Population-based cohort investigations of the risk for malignant tumors in first-degree relatives and wives of men with breast cancer

Olsson, Håkan; Andersson, Henrik; Johansson, Ola; Möller, T.; Kristoffersson, Ulf; Wenngren, Eva

doi:10.1002/1097-0142(19930215)71:4<1273::aid-cncr2820710417>3.0.co;2-p

Cited by 28 publications

(9 citation statements)

References 14 publications

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“…Critics believe that this arbitrary transfer of information confers inadequate treatment guidelines and undermines a complete understanding of male breast cancer [8,21,22]. In addition, the literature suggests that there may be a different pathological development of breast cancer in men and women and advocates research charting the tumors' discrepancies and reactions to treatment [7][8][9][21][22][23][24][25]. Evident in the confusion relating to drug therapy and the potential side effects of treatment, this lack of evidence-based medicine had direct consequences for my participants.…”

Section: Discussionmentioning

confidence: 99%

Male breast cancer: incompatible and incomparable

Naymark¹

2006

The Journal of Men's Health & Gender

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Background: In recent years, increased advocacy for breast cancer awareness and research has resulted in a vast array of support services and progressive treatment strategies. Although rare, male breast cancer remains a substantial cause for morbidity and mortality in men. This is often explained by its late diagnosis. Method: Six men with breast cancer and five health professionals were interviewed to discuss their experiences with male breast cancer. All data were analyzed thematically. Discussion centered on patient encounters with breast cancer and details of its treatment. Results: Interviews highlighted the gender disparities within breast cancer research, treatment and services. Research into discussions in men's health often emphasizes masculinity as the main hindrance to men accessing health services and seeking medical consultation. However interviews demonstrated additional deterrents that obstruct men with breast cancer from benefiting from a full range of health services. These ranged from gendered assumptions of behavior and needs, inadequate awareness efforts and sources of information to inappropriate support options. Conclusions: Findings suggest that treatment for male breast cancer is hindered by responses and perceptions that are gender contingent. The lack of qualitative effort afforded to the experience of male breast cancer and the transfer of understanding of breast cancer from women to men fosters a misconstrued interpretation and comprehension of breast cancer in men, both medically and socially. Equally, this study demonstrates a need to redefine our current understanding of men's health in order to make services more accessible and compelling to men and that fit current male frameworks for accessing medical advice and coping with illness.

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Section: Discussionmentioning

confidence: 99%

Male breast cancer: incompatible and incomparable

Naymark¹

2006

The Journal of Men's Health & Gender

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“…2,3 Incidence of male breast cancer varies between populations, with higher rates observed among men of African and Jewish ancestry. 3,4 In Israel, male breast cancer rates are higher for Ashkenazi (East European ancestry) than non-Ashkenazi Jews. 5 These observations may be attributable in part to the relatively high carrier frequency (Ͼ2%) of the founder BRCA1 (185delAG; 5382insC) and BRCA2 (6174delT) mutations in the general Ashkenazi population.…”

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confidence: 99%

CHEK2*1100delC and male breast cancer risk in Israel

Ohayon

Gal

Baruch

et al. 2003

Intl Journal of Cancer

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Dear Sir,Fewer than 1% of all breast cancers occur in males. 1 Known risk factors for male breast cancer primarily include Klinefelter syndrome and other clinical conditions associated with aberrant hormonal status (e.g., benign breast disease and gynecomastia, liver cirrhosis, estrogen therapy, testicular pathologies), exposure ionizing radiation and either personal or family history of breast cancer. 2,3 Incidence of male breast cancer varies between populations, with higher rates observed among men of African and Jewish ancestry. 3,4 In Israel, male breast cancer rates are higher for Ashkenazi (East European ancestry) than non-Ashkenazi Jews. 5 These observations may be attributable in part to the relatively high carrier frequency (Ͼ2%) of the founder BRCA1 (185delAG; 5382insC) and BRCA2 (6174delT) mutations in the general Ashkenazi population. 6 Combined, these 3 founder mutations account for Ն17% of all incident Israeli male breast cancer cases, with higher prevalence of mutations detected among Ashkenzi individuals with family history of breast and ovarian cancer. 7,8 In other ethnic populations, BRCA2 mutations account for 4 -14% of male breast cancer cases, 9,10 and as many as 40% in the Icelandic population, where a single founder mutation (BRCA2: 999del5) occurs at a rate of 0.6% in the general population. 11 The proportion of male breast cancer cases attributable to BRCA1 appears to be lower, with no mutations identified in some population-based patient series, 10,12 whereas other studies find as many as 4 -10% of cases to carry deleterious BRCA1 mutations. 7,13 These differences in observed mutation frequencies may reflect enrichment for BRCA1 mutation carriers in the latter studies due to populationspecific founder effects or ascertainment bias. Thus, both BRCA1 and BRCA2 germline mutations have been reported to confer elevated risk of male breast cancer. Cumulative risk estimates for BRCA2 are 2.8% (95% CI ϭ 0.6 -13%) by age 70 years, and 6.9% (95% CI ϭ 1.2-38.6%) by age 80 years, 14 whereas that estimated for BRCA1 in a smaller cohort is reported to be 5.8% by age 110 years (95% CI ϭ 1.3-10.4). 15 To date, few genes other than BRCA1 and BRCA2 have been implicated in conferring male breast cancer susceptibility. Germline mutations of androgen receptor appear to contribute to a small proportion of cases. 16 -19 Similarly, germline mutations of the PTEN 20 and hMLH1 21,22 genes in male breast cancer patients suggest elevated risks in the context of Cowden and hereditary non-polyposis colorectal cancer (HNPCC) familial cancer syndromes, respectively. A modest risk is associated with a promoter polymorphism in the CYP17 gene (OR ϭ 2.10; 95% CI ϭ 1.04 -4.27). 23 Similarly, there is some suggestion, although not statistically significant, that long alleles (Ն30 repeats) of the androgen receptor exon 1 polymorphic CAG repeat may be associated with disease. 18,24 More recently, an approximately 10-fold increased risk of male breast cancer associated with the CHEK2*1100delC variant was reported in high ris...

