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Identification of the Woman at Risk for Breast Cancer: Problem Solved?

  • Conference paper
Chemoprevention of Cancer

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 151))

Abstract

The clinical availability of antiestrogens to reduce breast cancer incidence has focused increased attention on the ability to identify women at increased risk for breast cancer development. Multiple risk factors, which can be grouped under the headings of genetic and familial factors, hormonal factors, benign breast disease, and environmental factors have been described. However, of these risk factors, only genetic mutations and atypical hyperplasia, lobular carcinoma in situ, and ductal carcinoma in situ have a relative risk of four or more. Many of the other risk factors, although associated with statistically significant increases in risk in large populations, are of little practical significance for the individual woman. Lack of knowledge of the interactions among various positive and negative risk factors also complicates the evaluation of risk. In addition, the impact of some risk factors may not be constant over time, and the majority of data on risk come from studies of white women, and little is known about the impact of ethnic diversity on these factors. Finally, there is no consensus about what level of increase in risk is necessary for a women to be labeled “high risk.” It is important to recognize that only 50% of breast cancers occur in women with identifiable risk factors other than age. Thus, an improved ability to define risk status is needed if prevention studies directed at high-risk women are to have a major impact on breast cancer incidence and mortality.

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References

  • Anderson DE, Badzioch MD (1989) Combined effect of family history and reproductive factors on breast cancer risk. Cancer 63:349–353.

    Article  PubMed  CAS  Google Scholar 

  • Anderson JA (1984) Lobular carcinoma in situ. A long term follow-up in 52 cases. Acta Pathol Microbiol Scand 85:519–533.

    Google Scholar 

  • Bernstein L, Henderson BE, Hanisch R et al. (1994) Physical exercise activity reduces the risk of breast cancer in young women. J Natl Cancer Inst 86:1403–1408.

    Article  PubMed  CAS  Google Scholar 

  • Bobrow LG, Happerfield LC, Gregory WM et al. (1994) The classification of ductal carcinoma in situ and its association with biological markers. Semin Diagn Pathol 11:199–207.

    PubMed  CAS  Google Scholar 

  • Bondy M, Lustbader ED, Halabi S et al. (1994) Validation of a breast cancer risk assessment model in women with a positive family history. J Natl Cancer Inst 86:620–625.

    Article  PubMed  CAS  Google Scholar 

  • Brinton L, William R, Hoover R et al. (1979) Breast cancer risk factors among screening program participants. J Natl Cancer Inst 62:37–44.

    PubMed  CAS  Google Scholar 

  • Brinton LA, Hoover R, Fraumeni JF (1982) Interaction of familial and hormonal risk factors for breast cancer. J Natl Cancer Inst 69:817–822.

    PubMed  CAS  Google Scholar 

  • Colditz GA, Willett WC, Hunter DJ et al. (1993) Family history, age, and risk of breast cancer. Prospective data from the Nurses’ Healthy study. JAMA 270:338–343.

    CAS  Google Scholar 

  • Daling JR, Malone KE, Voight LF, White E, Weiss NS (1994) Risk of breast cancer among young women: relationship to induced abortion. J Natl Cancer Inst 86:1584–1592.

    Article  PubMed  CAS  Google Scholar 

  • Dewaard F, Baanders-van Halewijn E (1974) A prospective study in general practice on breast cancer risk in postmenopausal women. Int J Cancer 14:153–160.

    Article  CAS  Google Scholar 

  • Dorgan JF, Brown C, Barrett M et al. (1994) Physical activity and risk of breast cancer in the Framingham heart study. Am J Epidemiol 139:662–669.

    PubMed  CAS  Google Scholar 

  • Duffy S, Robert M, Elton R (1983) Risk factors for breast cancer: relevance to screening. J Epidemiol Community Health 37:127–131.

    Article  PubMed  CAS  Google Scholar 

  • Dupont WD, Page D (1985) Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med 312:146–151.

    Article  PubMed  CAS  Google Scholar 

  • Dupont WD, Page D (1989) Relative risk of breast cancer varies with time since diagnosis of atypical hyperplasia. Hum Pathol 20:723–725.

    Article  PubMed  CAS  Google Scholar 

  • Ekbom A, Trichopoulos D, Adami H et al. (1995) Evidence of prenatal influence on breast cancer risk. Lancet 340:1015–1018.

