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. 2007;9(3):R39.
doi: 10.1186/bcr1737.

Is breast cancer prognosis inherited?

Mikael Hartman  1 , Linda Lindström, Paul W Dickman, Hans-Olov Adami, Per Hall, Kamila Czene
Affiliations

Is breast cancer prognosis inherited?

Mikael Hartman et al. Breast Cancer Res. 2007.

Abstract

Introduction: A genetic component is well established in the etiology of breast cancer. It is not well known, however, whether genetic traits also influence prognostic features of the malignant phenotype.

Methods: We carried out a population-based cohort study in Sweden based on the nationwide Multi-Generation Register. Among all women with breast cancer diagnosed from 1961 to 2001, 2,787 mother-daughter pairs and 831 sister pairs with breast cancer were identified; we achieved complete follow-up and classified 5-year breast cancer-specific prognosis among proband (mother or oldest sister) into tertiles as poor, intermediary, or good. We used Kaplan-Meier estimates of survival proportions and Cox models to calculate relative risks of dying from breast cancer within 5 years depending on the proband's outcome.

Results: The 5-year survival proportion among daughters whose mothers died within 5 years was 87% compared to 91% if the mother was alive (p = 0.03). Among sisters, the corresponding proportions were 70% and 88%, respectively (p = 0.001). After adjustment for potential confounders, daughters and sisters of a proband with poor prognosis had a 60% higher 5-year breast cancer mortality compared to those of a proband with good prognosis (hazard ratio [HR], 1.6; 95% confidence interval [CI], 1.2 to 2.2; p for trend 0.002). This association was slightly stronger among sisters (HR, 1.8; 95% CI, 1.0 to 3.4) than among daughters (HR, 1.6; 95% CI, 1.1 to 2.3).

Conclusion: Breast cancer prognosis of a woman predicts the survival in her first-degree relatives with breast cancer. Our novel findings suggest that breast cancer prognosis might be inherited.

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Figures

Figure 1
Figure 1
Kaplan-Meier estimates of breast cancer-specific mortality of women whose cancer was diagnosed since 1991 and who have a first-degree relative with breast cancer. Estimates are stratified by proband's cause-specific outcome. (a) One thousand seven hundred seventy-eight daughters with mother as proband. (b) Eight hundred forty-nine daughters with a mother younger than 70 years of age as proband. (c) Three hundred forty-eight sisters with an older sister as proband.
See this image and copyright information in PMC

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