. OBJECTIVE To determine whether first-degree family history is associated with increased risk of breast cancer among older women, and identify whether the association varies by breast density. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study between 1996 and 2012 from 7 Breast Cancer Surveillance Consortium (BCSC) registries located in New Hampshire, North Carolina, San Francisco Bay area, westernWashington state, New Mexico, Colorado, and Vermont. During a mean (SD) follow-up of 6.3 (3.2) years, 10 929 invasive breast cancers were diagnosed in a cohort of 403 268 women 65 years and older with data from 472 220 mammography examinations.We estimated the 5-year cumulative incidence of invasive breast cancer by first-degree family history, breast density, and age groups. Cox proportional hazards models were fit to estimate the association of first-degree family history with risk of invasive breast cancer (after adjustment for breast density, BCSC registry, race/ethnicity, body mass index, postmenopausal hormone therapy use, and benign breast disease for age groups 65 to 74 years and 75 years and older, separately). Data analyses were performed between June 2016 and June 2017. EXPOSURE First-degree family history of breast cancer. MAIN OUTCOMES AND MEASURES Incident breast cancer. RESULTS In 403 268 women 65 years and older, first-degree family history was associated with an increased risk of breast cancer among women ages 65 to 74 years (hazard ratio [HR], 1.48; 95%CI, 1.35-1.61) and 75 years and older (HR, 1.44; 95%CI, 1.28-1.62). Estimates were similar for women 65 to 74 years with first-degree relative's diagnosis age younger than 50 years (HR, 1.47; 95%CI, 1.25-1.73) vs 50 years and older (HR, 1.33; 95%CI, 1.17-1.51) and for women ages 75 years and older with the relative's diagnosis age younger than 50 years (HR, 1.31; 95%CI, 1.05-1.63) vs 50 years and older (HR, 1.55; 95%CI, 1.33-1.81). Among women ages 65 to 74 years, the risk associated with first-degree family history was highest among those with fatty breasts (HR, 1.67; 95%CI, 1.27-2.21), whereas in women 75 years and older the risk associated with family history was highest among those with dense breasts (HR, 1.55; 95%CI, 1.29-1.87). CONCLUSIONS AND RELEVANCE First-degree family history was associated with increased risk of invasive breast cancer in all subgroups of older women irrespective of a relative's age at diagnosis.

AB - IMPORTANCE First-degree family history is a strong risk factor for breast cancer, but controversy exists about the magnitude of the association among older women. OBJECTIVE To determine whether first-degree family history is associated with increased risk of breast cancer among older women, and identify whether the association varies by breast density. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study between 1996 and 2012 from 7 Breast Cancer Surveillance Consortium (BCSC) registries located in New Hampshire, North Carolina, San Francisco Bay area, westernWashington state, New Mexico, Colorado, and Vermont. During a mean (SD) follow-up of 6.3 (3.2) years, 10 929 invasive breast cancers were diagnosed in a cohort of 403 268 women 65 years and older with data from 472 220 mammography examinations.We estimated the 5-year cumulative incidence of invasive breast cancer by first-degree family history, breast density, and age groups. Cox proportional hazards models were fit to estimate the association of first-degree family history with risk of invasive breast cancer (after adjustment for breast density, BCSC registry, race/ethnicity, body mass index, postmenopausal hormone therapy use, and benign breast disease for age groups 65 to 74 years and 75 years and older, separately). Data analyses were performed between June 2016 and June 2017. EXPOSURE First-degree family history of breast cancer. MAIN OUTCOMES AND MEASURES Incident breast cancer. RESULTS In 403 268 women 65 years and older, first-degree family history was associated with an increased risk of breast cancer among women ages 65 to 74 years (hazard ratio [HR], 1.48; 95%CI, 1.35-1.61) and 75 years and older (HR, 1.44; 95%CI, 1.28-1.62). Estimates were similar for women 65 to 74 years with first-degree relative's diagnosis age younger than 50 years (HR, 1.47; 95%CI, 1.25-1.73) vs 50 years and older (HR, 1.33; 95%CI, 1.17-1.51) and for women ages 75 years and older with the relative's diagnosis age younger than 50 years (HR, 1.31; 95%CI, 1.05-1.63) vs 50 years and older (HR, 1.55; 95%CI, 1.33-1.81). Among women ages 65 to 74 years, the risk associated with first-degree family history was highest among those with fatty breasts (HR, 1.67; 95%CI, 1.27-2.21), whereas in women 75 years and older the risk associated with family history was highest among those with dense breasts (HR, 1.55; 95%CI, 1.29-1.87). CONCLUSIONS AND RELEVANCE First-degree family history was associated with increased risk of invasive breast cancer in all subgroups of older women irrespective of a relative's age at diagnosis.

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