Penetrance of breast cancer, ovarian cancer and contralateral breast cancer in and families: high cancer incidence at older age
Résumé
Accurate estimations of lifetime risks of breast and ovarian cancer are crucial for counselling women from families. We therefore determined breast and ovarian cancer penetrance in / mutation families in the northern Netherlands and compared them with the incidence of cancers in the general population in this region. We identified 1188 female mutation carriers and first-degree female relatives in 185 families with a pathogenic or mutation. The occurrence of breast cancer, contralateral breast cancer and ovarian cancer was recorded. The cumulative incidence of breast cancer by age 70 was 71.4% (95% CI 67.2–82.4%) in and 87.5% (82.4–92.6%) in mutation carriers. For ovarian cancer at age 70, it was 58.9% (53.5–64.3%) in and 34.5% (25.0–44.0%) in mutation carriers. For breast cancer we saw a rise of 24.2% in the cumulative incidence in the seventh decade for mutation carriers versus 6.3% for . For ovarian cancer the rise in the seventh decade was 17.3% for mutation carriers and 15.1% for . The 10-year risk for contralateral breast cancer was 34.2% (29.4–39.0%) in families and 29.2% (22.9–35.5%) in . We show that the incidence of breast and ovarian cancer in mutation carriers and of ovarian cancer in mutation carriers is still high after 60 years. This may justify intensive breast screening as well as oophorectomy even after age 60. The risk of contralateral breast cancer rises approximately 3% per year, which may affect preventive choices.
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