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“…The cohort of wives of men with breast cancer had a risk of breast cancer of 0.97 (0.31-2.26), 15 while in the Swedish Cancer Family Database the risk of breast cancer was 1.29 (95% CI 0.89-1.77) in women with a husband diagnosed with breast cancer. 16 In a Swedish study on wives of men with breast cancer, 15 the only significant association was with brain cancer (standardized mortality ratio 5 4.37, 95% CI 0.90-12.78), based however on 3 cases only. In this analysis, we did not find a significant association between brain cancer in the husband and breast cancer in the wife, although brain cancer was one of the few sites where the point estimate of the OR was slightly above unity (OR 5 1.2), the other 2 being the larynx and the prostate.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, our data were too scanty to investigate the relation between breast cancer in both spouses. The cohort of wives of men with breast cancer had a risk of breast cancer of 0.97 (0.31-2.26), 15 while in the Swedish Cancer Family Database the risk of breast cancer was 1.29 (95% CI 0.89-1.77) in women with a husband diagnosed with breast cancer. 16 In a Swedish study on wives of men with breast cancer, 15 the only significant association was with brain cancer (standardized mortality ratio 5 4.37, 95% CI 0.90-12.78), based however on 3 cases only.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, a relative risk of breast cancer of 0.77 was found in a cohort of wives of men with colon cancer, 14 and no cases of colon cancer were found in a cohort of wives of men with breast cancer, as compared to 1.82 expected. 15 In contrast, a study of the proportional frequency of combinations of sites in 195 married couples found a relative risk of 2.9 (95% CI 1.9-4.1) for a husband with colon and a wife with breast cancer, when compared to the general population, but the risk was 0.96 (0.6-1.4) when estimated using a permutation test on the sample distribution. …”

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confidence: 99%

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A history of cancer in the husband does not increase the risk of breast cancer

Negri

Bertuccio

Talamini

et al. 2006

Intl Journal of Cancer

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Spouses share the home environment, and dietary and other lifestyle habits. Furthermore, a cancer diagnosis in the husband is a stressful event for the wife also. Thus, a history of cancer in the husband may be an indicator of breast cancer risk. We investigated the issue in a large Italian multicentric case-control study on 2,588 women with incident breast cancer and 2,569 female hospital controls, admitted for acute, non neoplastic diseases. The adjusted odds ratio (OR) was 1.0 (95% confidence interval, CI, 0.7-1.4) for a history of any type of cancer in the husband, 1.0 (95% 0.4-2.7) for stomach, 0.7 (95% 0.2-2.3) for intestinal (chiefly colorectal), 0.9 (95% CI 0.5-1.7) for lung, and 1.3 (95% CI 0.4-4.3) for prostate cancer. The OR was close to unity also when data were analyzed in separate strata of patient's or husband's age, patient's education, or vital status of the husband. This study suggests that women whose husband had a diagnosis of cancer are not at increased risk of breast cancer, although results for individual cancer sites should be interpreted with caution, due to small numbers. ' 2006 Wiley-Liss, Inc.Key words: breast neoplasms; case-control study; spouses; risk factors Besides the home environment, married couples share dietary and other lifestyle habits, 1-4 and nutrition and alcohol affect the risk of breast and other cancers. 5 Furthermore, a cancer diagnosis in the husband is a cause of emotional stress for the patient and also for his family, 6 and stressful events have been suspected to affect breast cancer risk.7 Thus, an association between history of cancer in the husband and breast cancer in the wife is conceivable. Given the scant epidemiological evidence, we have investigated the issue using the data of a large multicentric Italian case-control study. 8 Subjects and methodsA hospital-based case-control study was conducted in 4 Italian regions between 1991 and 1994 on 2,569 women with histologically confirmed breast cancer (median age 55 years, range 23-74) and 2,588 controls (median age 56 years, range 20-74) admitted to the same hospitals as cases for acute, nonneoplastic conditions (22% traumas, 33% nontraumatic orthopedic disorders, 15% surgical conditions and 30% miscellaneous other diseases).8 For this analysis, only ever married women were included, thus leaving a total of 2,341 cases and 2,355 controls. Interviews were conducted in hospital using a structured questionnaire. Information was collected on socio-demographic factors, anthropometric variables, tobacco, alcohol and other lifestyle habits, physical activity, a validated food frequency questionnaire, obstetric and gynecologic history and history of selected conditions and of use of female hormone preparations.In the section on family history was recorded, for any husband, parent, sibling, child or grandparent with history of cancer, the site of the cancer, the age at diagnosis, the vital status and the current age or the age at death. We recorded only husband's cancers that occurred before the woman's breast cance...

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Population-based cohort investigations of the risk for malignant tumors in first-degree relatives and wives of men with breast cancer

Cited by 28 publications

References 14 publications

Male breast cancer: incompatible and incomparable

Male breast cancer: incompatible and incomparable

CHEK2*1100delC and male breast cancer risk in Israel

A history of cancer in the husband does not increase the risk of breast cancer

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