Song Jun-Long, Chen Chuang, Yuan Jing-Ping, Sun Sheng-Rong
Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, People's Republic of China.
Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, People's Republic of China.
Fam Cancer. 2017 Jul;16(3):339-349. doi: 10.1007/s10689-017-9969-x.
Whether a positive family history of breast cancer or ovarian cancer (FHBOC) would affect the prognosis of breast cancer is still up for debate and further study. This meta-analysis was performed to clarify this issue. We reviewed two databases (PubMed and CNKI) for research articles published at any time from the inception of these databases to April 1, 2016 for articles detecting the impact of FHBOC on the prognosis of breast cancer. A meta-analysis was conducted to generated combined hazard ratios (HR) with 95% confidence intervals (CI) for overall survival (OS) and breast cancer-specific survival (BCSS). Eighteen studies were included in our qualitative analysis, with 15 studies ultimately part of the quantitative analysis. The pooled results demonstrated that a positive FHBOC was associated with better OS (0.89, 95% CI 0.83-0.95) and BCSS (0.90, 95% CI 0.82-0.99). In subgroup analyses, several subgroups (maximally adjusted studies, population based studies, high quality studies, family history of breast cancer, studies from Europe, studies from Asia, 1 affected relative, or tumor size > 2 cm), a positive first-degree FHBOC was associated with better prognosis of breast cancer. Notably, for those patients who underwent breast-conserving surgery, first-degree FHBOC was not a risk factor for OS (HR 1.08, 95% CI 0.53-2.21). Our meta-analysis demonstrated that a first-degree FHBOC was associated with better OS and BCSS in patients with breast cancer. These findings support that clinical management should not differ between women with and without FHBOC.
乳腺癌或卵巢癌的阳性家族史（FHBOC）是否会影响乳腺癌的预后仍存在争议，有待进一步研究。本荟萃分析旨在阐明这一问题。我们检索了两个数据库（PubMed和中国知网），以查找从这些数据库建立之初到2016年4月1日期间发表的、检测FHBOC对乳腺癌预后影响的研究文章。进行荟萃分析以生成总生存期（OS）和乳腺癌特异性生存期（BCSS）的合并风险比（HR）及95%置信区间（CI）。18项研究纳入我们的定性分析，最终15项研究纳入定量分析。汇总结果表明，FHBOC阳性与更好的OS（0.89，95%CI 0.83 - 0.95）和BCSS（0.90，95%CI 0.82 - 0.99）相关。在亚组分析中，几个亚组（最大程度调整研究、基于人群的研究、高质量研究、乳腺癌家族史、欧洲研究、亚洲研究、1名受累亲属或肿瘤大小>2 cm）中，一级FHBOC阳性与乳腺癌更好的预后相关。值得注意的是，对于接受保乳手术的患者，一级FHBOC不是OS的危险因素（HR 1.08，95%CI 0.53 - 2.21）。我们的荟萃分析表明，一级FHBOC与乳腺癌患者更好的OS和BCSS相关。这些发现支持，有或没有FHBOC的女性在临床管理上不应有差异。
