The Early Findings From A Surveillance Screening Program For Women With A Family History Of Breast Cancer

20045 Background: The Gail model is widely used to estimate breast cancer (BC) risk. It has been validated as a reliable risk predictor in North America, but very few studies have been done in other countries. This study intends to examine the estimated BC risk using the Gail Model in a sample of women from Southern Brazil a region with the highest BC incidence and mortality rates of the country. Methods: Lifetime and 5-year BC risk estimates were obtained for the first 1002 asymptomatic women (ages 40–69 years) enrolled in an annual BC screening program. The frequency of each of the model’s variables was recorded and compared to other studies. Information about family history (FH) included: presence of bilateral BC, male BC, first degree relative with BC and/or ovarian cancer (OC), relative with BC under age 50 and ≥ 2 relatives with either BC, OC or colorectal cancer (CRC). Other potential risk factors for BC such as body mass index and smoking were recorded. Results: Mean (± SD) values for age, age at menarche and age at birth of the first live child were 50.4 (± 7.75), 13.0 (± 1.80), and 21.6 (± 5.00) years, respectively. Only 50 (5.0%) women were nulliparous and 62 (6.2%) reported their first live birth after age 30. History of at least one first-degree relative (FDR) affected with BC was reported by 52 (5.2%), and 31 (3.1%) had a previous breast biopsy. The mean estimated BC risk in 5 years was 0.92% (± 0.49); for those under age 60, 24 (2.8%) had an estimated 5-yr risk over 1.66%. The mean estimated lifetime BC risk was 7.80 (± 3.2). Interestingly, a history of cancer in a FDR was reported by 32.6% of the women, and evidence of familial BC was observed in 20.4%. The estimated BC risk using the Gail model was significantly higher in women with a family history of BC < 50ys and with ≥ 2 relatives with either BC, OC or CRC. Smoking and overweight were reported by 28% and 65% of the women, respectively. Conclusions: BC risk estimates obtained with the Gail Model did not differ significantly from those described in other populations. However, specific findings in cancer FH were associated with higher risk estimates. The importance of FH and overweight will be further explored in a larger sample. Population-specific risk factors for BC should be sought in different communities to ensure proper risk estimates. No significant financial relationships to disclose.

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Progesterone receptor gene polymorphism (PROGINS) in 701 women from a mammographic breast cancer screening program (NMPOA) in Southern Brazil

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.21048 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 21048-21048

Author(s):

J. Giacomazzi ◽

E. Aguiar ◽

E. I. Palmero ◽

L. Kalakun ◽

L. Schuler-Faccini ◽

...

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

Family History ◽

Progesterone Receptor ◽

Body Mass ◽

Screening Program ◽

Gail Model ◽

Porto Alegre ◽

Incidence And Mortality ◽

History Of

21048 Background: Several genetic polymorphisms in hormone receptor genes have been associated with breast cancer (BC) risk. Among these, a 306 base-pair insertion of the Alu subfamily in intron 7 of the progesterone receptor (PR) gene, (PROGINS), has been associated with decreased BC risk in several populations. In Brazil, BC is a significant public health problem, due to its high incidence and mortality rates. In Porto Alegre, Brazil`s southernmost capital, a multidisciplinary Breast Cancer Prevention Project - the Nucleo Mama Porto Alegre Cohort (NMPOA) was started in 2004 and includes a mammographic screening program for women ages 40–69 years. Goal: Determine the allelic and genotypic frequencies of PROGINS in women undergoing annual BC screening and correlate its presence with mammography results and presence of additional BC risk factors (family history of BC, body mass index, estimated BC risk by the Gail model and age) at baseline and after 10 years. Methods: A sample of 701 women from the NMPOA BC screening program was consecutively enrolled in the study from November/2005 until March/2006. Clinical data, mammography results (as BIRADS categories) and BC risk information was obtained by chart review. PROGINS genotyping was performed by polymerase chain reaction (PCR). Results: Of the 701 patients studied, 504 (71,0%) were wild-type homozygous, 184 (26,2%) heterozygous and 13 (1,8%) homozygous for the PROGINS polymorphism. These genotypic frequencies are similar to those of other reports in different populations. Genotype was correlated with 5-year and vital BC risk estimates (Gail model), body mass index, family history of BC and mammography findings. A statistically significant association was found between the presence of PROGINS and a positive family history of BC (p< 0,05). Conclusions: The genotypic and allelic frequencies of the PROGINS polymorphism were not significantly different from those reported previously for other populations. Prospective clinical evaluation of the women followed in this program and correlation of genotype with clinical findings may be important to elucidate additional risks associated with the PROGINS polymorphism. No significant financial relationships to disclose.

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MR-guided intervention in women with a family history of breast cancer

Yearbook of Diagnostic Radiology ◽

10.1016/s0098-1672(08)70045-6 ◽

2007 ◽

Vol 2007 ◽

pp. 58-59

Author(s):

R.L. Birdwell

Keyword(s):

Breast Cancer ◽

Family History ◽

History Of

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Family history of breast cancer and local recurrence after breast conserving therapy

European Journal of Cancer ◽

10.1016/s0959-8049(98)80040-3 ◽

1998 ◽

Vol 34 ◽

pp. S12

Author(s):

C.T.M. Brekelmans ◽

A.C. Voogd ◽

G. Botke ◽

A.N. van Geel ◽

P. Rodrigus ◽

...

Keyword(s):

Breast Cancer ◽

Family History ◽

Local Recurrence ◽

Breast Conserving Therapy ◽

History Of

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A Group Therapy Approach to Facilitate Integration of Risk Information for Women at Risk for Breast Cancer

The Canadian Journal of Psychiatry ◽

10.1177/070674379804300405 ◽

1998 ◽

Vol 43 (4) ◽

pp. 375-380 ◽

Cited By ~ 17

Author(s):

Mary Jane Esplen ◽

Brenda Toner ◽

Jonathan Hunter ◽

Gordon Glendon ◽

Kate Butler ◽

...

Keyword(s):

Breast Cancer ◽

At Risk ◽

Family History ◽

Group Therapy ◽

Perceived Risk ◽

Positive Family History ◽

Risk Information ◽

Degree Relative ◽

Therapy Approach ◽

History Of

Objective: To describe and illustrate elements of a group counselling approach designed to enhance the communication of risk information on breast cancer (BC) to women with a family history of this disease. Breast cancer is a leading cause of female cancer death. The most important risk factor for BC is a positive family history in at least 1 first-degree relative, and approximately one-third of women with BC have a family history of the disease. Recent evidence suggests that there is a significant psychological impact associated with having a family history of BC, and this may influence the psychological adjustment and response to being counselled for personal risk. New counselling approaches are required. Method: This paper describes a group therapy approach that incorporates principles of supportive-expressive therapy designed to address the emotional impact of being at risk for BC and to promote accuracy of perceived risk. The key elements of the intervention are described along with clinical illustrations from groups that are part of an ongoing study to develop and standardize the group therapy. Conclusion: Qualitative data from the groups suggest that this model of therapy is both feasible and effective.

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