No evidence of familial correlation in breast cancer metastasis
Department of Health Research and Policy, Stanford University School of Medicine, Redwood Building, Room T204, Stanford, CA, 94305-5405, USA. Breast Cancer Research and Treatment
(Impact Factor: 3.94).
04/2009; 118(3):575-81. DOI: 10.1007/s10549-009-0368-3
Animal experiments support the hypothesis that the metastatic potential of breast cancer is a heritable trait of the host. Our objective was to evaluate correlations in metastasis occurrence in large families with multiple cases of breast cancer. We evaluated correlation among pairs of relatives in the occurrence and timing of distant metastasis using retrospective cohort data from 743 female breast cancer patients in 242 families. We adjusted for correlation in their age at diagnosis, year of diagnosis, educational level, lymph node involvement, and estrogen receptor status. Distant metastasis occurred in 255 patients (34.3%) during mean followup of 11.7 years. None of the correlation coefficients for metastasis in blood relatives differed significantly from zero. The estimated correlation coefficient in first-degree relatives was -0.03 (95% confidence interval -0.11 to 0.06). These findings suggest that a family history of metastatic breast cancer does not contribute substantially to risk of metastasis for breast cancer patients.
Available from: synapse.koreamed.org
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ABSTRACT: Purpose: Axillary lymph node metastasis is one of the most important prognostic factors in breast cancer. Previous reports show differences that clinicopathologic factors influence the systemic recurrence and survival in axillary lymph node negative breast cancer. Thus, we have attempted to determine the prognostic factors influence on the systemic recurrence and survival in axillary lymph node negative breast cancer. Methods: We retrospectively reviewed the data of 1,351 node negative breast cancer patients who underwent curative surgery to determine the prognostic factors such as age, sex, body mass index (BMI), family history, bilateral breast cancer, operation method, tumor size, stage, histologic grade, number of resected lymph nodes, hormone receptor status, overexpression of p53 and c-erbB2, and adjuvant therapy that influence the systemic recurrence and 10-year-distant relapse-free survival. Results: Systemic recurrence occurred in 58 patients (4.3%) during, 53.3 months median follow up period. The tumor size (P=0.001.), stage (P=0.005), histologic grade (P=0.049). ER (P=0.028), PR (P=0.002), overexpression of p53 (P=0.001.) and bilateral breast cancer (P=0.043) were statistically significant factors that influenced the systemic recurrence. In multivariate analysis, only tumor size was associated with the systemic recurrence (P=0.003). Tumor size (P=0.004), histologic grade (P=0.035), ER (P=0.046), PR (P=0.001) and bilateral cancer (P=0.003) were statistically significant factors that influenced 10-year-distant relapse-free survival. Conclusion: The larger tumor size was determined to be an independent prognostic value in axillary lymph node negative breast cancer. (J Korean Surg Soc 2009;77:238-245)
Available from: Massimo Usel
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ABSTRACT: Population-based studies have shown a concordance of breast cancer survival among first-degree relatives (FDRs), suggesting a heritable component. Reasons for such heritability remain to be elucidated. We aimed to determine whether association of breast cancer survival among FDRs is linked to shared patient and tumor characteristics or type of treatment. At the population-based Geneva Breast Cancer Registry, we identified 162 FDR pairs diagnosed with breast cancer. We categorized FDRs into poor, medium and good familial survival risk groups according to breast cancer-specific survival of their proband (mother or sister). We compared patient, tumor and treatment characteristics between categories and calculated standardized mortality ratios (SMRs) and adjusted disease-specific mortality for each group. Breast cancer patients in the poor familial survival risk group were more likely to be diagnosed at later stages than those in the good familial survival risk group. Similarly, they had higher SMRs than those in the medium and good survival risk groups (18.7, 95% confidence interval [CI]: 9.4-33.5 vs. 16.5, 95% CI: 7.5-31.3 and 9.4, 95% CI: 3.4-20.4, respectively). After adjustment for patient and tumor characteristics and type of treatment, women in the poor familial survival risk group were almost five times more likely to die of breast cancer than those in the good familial survival risk group (adjusted hazard ratio 4.8, 95% CI: 1.4-16.4). Our study shows that breast cancer prognosis clusters within families and suggests that the hereditary component is independent of patient and tumor characteristics and type of treatment.
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ABSTRACT: Background: Breast cancer is one of the most common malignancies in women and its metastasis plays an important role in mortality, treatment failures and complications. The objective of this study was to evaluate the risk factors of metastatic breast cancer. Methods: In a retrospective cohort study, breast cancer patients in Isfahan, Iran were followed up for ten years. The existence of metastasis was considered as the dependent variable while independent variables included age at diagnosis, hormone receptor status, family history, number of lymph nodes dissected in surgery and involved ones, number of pregnancies, age at first pregnancy and menarche, menstrual status, histopathology and tumor size. All data was collected from patients' profiles and analyzed using logistic regression in SPSS16. Findings: A total of 685 patients with breast cancer were studied during 1999-2009. While 91.4% of cases had no metastasis, distant metastasis was found in 8.6% of subjects. Sites of metastasis according to prevalence were lung (4.7%), bone (2.6%), other organs (1.1%), and liver (0.3%). Number of involved lymph nodes (P = 0.043) and number of pregnancies (P = 0.022) had significant relationships with metastasis. Conclusion: We concluded that less pregnancies and more involved lymph nodes indicate a high probability of metastasis occurrence. Therefore, survival improvement might be possible with early diagnosis of breast cancer, using prophylactic treatments, and identifying metastatic cases by diagnostic tests.
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