    Article  Google Scholar 

  • Frisch R, Gotz-Welbergen A, McArthur J et al. (1981) Delayed menarche and amenorrhea of college athletes in relation to age of onset of training. JAMA 246:1559–1563.

    Article  PubMed  CAS  Google Scholar 

  • Gail MH, Brinton LA, Byar DP et al. (1989) Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 81:1879–1886.

    Article  PubMed  CAS  Google Scholar 

  • Gapstur SM, Potter JD, Folsom AR (1992) Increased risk of breast cancer with alcohol consumption in postmenopausal women. Am J Epidemiol 136:1221–1231.

    PubMed  CAS  Google Scholar 

  • Garland FC, Garland CF, Gorham ED et al. (1990) Geographic variation in breast cancer mortality in the United States: a hypothesis involving exposure to solar radiation. Prev Med 19:614–622.

    Article  PubMed  CAS  Google Scholar 

  • Haagensen CD, Bodian C, Haagensen DE (1981) Lobular neoplasia (lobular carcinoma in situ). In: Haagensen CD, Bodian C, Haagensen DE (eds) Breast carcinoma: risk and detection. Saunders, Philadelphia.

    Google Scholar 

  • Hancock SL, Tucker MA, Hoppe RT (1993) Breast cancer after treatment of Hodgkin’s disease. J Natl Cancer Inst 85:25–31.

    Article  PubMed  CAS  Google Scholar 

  • Harris BM, Eklund G, Meirik O, Rutqvist LE, Wiklund L (1989) Risk of cancer of the breast after legal abortion during the first trimester: a Swedish register study. BMJ 299:1430–1432.

    Article  PubMed  CAS  Google Scholar 

  • Henderson B, Ross R, Bernstein L (1988) Estrogens as a cause of human cancer: the Richard and Hinda Rosenthal Foundation Award Lecture. Cancer Res 48:246–253.

    PubMed  CAS  Google Scholar 

  • Hildreth NG, Shore RE, Dvoretsky PM (1989) The risk of breast cancer after irradiation of the thymus in infancy. N Engl J Med 321:1281–1284.

    Article  PubMed  CAS  Google Scholar 

  • Hunter D, Spiegelman D, Adami H et al. (1996) Cohort studies of fat intake and the risk of breast cancer: a pooled analysis. N Engl J Med 334:356–361.

    Article  PubMed  CAS  Google Scholar 

  • Hunter DJ, Willett WC (1996) Dietary factors. In: Harris JR, Lippman ME, Morrow M, Hellman S (eds) Disease of the Breast. Lippincott-Raven, Philadelphia, pp 201–212.

    Google Scholar 

  • Hutter R (1986) Consensus meeting: Is “fibrocystic disease” of the breast precancerous? Arch Pathol Lab Med 110:171–173.

    Google Scholar 

  • Kvale G, Heuch I (1988) Lactation and cancer risk: is there a relation specific to breast cancer? J Epidemiol Community Health 42:30–37.

    Article  PubMed  CAS  Google Scholar 

  • Lambe M, Hsieh CC, Trichopoulos D et al. (1994) Transient increase in the risk of breast cancer after giving birth. N Engl J Med 331:5–12.

    Article  PubMed  CAS  Google Scholar 

  • Land CE, McGregor DH (1979) Breast cancer incidence among atomic bomb survivors: implications for radiobiologie risk at low doses. J Natl Cancer Inst 62:17–21.

    PubMed  CAS  Google Scholar 

  • Layde PM, Webster LA, Baughman AL (1989) The independent associations of parity, age at first full-term pregnancy, and duration of breast feeding with the risk of breast cancer. J Clin Epidemiol 42:963–973.

    Article  PubMed  CAS  Google Scholar 

  • London SJ, Colditz GA, Stampfer WJ et al. (1989) Prospective study of relative weight, height, and risk of breast cancer. JAMA 262:2853–2858.

    Article  PubMed  CAS  Google Scholar 

  • Longnecker M, Berlin J, Orza M et al. (1988) A metaanalysis of alcohol consumption in relation to breast cancer risk. JAMA 260:652–656.

