Early Screening Not Related To Family Breast Cancer

New research suggests that just because a woman has family members with breast cancer, it does not mean that she should undergo early screening for the cancer. According to the report, there are certain factors doctors can look for to determine whether early screening is advisable.

"Breast cancer is very common. Familial clustering is also rather common," Dr. Geertruida H. de Bock, the study's first author, told Reuters Health. "About 25 to 30 percent of breast cancer is family clustered, but the (rate) of breast cancer in the family is not very useful in predicting if you will get breast cancer yourself."

At present, having a first-degree relative (mother, sister, or daughter) diagnosed with breast cancer before age 40 is considered to be an indication for starting breast cancer screening before age 50, de Bock and her team note in the journal BMC Cancer. However, this practice is based on estimates from families with risky gene mutations or who are otherwise cancer-prone.

To better understand the risk in the general population, the researchers looked at 1,987 women, all of whom had sisters who had been diagnosed with breast cancer. Some of the study participants had breast cancer while others didn't.

The researchers identified four familial factors that were related to developing breast cancer at a younger age:

--at least two cases of breast cancer in a first-degree relative;

--at least two cases of breast cancer in first or second-degree (grandparent, grandchild, uncle, aunt, nephew, niece, half-sibling) relatives younger than 50;

--at least one case of breast cancer in a first or second-degree relative younger than 40;

--or any case of cancer affecting both breasts

Women who had at least two of these risk factors were roughly eleven times more likely than those with no risk factors to develop breast cancer by age 30. For cancers occurring before ages 40 and 50, the presence of two or more factors raised the risks by five-fold and two-fold, respectively.

However, because breast cancer is so uncommon in younger women, even with two or more of the above factors, the odds of breast cancer by age 30 is just 1 percent. By ages 50 and 70, the risks of breast cancer increased to 13 and 11 percent, respectively. Given that these risks are already pretty low, women with just one factor are likely to have a very low risk and may not require early screening at all.

The authors believe that by looking for the factors they identified, doctors can better inform patients of their true risk of breast cancer and whether early screening is warranted.

"There is a tendency to screen everyone and I think screening has disadvantages as well as advantages," de Bock said. Doctors "should be critical about it and really think about it if there isn't really an increased risk."

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