Family history and outcome of young patients with breast cancer in the UK (POSH study)

Abstract

Background: Young patients presenting to surgical clinics with breast cancer are usually aware of their family history and frequently believe that a positive family history may adversely affect their prognosis. Tumour pathology and outcomes were compared in young British patients with breast cancer with and without a family history of breast cancer.Methods: Prospective Outcomes in Sporadic versus Hereditary breast cancer (POSH) is a large prospective cohort study of women aged less than 41 years with breast cancer diagnosed and treated in the UK using modern oncological management. Personal characteristics, tumour pathology, treatment and family history of breast/ovarian cancer were recorded. Follow-up data were collected annually.Results: Family history data were available for 2850 patients. No family history was reported by 65⋅9 per cent, and 34⋅1 per cent reported breast/ovarian cancer in at least one first-or second-degree relative. Patients with a family history were more likely to have grade 3 tumours (63⋅3 versus 58⋅9 per cent) and less likely to have human epidermal growth factor receptor 2-positive tumours (24⋅7 versus 28⋅8 per cent) than those with no family history. In multivariable analyses, there were no significant differences in distant disease-free intervals for patients with versus those without a family history, either for the whole cohort (hazard ratio (HR) 0⋅89, 95 per cent c.i. 0⋅76 to 1⋅03; P = 0⋅120) or when stratified by oestrogen receptor (ER) status (ER-negative: HR 0⋅80, 0⋅62 to 1⋅04, P = 0⋅101; ER-positive: HR 0⋅95, 0⋅78 to 1⋅15, P = 0⋅589). Conclusion:Young British patients presenting to breast surgical clinics with a positive family history can be reassured that this is not a significant independent risk factor for breast cancer outcome.

Breast cancer diagnosed before the 40 years: imaging findings and correlation with histology and molecular subtype

“…In this age group malignant lesions are less common, difficult to detect and can more easily be interpreted as benign lesions. In the current study, 61% of the patients had negative family history of breast or ovarian cancer and 75.6% was symptomatic at diagnosis, which is consistent with other studies [9,10]. Our results showed that mammography can provide essential information on the diagnosis of breast cancer in women under 40 years.…”

BRCAness Combined With a Family History of Cancer Is Associated With a Poor Prognosis for Breast Cancer Patients With a High Risk of BRCA Mutations

“…In women aged < 35 or 40 years with a positive first-degree FH of breast or ovarian cancer, the positive FH was not associated with survival. 39,40 However, our present results have shown that a positive FH of breast, ovarian, pancreatic, and/or prostate cancer in…”

Family history of breast cancer and its association with disease severity and mortality

“…With regard to disease‐free survival, recent findings from the UK Prospective Outcomes in Sporadic versus Hereditary breast cancer (POSH) suggested that there is no difference in disease progression between female BC patients with or without a family history, with a HR of 0.89 (95% CI: 0.76–1.03) . It is clinically relevant to know that women with a family history of BC are not necessarily at a greater risk.…”