Trasias Mukama, MPH
In a study reported in JAMA Oncology, Trasias Mukama, MPH, and colleagues identified risk-adapted screening starting ages for relatives of patients with breast cancer according to the number of affected first-degree and second-degree relatives and the age at diagnosis of affected relatives.
The nationwide cohort study analyzed. Swedish family cancer data sets. Women born from 1932 onward with at least one known first-degree relative with breast cancer were included, with data on breast cancer history diagnoses from January 1958 to December 2015 being used in the analysis.
Among the 5,099,172 women included in the study, 118,953 (2.3%) were diagnosed with primary invasive breast cancer. Among the women in this group, 102,751 (86.4%) with a mean age at diagnosis of 55.9 years did not have a family history of breast cancer in first- or second-degree relatives at the time of diagnosis.
The age at which women with a family history of breast cancer attained a risk equal to that of women with average risk (starting guideline-recommended screening at ages 40, 45, and 50 years in the general population) varied according to the number of affected first- and second-degree relatives and the age at diagnosis of affected relatives. For example, the 10-year cumulative risk of invasive breast cancer was 2.2% in women aged 50 years in the general population, an age at which some guidelines recommend the start of mass screening. This level of risk was attained at:
The investigators concluded, “This study identifies possible risk-based starting ages for breast cancer screening based on population-based registers. These results may serve as high-quality evidence to supplement current screening guidelines for relatives of patients with breast cancer.”
Mukama T et al: JAMA Oncol. November 14, 2019 (early release online). ■