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      História familiar em segundo grau como fator de risco para câncer de mama Translated title: Second-degree family history as a risk factor for breast cancer

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          Abstract

          Objetivos: investigar a associação entre história familiar de câncer de mama em segundo grau e o risco de apresentar a doença. Métodos: estudo de caso-controle com casos incidentes. Foram avaliados 66 casos e 198 controles selecionados entre mulheres que realizaram mamografia em Serviço Privado de Radiodiagnóstico no período de janeiro de 94 a julho de 97. Casos e controles foram pareados quanto idade, idade da menarca, da primeira gestação e da menopausa, paridade, uso de anticoncepcionais orais e terapia de reposição hormonal. Resultados: não houve diferença significativa entre casos e controles em relação a outros fatores de risco que não história familiar em segundo grau. As pacientes com câncer de mama apresentaram maior chance de ter história familiar em segundo grau comparadas aos controles (RC=2,77; IC 95%, 1,03-7,38; p=0,039). Conclusões: a neoplasia maligna de mama está associada à presença de história familiar em segundo grau para essa doença.

          Translated abstract

          Purpose: to evaluate the association between second-degree family history of breast cancer and the risk to develop the disease. Methods: case-control study of incident cases. Sixty-six incident breast cancer cases and 198 controls were selected among women who were submitted to mammography in a private clinic between January 1994 and July 1997. Cases and controls were paired regarding age, age at menarche, at first live birth, at menopause, parity, oral contraceptives and use of hormonal replacement therapy. Results: there was no significant difference between cases and controls regarding all risk factors evaluated, besides second-degree family history. Patients with breast cancer were more likely to have second-degree relatives with breast cancer when compared to controls (OR=2.77; 95% CI, 1.03-7.38; p=0.039). Conclusions: malignant neoplasm of the breast is significantly associated with a second-degree family history of this disease.

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          Family history and the risk of breast cancer: A systematic review and meta-analysis

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            A comprehensive evaluation of family history and breast cancer risk. The Utah Population Database.

            The purpose of this study is to assess the impact of family history on the risk of developing breast cancer. A case-control study design was used. To provide a comprehensive assessment of family history risk, we used the Utah Population Database, a linked database compiled of genealogy data of the descendants of Mormon pioneer families, cancer data from the Utah Cancer Registry, and mortality data from the Utah Department of Vital Statistics. All women diagnosed with breast cancer who were in the genealogy database and the Utah Cancer Registry were included. Controls were women selected from the genealogy, who like cases had no record of previous cancer. They were matched to the cases by age and place of birth. Several definitions of family history were used. The total familial risk variable, developed to work effectively in the Utah Genealogy Database, accounts for all family members, their degree of relatedness to the case, and the amount of time they were observed for possible cancer diagnosis. A threefold increase in risk, estimated by the odds ratio (OR), of breast cancer among those with the highest family history score (6% of cases) was observed when compared with those with the lowest family history score. The OR for women with a first-degree relative with breast cancer was 2.45 (95% confidence interval [CI], 1.84 to 3.06). If the nearest relative was a second-degree relative, the OR was 1.82 (95% CI, 1.39 to 2.24); if the nearest relative was a third-degree relative, the OR was 1.35 (95% CI, 1.07 to 1.64). A slightly greater risk was observed if the first-degree relative was a woman's mother (OR, 2.44; 95% CI, 1.77 to 3.42) rather than a sister (OR, 2.01; 95% CI, 1.66 to 2.43). Among subjects diagnosed before the age of 50 years, the disease experience of relatives prior to age 50 was most important, while for older subjects the experience of relatives of all ages was of roughly equal importance. Women who developed contralateral breast cancer within 3 years of initial diagnosis were nearly 10 times as likely as women without breast cancer to have a first-degree relative with breast cancer. Based on the risk estimates in this study, we have estimated that approximately 17% to 19% of breast cancer in the population could be attributed to family history. Women who had a first-degree relative with colon cancer had a 30% increased risk of breast cancer. In this study population, women with a family history of breast cancer, even if the nearest relative with breast cancer is a third-degree relative, are at increased risk of the disease.
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              The association of age and familial risk in a case-control study of breast cancer.

              To investigate the association of breast cancer risk, age, and family history of breast cancer, 779 breast cancer patients and 1,558 comparably aged control patients without cancer or a history of cancer were studied. All patients were admitted to Roswell Park Memorial Institute, Buffalo, New York between 1982 and 1987. After adjustment for the effects of other major breast cancer risk factors, no overall increase in risk for a history of breast cancer in a first-degree relative was observed among younger women. However, when the age at reported occurrence of breast cancer was considered, increased relative risk (RR) was observed when the affected first-degree relative was diagnosed at a young age (RR = 1.3). In contrast, among older patients, greater risk (RR = 1.9) was associated with diagnosis in a first-degree relative at an older age. Among patients aged 55 years or older, risk for reporting one first-degree relative with breast cancer was significant (RR = 1.8) and was greater when more than one first-degree relative was reported to have breast cancer (RR = 3.3). Bilaterality in an affected first-degree relative was associated with increased risk only among older patients (RR = 2.3). Other studies have observed various age-related effects, but the present research differs in that the authors studied both the age of the patient at risk and the age of the affected relatives across the full range of ages at which breast cancer occurs. These findings may have implications for the identification of populations for earlier initiation of routine screening and for laboratory investigation of the genetic etiology of breast cancer.
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                Author and article information

                Journal
                rbgo
                Revista Brasileira de Ginecologia e Obstetrícia
                Rev. Bras. Ginecol. Obstet.
                Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (Rio de Janeiro, RJ, Brazil )
                0100-7203
                1806-9339
                September 1998
                : 20
                : 8
                : 469-473
                Affiliations
                [01] orgnameUniversidade Federal do Rio Grande do Sul orgdiv1Faculdade de Medicina orgdiv2Hospital São Rafael
                [02] Novo Hamburgo RS orgnamePontifícia Universidade Católica de Porto Alegre orgdiv1Faculdade de Medicina souza@ 123456nh.conex.com.br
                Article
                S0100-72031998000800007 S0100-7203(98)02000807
                10.1590/S0100-72031998000800007
                a1406b0f-a625-4e78-b4b2-cf7b6d87aee2

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 5
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                SciELO Brazil

                Categories
                Trabalhos Originais

                Fatores de risco,Hereditariedade,Breast neoplasms,Risk factors,Heredity,Mama: câncer,Câncer: epidemiologia

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