Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 150 No. 3738 (2020)

Concordance of tumour characteristics and survival clustering among pairs of first-degree relatives with breast cancer

Cite this as:
Swiss Med Wkly. 2020;150:w20327



Family history is a known risk factor for breast cancer, but its prognostic value and the prognostic value of tumour characteristics in relation to family history has not been clearly established. In addition, studies of intra-familial tumour characteristics and prognosis in population-based settings are very rare. Two previous studies have suggested that breast cancer prognosis clusters within families. However, both studies lack information on HER2 expression status, which is a strong prognostic factor and could contribute to the observed results.


We conducted a population-based study on 145 mother-daughter and sister-sister affected pairs using data extracted from the Geneva Cancer Registry. Histopathological characteristics were determined in archived tumour blocks by immunochemistry techniques. Breast cancer survival among family members was studied according to patient and tumour characteristics.


No significant intra-familial agreement of pathological characteristic features was observed. We found that relatives of breast cancer patients experienced a much higher risk of breast cancer death compared to the general population. However, we did not find significant concordance in good and poor breast cancer-specific survival between pairs. The small number of family pairs and deaths from breast cancer may partly explain our results.


Large-scale studies with accurate data on strong prognosticators are still needed to confirm the possibility of familial inheritance of breast cancer prognosis.


  1. Stratton MR, Rahman N. The emerging landscape of breast cancer susceptibility. Nat Genet. 2008;40(1):17–22. doi:.
  2. Malone KE, Daling JR, Weiss NS, McKnight B, White E, Voigt LF. Family history and survival of young women with invasive breast carcinoma. Cancer. 1996;78(7):1417–25. doi:.<1417::AID-CNCR7>3.0.CO;2-H
  3. Jobsen JJ, van der Palen J, Brinkhuis M, Ong F, Struikmans H. Long-term effects of first degree family history of breast cancer in young women: Recurrences and bilateral breast cancer. Acta Oncol. 2016;55(4):449–54. doi:.
  4. Chang ET, Milne RL, Phillips KA, Figueiredo JC, Sangaramoorthy M, Keegan TH, et al. Family history of breast cancer and all-cause mortality after breast cancer diagnosis in the Breast Cancer Family Registry. Breast Cancer Res Treat. 2009;117(1):167–76. doi:.
  5. Russo A, Herd-Smith A, Gestri D, Bianchi S, Vezzosi V, Rosselli Del Turco M, et al. Does family history influence survival in breast cancer cases? Int J Cancer. 2002;99(3):427–30. doi:.
  6. Melvin JC, Wulaningsih W, Hana Z, Purushotham AD, Pinder SE, Fentiman I, et al. Family history of breast cancer and its association with disease severity and mortality. Cancer Med. 2016;5(5):942–9. doi:.
  7. Song JL, Chen C, Yuan JP, Sun SR. The association between prognosis of breast cancer and first-degree family history of breast or ovarian cancer: a systematic review and meta-analysis. Fam Cancer. 2017;16(3):339–49. doi:.
  8. