Breast cancer family history does not mean worse prognosis

By Bianca Nogrady
Young women with breast cancer and a family history of the disease can be reassured that their prognosis is no worse than for someone without a family history, researchers say.

Data from a UK prospective cohort study of 2850 patients aged less than 41 years with breast cancer showed there were no significant differences in distant disease­-free intervals between patients with a family history of breast cancer and those without. This was observed regardless of oestrogen receptor status, although the data did show that in the oestrogen receptor­ negative subgroup, patients with a family history actually had a slightly higher distant disease­-free survival rate.

Patients with a family history were significantly more likely to have a tumour that was higher grade and negative for human epidermal growth factor receptor-­2 (HER-­2) than those without a family history, according to the study published in the British Journal of Surgery. Women with a family history of breast cancer were also more likely to undergo mastectomy.

‘Given that median tumour size was the same in both groups and there were not statistically more multifocal cancers in the [positive family history] group, the presence of a family history may have influenced the surgeon and/or woman to choose mastectomy,’ the authors wrote.

Commenting on the study, medical oncologist Professor Kelly­-Anne Phillips said the findings of this well­-designed study should reassure women that their family history does not mean a worse prognosis.

‘Women with newly diagnosed breast cancer and a family history that includes many relatives dying of breast cancer often feel very concerned that their prognosis is poorer than that of women without a family history,’ said Professor Phillips, from the Peter MacCallum Cancer Centre, Melbourne. ‘This study confirms the results of previous research done by our group and others that show that family history does not affect breast cancer prognosis.’

However, Professor Phillips told Medicine Today that it is important to distinguish between the risk of metastatic disease and the risk of a new primary breast cancer. ‘The risk of a new primary for women with a strong family history who carry a breast gene mutation is significantly higher.’

Br J Surgery 2015; 102: 924-935, doi: 10.1002/bjs.9816.

Picture credit: © GJLP/CNRI/SPL.