Rachel S van Leeuwaarde1, Koen M Dreijerink1, Margreet G Ausems2, Hanneke J Beijers3, Olaf M Dekkers4,5, Wouter W de Herder6, Anouk N van der Horst-Schrivers7, Madeleine L Drent8, Peter H Bisschop9, Bas Havekes10, Petra H M Peeters11, Ruud M Pijnappel12, Menno R Vriens13, Gerlof D Valk1. 1. Department of Endocrine Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands. 2. Department of Clinical Genetics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands. 3. Department of Endocrinology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands. 4. Department of Endocrinology and Metabolism, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands. 5. Department of Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands. 6. Department of Internal Medicine, Erasmus Medical Center, 3000 WB Rotterdam, The Netherlands. 7. Department of Endocrinology, University of Groningen, University Medical Center Groningen, 9700 VG Groningen, The Netherlands. 8. Department of Internal Medicine, Section of Endocrinology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands. 9. Department of Endocrinology and Metabolism, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands. 10. Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands. 11. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands. 12. Department of Radiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands. 13. Department of Endocrine Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
Abstract
Objective: Multiple endocrine neoplasia type 1 (MEN1) is associated with an early-onset elevated breast cancer risk. This finding potentially has implications for breast cancer screening for women with MEN1, and therefore it is necessary to assess whether other risk factors are involved to identify those at greatest risk. Design: A cross-sectional case control study was performed using the Dutch MEN1 cohort, including >90% of the adult Dutch MEN1 population. All women with a confirmed MEN1 mutation received a questionnaire regarding cancer family history and breast cancer-related endocrine and general cancer risk factors. Results: A total of 138 of 165 (84%) eligible women with MEN1 completed the questionnaire. Eleven of the 138 women had breast cancer. Another 34 relatives with breast cancer were identified in the families of the included women, of whom 11 were obligate MEN1 carriers, 14 had no MEN1 mutation, and 9 had an unknown MEN1 status. The median age at breast cancer diagnosis of women with MEN1 (n = 22) was 45 years (range, 30 to 80 years), in comparison with 57.5 years (range, 40 to 85 years) in female relatives without MEN1 (n = 14; P = 0.03) and 61.2 years in the Dutch reference population. Known endocrine risk factors and general risk factors were not different for women with and without breast cancer. Conclusion: The increased breast cancer risk in MEN1 carriers was not related to other known breast cancer risk factors or familial cancer history, and therefore breast cancer surveillance from the age of 40 years for all women with MEN1 is justifiable.
Objective: Multiple endocrine neoplasia type 1 (MEN1) is associated with an early-onset elevated breast cancer risk. This finding potentially has implications for breast cancer screening for women with MEN1, and therefore it is necessary to assess whether other risk factors are involved to identify those at greatest risk. Design: A cross-sectional case control study was performed using the Dutch MEN1 cohort, including >90% of the adult Dutch MEN1 population. All women with a confirmed MEN1 mutation received a questionnaire regarding cancer family history and breast cancer-related endocrine and general cancer risk factors. Results: A total of 138 of 165 (84%) eligible women with MEN1 completed the questionnaire. Eleven of the 138 women had breast cancer. Another 34 relatives with breast cancer were identified in the families of the included women, of whom 11 were obligate MEN1 carriers, 14 had no MEN1 mutation, and 9 had an unknown MEN1 status. The median age at breast cancer diagnosis of women with MEN1 (n = 22) was 45 years (range, 30 to 80 years), in comparison with 57.5 years (range, 40 to 85 years) in female relatives without MEN1 (n = 14; P = 0.03) and 61.2 years in the Dutch reference population. Known endocrine risk factors and general risk factors were not different for women with and without breast cancer. Conclusion: The increased breast cancer risk in MEN1 carriers was not related to other known breast cancer risk factors or familial cancer history, and therefore breast cancer surveillance from the age of 40 years for all women with MEN1 is justifiable.
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