    Article  PubMed  CAS  Google Scholar 

  • Loomis DP, Savitz DA, Ananth CV (1994) Breast cancer mortality among female electrical workers in the United States. J Natl Cancer Inst 86:921–925.

    Article  PubMed  CAS  Google Scholar 

  • MacMahon B, Cole P, Lin T (1970) Age at first birth and breast cancer risk. Bull WHO 43:209–210.

    PubMed  CAS  Google Scholar 

  • MacMahon B, Trichopoulos D, Brown J et al. (1982) Age at menarche, probability of ovulation and breast cancer risk. Int J Cancer 298:13–16.

    Article  Google Scholar 

  • Madigan MP, Ziegler RG, Benichou J et al. (1995) Proportion of breast cancer cases in the United States explained by well-established risk factors. J Natl Cancer Inst 87:1681–1685.

    Article  PubMed  CAS  Google Scholar 

  • Malone KE, Daling JR, Weiss N (1993) Oral contraception in relation to breast cancer. Epidemiol Rev 15:80–97.

    PubMed  CAS  Google Scholar 

  • Meirik O, Lunde E, Adami H et al. (1986) Oral contraceptive use and breast cancer in younger women. A joint national case control study in Sweden and Norway. Lancet 11:650–654.

    Google Scholar 

  • Melbye M, Wohlfohrt J, Olsen JH et al. (1997) Induced abortion and the risk of breast cancer. N Engl J Med 336:81–85.

    Article  PubMed  CAS  Google Scholar 

  • Miller AB, Howe GR, Sherman GJ et al. (1989) Mortality from breast cancer after irradiation during fluoroscopic examinations in patients being treated for tuberculosis. N Engl J Med 321:1285–1298.

    Article  PubMed  CAS  Google Scholar 

  • Morrow M (1990) Management of nonpalpable breast masses. PPO Updates 4:1–11.

    Google Scholar 

  • Morrow M (1992) Pre-cancerous breast lesions: implications for breast cancer prevention trials. Int J Radiat Oncol Biol Phys 23:1071–1078.

    Article  PubMed  CAS  Google Scholar 

  • Morrow M, Schnitt SJ (1996) Lobular carcinoma in situ. In: Harris JR, Lippman ME, Morrow M, Hellman S (eds) Diseases of the breast. Lippincott-Raven, Philadelphia, pp 369–374.

    Google Scholar 

  • Newcomb PA, Storer BE, Longnecker MP et al. (1994) Lactation and a reduced risk of premenopausal breast cancer. N Engl J Med 330:81–87.

    Article  PubMed  CAS  Google Scholar 

  • Newcomb PA, Storer BE, Longnecker MP, Mittendorf R, Greenberg ER, Willett WC (1996) Pregnancy termination in relation to risk of breast cancer. JAMA 275:283–287.

    Article  PubMed  CAS  Google Scholar 

  • Ottesen GL, Graversen HP, Blichert-Tort M et al. (1993) Lobular carcinoma in situ of the female breast. Short-term results of a prospective nationwide study. Am J Surg Pathol 17:14–21Page.

    Article  PubMed  CAS  Google Scholar 

  • Page DL, Kidd TE, Dupont WD et al. (1991) Lobular neoplasia of the breast: higher risk for subsequent invasive cancer predicted by more extensive disease. Hum Pathol 22:1232–1239.

    Article  PubMed  CAS  Google Scholar 

  • Page DL, Dupont WD, Rogers LW et al. (1995) Continued local recurrence of carcinoma 15–25 years after a diagnosis of low grade ductal carcinoma in situ of the breast treated only by biopsy. Cancer 76:1197–1200.

    Article  PubMed  CAS  Google Scholar 

  • Porter BL, Garcia R, Moe R et al. (1991) C-erb-2 oncogene protein in situ and invasive lobular breast neoplasia. Cancer 68:331–334.

    Article  PubMed  CAS  Google Scholar 

  • Ries LAG, Miller BA, Hankey BF et al. (eds) (1994) SEER Cancer Statistics Review, 1973–1991. (NIH publication 94–2789) US DHHS National Cancer Institute, Bethesda.

    Google Scholar 

  • Rosen PP, Lieberman PH, Braun DW Jr et al. (1978) Lobular carcinoma in situ of the breast. Am J Surg Pathol 2:225–251.

