Simon Michael S, Korczak Jeannette F, Yee Cecilia L, Malone Kathleen E, Ursin Giske, Bernstein Leslie, McDonald Jill A, Deapen Dennis, Strom Brian L, Press Michael F, Marchbanks Polly A, Burkman Ronald T, Weiss Linda K, Schwartz Ann G
Division of Hematology and Oncology,Karmanos Cancer Institute at Wayne State University, Detroit, MI 48201, USA.
J Clin Oncol. 2006 Jun 1;24(16):2498-504. doi: 10.1200/JCO.2005.04.1087.
Family history is a well-recognized risk factor for breast cancer. Familial aggregation and segregation analyses have estimated breast cancer risk based on family history primarily for white women; such information is limited for African American (AA) women. The purpose of this report is to update breast cancer risk estimates associated with a family history of breast cancer for white and AA women.
We used family cancer history from 2,676 white and 1,525 AA women with breast cancer (probands) in the population-based National Institute of Child Health and Human Development's Women's Contraceptive and Reproductive Experiences (CARE) Study to estimate age-specific breast cancer risks in their first degree adult female relatives. Cumulative hazard curves were calculated for relatives of all probands using Cox proportional hazards models, and were stratified by the proband's race and age at diagnosis and number of relatives affected.
Breast cancer risks for white and AA women with a family history of the disease are similar through age 49 years, but diverge afterwards, with higher risks by age 79 in white women than in AA women (17.5% [SE, 0.9%] v 12.2% [SE, 1.1%]; P < .001). These risks increase as the number of affected first degree relatives increases, reaching 25.2% (SE, 3.4%) and 16.9% (SE, 4.0%) in white and AA women with more than one affected relative, respectively (P = .3).
We found age-related racial differences in breast cancer risk in women with a family history of breast cancer and have updated risk estimates for white and AA women for clinical use.
家族史是公认的乳腺癌风险因素。家族聚集性和分离分析主要基于白人女性的家族史来估计乳腺癌风险；而针对非裔美国（AA）女性的此类信息有限。本报告的目的是更新白人和AA女性乳腺癌家族史相关的乳腺癌风险估计。
我们利用美国国立儿童健康与人类发展研究所基于人群的妇女避孕与生殖经历（CARE）研究中2676名患有乳腺癌的白人女性和1525名AA女性（先证者）的家族癌症史，来估计其成年女性一级亲属特定年龄的乳腺癌风险。使用Cox比例风险模型为所有先证者的亲属计算累积风险曲线，并按先证者的种族、诊断时年龄以及受影响亲属数量进行分层。
有乳腺癌家族史的白人和AA女性在49岁之前的乳腺癌风险相似，但之后出现差异，79岁时白人女性的风险高于AA女性（17.5%[标准误，0.9%]对12.2%[标准误，1.1%]；P<.001）。这些风险随着受影响的一级亲属数量增加而增加，在有多个受影响亲属的白人和AA女性中分别达到25.2%（标准误，3.4%）和16.9%（标准误，4.0%）（P = 0.3）。
我们发现有乳腺癌家族史的女性中存在与年龄相关的种族差异，并更新了白人和AA女性的风险估计以供临床使用。
