A REVIEW ON FAMILY HISTORY OF BREAST-CANCER - SCREENING AND COUNSELING PROPOSALS FOR WOMEN WITH FAMILIAL (NONHEREDITARY) BREAST-CANCER

With the aim to specify screening recommendations for women with famil ial (non-hereditary) breast cancer (FBC) we analysed 59 studies using quantitative methods of pooling. The pooled relative risk (RR) and cum ulative probability were used to estimate breast cancer risk. The RRs for women with a family history of breast cancer in a first-degree rel ative was 2.03 (95% CI 1.09-2.22). The highest RR Is observed for wome n with a family history and atypical hyperplasia in their breast biops y specimen (RR=10.87, 95% CI 6.05-19.69). A high cumulative probabilit y before the age of 50 was only found for women with a combination of two risk factors: a family history and atypical hyperplasia, namely 19 % (95% CI 11-33%). The cumulative probabilities of women aged 50 to 70 years who have a family history were between 11% (95% CI 9-13%, a fam ily history in combination with age at first birth before 22 years) an d 53% (95% CI 35-75%, a family history in combination with atypical hy perplasia). These high risks suggest that women over 50 years of age w ho have a family history of FBC have to be actively encouraged to part icipate in a screening program consisting of a biannual palpation by a specialist, an annual mammogram and a monthly self-control. Yearly sc reening is recommended for women under 50 years of age who have a fami ly history and atypical hyperplasia. These recommendations remain vali d until the effectiveness of such screening programs is assessed. (C) 1997 Elsevier Science Ireland Ltd.