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Breast Cancer Research and Treatment

pp 1–8

First Online: 03 June 2017Received: 25 May 2017Accepted: 29 May 2017DOI: 10.1007-s10549-017-4325-2

Cite this article as: Brewer, H.R., Jones, M.E., Schoemaker, M.J. et al. Breast Cancer Res Treat 2017. doi:10.1007-s10549-017-4325-2


PurposeFamily history is an important risk factor for breast cancer incidence, but the parameters conventionally used to categorize it are based solely on numbers and-or ages of breast cancer cases in the family and take no account of the size and age-structure of the woman’s family.

MethodsUsing data from the Generations Study, a cohort of over 113,000 women from the general UK population, we analyzed breast cancer risk in relation to first-degree family history using a family history score FHS that takes account of the expected number of family cases based on the family’s age-structure and national cancer incidence rates.

ResultsBreast cancer risk increased significantly Ptrend < 0.0001 with greater FHS. There was a 3.5-fold 95% CI 2.56–4.79 range of risk between the lowest and highest FHS groups, whereas women who had two or more relatives with breast cancer, the strongest conventional familial risk factor, had a 2.5-fold 95% CI 1.83–3.47 increase in risk. Using likelihood ratio tests, the best model for determining breast cancer risk due to family history was that combining FHS and age of relative at diagnosis.

ConclusionsA family history score based on expected as well as observed breast cancers in a family can give greater risk discrimination on breast cancer incidence than conventional parameters based solely on cases in affected relatives. Our modeling suggests that a yet stronger predictor of risk might be a combination of this score and age at diagnosis in relatives.

KeywordsBreast cancer Risk factors Cohort study Family history AbbreviationsFHSFamily history score

GSGenerations study

HRHazard ratio

CIConfidence interval

SIRStandard incidence ratio

DCISDuctal carcinoma in situ

Electronic supplementary materialThe online version of this article doi:10.1007-s10549-017-4325-2 contains supplementary material, which is available to authorized users.

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Autor: Hannah R. Brewer - Michael E. Jones - Minouk J. Schoemaker - Alan Ashworth - Anthony J. Swerdlow


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