Lynch H T, Watson P, Conway T, Fitzsimmons M L, Lynch J
Department of Preventive Medicine/Public Health, Creighton University School of Medicine, Omaha, NE 68178.
Breast Cancer Res Treat. 1988 Jul;11(3):263-7. doi: 10.1007/BF01807285.
Since full breast cancer screening is not generally recommended for young women, it is important to identify individuals who are at higher risk for early onset breast cancer. We investigated the relationship between age of onset of breast cancer in 328 probands (consecutively ascertained patients from our oncology clinic) and breast cancer incidence and age of onset in their female relatives. We found that a family history of early onset breast cancer was associated with higher risk of early onset breast cancer. A family history of early onset breast cancer occurred more frequently among young (less than 40) breast cancer probands than among older (greater than or equal to 40) breast cancer probands (p less than 0.001; OR = 23). This relationship was particularly evident when the analysis was restricted to the hereditary breast cancer probands (p less than 0.001; OR = 44). We also observed a positive family history of breast cancer (any age) more frequently in young breast cancer probands than in older breast cancer probands (p less than 0.001; OR = 2.8). These observations have important pragmatic implications for surveillance. We recommend intense surveillance for breast cancer, initiated earlier, for women with close relatives diagnosed with early onset breast cancer.
由于一般不建议对年轻女性进行全面的乳腺癌筛查，因此识别出早发性乳腺癌风险较高的个体非常重要。我们调查了328名先证者（来自我们肿瘤诊所的连续确诊患者）的乳腺癌发病年龄与其女性亲属的乳腺癌发病率和发病年龄之间的关系。我们发现，早发性乳腺癌家族史与早发性乳腺癌的较高风险相关。早发性乳腺癌家族史在年轻（小于40岁）乳腺癌先证者中比在年长（大于或等于40岁）乳腺癌先证者中更频繁出现（p<0.001；OR=23）。当分析仅限于遗传性乳腺癌先证者时，这种关系尤为明显（p<0.001；OR=44）。我们还观察到，年轻乳腺癌先证者中乳腺癌阳性家族史（任何年龄）的出现频率高于年长乳腺癌先证者（p<0.001；OR=2.8）。这些观察结果对监测具有重要的实际意义。我们建议，对于有近亲被诊断为早发性乳腺癌的女性，应更早开始对乳腺癌进行强化监测。
