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Optimal age to start preventive measures in women with BRCA1/2 mutations or high familial breast cancer risk.
MedLine Citation:
PMID:  23292943     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Women from high risk families consider preventive measures for breast cancer including screening. Guidelines on screening differ considerably regarding starting age. We investigated whether age at diagnosis in affected relatives is predictive for age at diagnosis. We analyzed the age of breast cancer detection of 1304 first and second degree relatives of 314 BRCA1, 164 BRCA2 and 244 high-risk participants of the Dutch MRI-SCreening study. The within and between family variance in the relative's age at diagnosis was analyzed with a random effect linear regression model. We compared the starting age of screening based on risk-group (25 years for BRCA1, 30 years for BRCA2 and 35 years for familial risk), on family history, and on the model, which combines both. The findings were validated in 63 families from the UK-MARIBS study. Mean age at diagnosis in the relatives varied between families; 95% range of mean family ages was 35-55 in BRCA1 -, 41-57 in BRCA2- and 44-60 in high-risk families.14% of the variance in age at diagnosis, in BRCA1 even 23%, was explained by family history, 7% by risk group. Determining start of screening based on the model and on risk-group gave similar results in terms of cancers missed and years of screening. The approach based on familial history only, missed more cancers and required more screening years in both the Dutch and UK datasets. Age at breast cancer diagnosis is partly dependent on family history which may assist planning starting age for preventive measures. © 2013 Wiley Periodicals, Inc.
Authors:
Madeleine M A Tilanus-Linthorst; Hester F Lingsma; D Gareth Evans; Deborah Thompson; Reinoutje Kaas; Peggy Manders; Christi J van Asperen; Muriel Adank; Maartje J Hooning; Gek E Kwan Lim; Rosalind Eeles; Jan C Oosterwijk; Martin O Leach; Ewout W Steyerberg
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-7
Journal Detail:
Title:  International journal of cancer. Journal international du cancer     Volume:  -     ISSN:  1097-0215     ISO Abbreviation:  Int. J. Cancer     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0042124     Medline TA:  Int J Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 UICC.
Affiliation:
Department of Surgical Oncology, Erasmus University Medical Center Rotterdam The Netherlands. m.tilanus-linthorst@erasmusmc.nl.
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