    Article  PubMed  CAS  Google Scholar 

  • Rubin E, Visscher D, Alexander R et al. (1988) Proliferative disease and atypia in biopsies performed for nonpalpable lesions detected mammographically. Cancer 61:2077–2082.

    Article  PubMed  CAS  Google Scholar 

  • Salvadori B, Bartoli C, Zurrida S et al. (1991) Risk of invasive cancer in women with lobular carcinoma in situ of the breast. Eur J Cancer 27:35–37.

    Article  PubMed  CAS  Google Scholar 

  • Seidman H, Stellman SD, Mushinski MH (1982) A different perspective on breast cancer risk factors: some implications of non-attributable risk. CA Cancer J Clin 32:301–312.

    Article  PubMed  CAS  Google Scholar 

  • Sillero-Arenas M, Delgado-Rodriguez M, Rodigues-Canteras R et al. (1992) Menopausal hormone replacement therapy and breast cancer: a meta-analysis. Obstet Gynecol 79:286–294.

    PubMed  CAS  Google Scholar 

  • Skolnick M, Cannon-Albright L, Goldgar D et al. (1990) Inheritance of proliferative breast disease in breast cancer kindreds. Science 250:1715–1720.

    Article  PubMed  CAS  Google Scholar 

  • Spiegelman D, Colditz GA, Hunter D et al. (1994) Validation of the Gail et al. model predicting individual breast cancer risk. J Natl Cancer Inst 86:600–607.

    Article  PubMed  CAS  Google Scholar 

  • Steinberg KK, Thacker SB, Smith J et al. (1991) A meta-analysis of the effect of estrogen replacement therapy on the risk of breast cancer. JAMA 265:1985–1990.

    Article  PubMed  CAS  Google Scholar 

  • Trichopoulos D, MacMahon B, Cole P (1972) Menopause and breast cancer risk. J Natl Cancer Inst 48:605–613.

    PubMed  CAS  Google Scholar 

  • UK National Case-Control Study Group (1989) Oral contraceptive use and breast cancer risk in young women. Lancet 1:976–982.

    Google Scholar 

  • Willett WC, Hunger DJ, Stampfer MJ et al. (1992) Dietary fat and fiber in relation to risk of breast cancer. An 8 year follow-up. JAMA 268:2037–2044.

    Article  PubMed  CAS  Google Scholar 

  • Wolff MS, Toniolo PG, Lee EW et al. (1993) Blood levels of organocholorine residues and risk of breast cancer. J Natl Cancer Inst 85:648–652.

    Article  PubMed  CAS  Google Scholar 

  • Young TB (1989) A case-control study of breast cancer and alcohol consumption habits. Cancer 64:552–558.

    Article  PubMed  CAS  Google Scholar 

  • Zafrani B, Leroyer A, Fourquet A et al. (1994) Mammographically detected ductal in situ carcinoma of the breast analyzed with a new classification. A study of 127 cases: correlation with estrogen and progesterone receptors, p53 and C-erb B-2 proteins, and proliferative activity. Semin Diagn Pathol 11:208–214.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Northwestern University School of Medicine, 333 East Superior Street, Suite 250, Chicago, IL, 60611, USA

    M. Morrow

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  1. M. Morrow
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Editors and Affiliations

  1. Center for Tumordetection and Prevention, Rorschacherstrasse 150, CH-9006, St. Gallen, Switzerland

    Hans-Jörg Senn

  2. European Institute of Oncology, Via Ripamonti, I-20141, Milan, Italy

    Alberto Costa M.D.

  3. Robert H. Lurie Cancer Center Breast Cancer Research Program, Olson Pavilion, Northwest-University Medical School, 503 E. Chicago Ave., 60611, Chicago, IL, USA

    V. Craig Jordan

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© 1999 Springer-Verlag Berlin · Heidelberg

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Morrow, M. (1999). Identification of the Woman at Risk for Breast Cancer: Problem Solved?. In: Senn, HJ., Costa, A., Jordan, V.C. (eds) Chemoprevention of Cancer. Recent Results in Cancer Research, vol 151. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59945-3_6

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  • DOI: https://doi.org/10.1007/978-3-642-59945-3_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64192-3

  • Online ISBN: 978-3-642-59945-3

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