Influence of a family history of breast and/or ovarian cancer on breast cancer outcomes

Abstract

Various published studies have been inconclusive in attempting to relate a family history of breast and/or ovarian cancer (BOC) to the survival of breast cancer patients. The aim of the study was to investigate the association of a family history of BOC with tumor characteristics, treatment response and the difference between the prognosis of familial breast cancer (FBC) patients and sporadic breast cancer (SBC) patients. Data on 348 operable FBC patients and 345 SBC patients were retrospectively analyzed. The overall survival (OS) and recurrence/metastasis-free survival (RFS) were compared for both groups. FBC cases were diagnosed at a relatively younger age (51.1±10.4 vs. 53.7±11.0 years, P=0.054) and presented a lower T stage (P=0.000) than the SBC cases. Patients with a family history of BOC had a significantly greater risk of recurrence/metastasis (P= 0.04) and a non-significantly increased risk of death (P=0.06) compared to the SBC patients. In a multivariate analysis, family history of BOC was an independent predictive factor for both recurrence/metastasis rate (P=0.01, HR=0.012, 95% CI 0.02-0.57) and mortality (P=0.044, HR=0.43, 95% CI 0.19-0.98) in the hormone receptor-positive population. Our results found that women diagnosed with FBC had an early onset of disease in the population studied, and the poor outcome of patients with a family history of BOC associated with survival was restricted to the hormone receptor-positive population.

Figure 1.

(A) Overall survival (OS) and (B) recurrence/metastasis-free survival (RFS) according to family history; (C) OS and (D) RFS in a population ≥40 years of age; (E) OS and (F) RFS in a population with higher TNM stage. ^*Adjusted for tumor size (≤2 vs. >2 cm) and lymph node status (positive vs. negative).

Figure 2.

(A) Overall survival (OS) and (B) recurrence/metastasis-free survival (RFS) according to hormone receptor-positive status; (C) OS and (D) RFS in a human epidermal growth factor receptor 2-negative population. ^*Adjusted for tumor size (≤2 vs. >2 cm) and lymph node status (positive vs. negative).

Figure 3.

(A) Overall survival (OS) and (B) recurrence/metastasis-free survival (RFS) according to chemotherapy; (C) OS and (D) RFS in patients receiving hormone therapy; (E) OS and (F) RFS in patients receiving no radiotherapy. ^*Adjusted for tumor size (≤2 vs. >2 cm) and lymph node status (positive vs. negative).