Southampton, United Kingdom — This study may serve as a wake-up call for fans of Angelina Jolie, feminists and hypochondriacs who couldn’t hold back their congratulatory messages after the Hollywood star decided to get her breasts removed for fear of developing cancer in them owing to her family’s medical history. It has been found that women who are diagnosed with breast cancer and have a family history of the disease face no worse of a prognosis after treatment than other women with breast cancer.
The study, which is published in the BJS (British Journal of Surgery), offers a positive message for women who may worry about their future in light of a family history of breast cancer.
About one-quarter of breast cancer cases in developed countries are thought to be related to hereditary factors. It can be scary for a woman to know that she has a family history of the disease, but after diagnosis, what’s her prognosis compared with patients without a family history?
To answer this question, Ramsey Cutress, an Associate Professor in breast surgery at the University of Southampton and University Hospital Southampton Foundation Trust, and his colleagues conducted an analysis of the Prospective Outcomes in Sporadic versus Hereditary breast cancer (POSH) study, which included 2850 women under the age of 41 who were diagnosed with breast cancer and treated in the UK. The study, led by principal investigator Professor Diana Eccles, recorded patients’ personal characteristics, tumour characteristics, treatment and family history of breast/ovarian cancer over a 15-year period.
The investigators found that there were no significant differences in cancer recurrence rates after treatment for women with a history of breast cancer in their family versus those without.
“Successful treatment for breast cancer is just as likely in young patients with a family history of breast cancer, as in those without a family history,” said Professor Cutress. “Patients with a family history of breast cancer can therefore be reassured that their family history alone does not mean that their outcome will be worse.”
The researchers now plan to investigate whether certain breast cancer gene variants have any impact on the effectiveness of different anticancer treatments.
“There is some evidence in laboratory experiments and observations in humans that BRCA1 gene carriers in particular may be more sensitive to certain types of chemotherapy,” said Professor Eccles. “If the outlook is more optimistic than might be expected for these patients, this will help in planning future preventive surgical options at the time of breast cancer treatment.”
Diagrams and explanation as per older theory
Note: The squares represent males and the circles represent females. The unshaded shapes represent unaffected individuals and the shaded shapes represent individuals diagnosed with cancer.
Details are needed from both the maternal and paternal sides of the family, as both have repercussions in a risk assessment. Age of diagnosis is particularly important because age is the top risk factor.
(1.) Older age at onset, few affected family members. Unlikely to have been caused by an inherited gene defect.
The family history on the left is of some concern because of the early age of onset breast cancer (<50y) but otherwise is not highly suggestive of there being a hereditary basis for cancer. Cervical cancer is not associated with a known hereditary cancer syndrome. The more detailed family history on the right is highly suggestive of hereditary breast and ovarian cancer because the pattern of pancreatic, breast and ovarian cancers are seen in such families along with young age of cancer onset.
- B. K. Eccles, E. R. Copson, R. I. Cutress, T. Maishman, D. G. Altman, P. Simmonds, S. M. Gerty, L. Durcan, L. Stanton, D. M. Eccles. Family history and outcome of young patients with breast cancer in the UK (POSH study). British Journal of Surgery, 2015; DOI: 10.1002/bjs.9816