The effect of family history on screening procedures and prognosis in breast cancer patients - Results of a large population-based case-control study. (February 2021)

• Record Type: Journal Article
• Authors: Seiffert, Katharina; Thoene, Kathrin; Eulenburg, Christine zu; Behrens, Sabine; Schmalfeldt, Barbara; Becher, Heiko; Chang-Claude, Jenny; Witzel, Isabell
• Is Part Of: Breast. Volume 55(2021)
• Page Start: 98
• Page End: 104
• Publication Date: 2021-02
• Subjects: Breast cancer -- Screening -- Familial risk -- Prognosis -- Mammography; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2020.12.008
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: 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. Highlights: Large case-control study with data about family history of breast cancer of 3813 cases and 7341controls and follow-up data. Breast cancer patients with a first degree family history of breast cancer had a higher number of performed mammograms. Breast cancer patients with first degree family history of breast cancer also had a higher rate of imaging-detected tumors. Patients with a positive family history of breast cancer were more likely to have a smaller tumor size at diagnosis. Imaging-assisted tumor detection was associated with better overall survival.