L S Lindström1, J Li2, M Lee3, Z Einbeigi4, M Hartman5, P Hall3, K Czene3. 1. Department of Surgery, University of California at San Francisco (UCSF), San Francisco, USA Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden linda.lindstrom@ki.se. 2. Division of Human Genetics, Genome Institute of Singapore Department of Epidemiology and Public Health, National University of Singapore, Singapore. 3. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm. 4. Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden. 5. Department of Surgery, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Abstract
BACKGROUND: Breast cancer survival has been shown to be associated among relatives. In this study, we used a population-based cohort of Swedish sisters, both diagnosed with breast cancer, to determine whether prognostic information of a previously diagnosed sibling is useful for the clinical management of a newly diagnosed sibling. PATIENTS AND METHODS: The population-based cohort included all sister pairs, 1617 sisters, diagnosed with breast cancer in Sweden, from 1 January 1992, through 31 December 2006, with complete follow-up. All information was collected manually from original pathology reports and patient records. The Kappa statistic was used to measure the agreement of primary tumor characteristics between the sisters. We modeled the breast cancer-specific survival using multivariate (Cox) proportional hazard analyses in two steps categorizing the older sister's survival. RESULTS: Estrogen receptor status was the only tumor characteristic significantly associated between the sisters [κ 0.18 (95% confidence interval (CI) 0.089-0.27)]. Younger sisters with poor older sister survival showed significantly worse survival compared with patients with good older sister survival (log rank, P = 0.017). A twofold increased hazard ratio (HR) for death from breast cancer was found in younger sisters with poor older sister survival compared with patients with good sister survival [HR 2.56 (95% CI 1.16-5.65)], adjusting for age and calendar period of diagnosis, socioeconomic factors, number of children and hospital of primary tumor diagnosis. When further adjusting for primary tumor characteristics and adjuvant therapy, the risk for death from breast cancer in younger sisters with poor older sister survival became more pronounced [HR 3.35 (1.34-8.34)]. CONCLUSIONS: Our findings derived from a population-based cohort of Swedish sister pairs suggest that breast cancer-specific survival is inherited independent of tumor characteristics and treatment in the sibling later diagnosed with the disease. Prognostic information of a previously diagnosed sibling with breast cancer could be important in the clinical management.
BACKGROUND:Breast cancer survival has been shown to be associated among relatives. In this study, we used a population-based cohort of Swedish sisters, both diagnosed with breast cancer, to determine whether prognostic information of a previously diagnosed sibling is useful for the clinical management of a newly diagnosed sibling. PATIENTS AND METHODS: The population-based cohort included all sister pairs, 1617 sisters, diagnosed with breast cancer in Sweden, from 1 January 1992, through 31 December 2006, with complete follow-up. All information was collected manually from original pathology reports and patient records. The Kappa statistic was used to measure the agreement of primary tumor characteristics between the sisters. We modeled the breast cancer-specific survival using multivariate (Cox) proportional hazard analyses in two steps categorizing the older sister's survival. RESULTS: Estrogen receptor status was the only tumor characteristic significantly associated between the sisters [κ 0.18 (95% confidence interval (CI) 0.089-0.27)]. Younger sisters with poor older sister survival showed significantly worse survival compared with patients with good older sister survival (log rank, P = 0.017). A twofold increased hazard ratio (HR) for death from breast cancer was found in younger sisters with poor older sister survival compared with patients with good sister survival [HR 2.56 (95% CI 1.16-5.65)], adjusting for age and calendar period of diagnosis, socioeconomic factors, number of children and hospital of primary tumor diagnosis. When further adjusting for primary tumor characteristics and adjuvant therapy, the risk for death from breast cancer in younger sisters with poor older sister survival became more pronounced [HR 3.35 (1.34-8.34)]. CONCLUSIONS: Our findings derived from a population-based cohort of Swedish sister pairs suggest that breast cancer-specific survival is inherited independent of tumor characteristics and treatment in the sibling later diagnosed with the disease. Prognostic information of a previously diagnosed sibling with breast cancer could be important in the clinical management.
Authors: Sander Canisius; Marjanka K Schmidt; Maria Escala-Garcia; Jean Abraham; Irene L Andrulis; Hoda Anton-Culver; Volker Arndt; Alan Ashworth; Paul L Auer; Päivi Auvinen; Matthias W Beckmann; Jonathan Beesley; Sabine Behrens; Javier Benitez; Marina Bermisheva; Carl Blomqvist; William Blot; Natalia V Bogdanova; Stig E Bojesen; Manjeet K Bolla; Anne-Lise Børresen-Dale; Hiltrud Brauch; Hermann Brenner; Sara Y Brucker; Barbara Burwinkel; Carlos Caldas; Federico Canzian; Jenny Chang-Claude; Stephen J Chanock; Suet-Feung Chin; Christine L Clarke; Fergus J Couch; Angela Cox; Simon S Cross; Kamila Czene; Mary B Daly; Joe Dennis; Peter Devilee; Janet A Dunn; Alison M Dunning; Miriam Dwek; Helena M Earl; Diana M Eccles; A Heather Eliassen; Carolina Ellberg; D Gareth Evans; Peter A Fasching; Jonine Figueroa; Henrik Flyger; Manuela Gago-Dominguez; Susan M Gapstur; Montserrat García-Closas; José A García-Sáenz; Mia M Gaudet; Angela George; Graham G Giles; David E Goldgar; Anna González-Neira; Mervi Grip; Pascal Guénel; Qi Guo; Christopher A Haiman; Niclas Håkansson; Ute Hamann; Patricia A Harrington; Louise Hiller; Maartje J Hooning; John L Hopper; Anthony Howell; Chiun-Sheng Huang; Guanmengqian Huang; David J Hunter; Anna Jakubowska; Esther M John; Rudolf Kaaks; Pooja Middha Kapoor; Renske Keeman; Cari M Kitahara; Linetta B Koppert; Peter Kraft; Vessela N Kristensen; Diether Lambrechts; Loic Le Marchand; Flavio Lejbkowicz; Annika Lindblom; Jan Lubiński; Arto Mannermaa; Mehdi Manoochehri; Siranoush Manoukian; Sara Margolin; Maria Elena Martinez; Tabea Maurer; Dimitrios Mavroudis; Alfons Meindl; Roger L Milne; Anna Marie Mulligan; Susan L Neuhausen; Heli Nevanlinna; William G Newman; Andrew F Olshan; Janet E Olson; Håkan Olsson; Nick Orr; Paolo Peterlongo; Christos Petridis; Ross L Prentice; Nadege Presneau; Kevin Punie; Dhanya Ramachandran; Gad Rennert; Atocha Romero; Mythily Sachchithananthan; Emmanouil Saloustros; Elinor J Sawyer; Rita K Schmutzler; Lukas Schwentner; Christopher Scott; Jacques Simard; Christof Sohn; Melissa C Southey; Anthony J Swerdlow; Rulla M Tamimi; William J Tapper; Manuel R Teixeira; Mary Beth Terry; Heather Thorne; Rob A E M Tollenaar; Ian Tomlinson; Melissa A Troester; Thérèse Truong; Clare Turnbull; Celine M Vachon; Lizet E van der Kolk; Qin Wang; Robert Winqvist; Alicja Wolk; Xiaohong R Yang; Argyrios Ziogas; Paul D P Pharoah; Per Hall; Lodewyk F A Wessels; Georgia Chenevix-Trench; Gary D Bader; Thilo Dörk; Douglas F Easton Journal: Nat Commun Date: 2020-01-16 Impact factor: 14.919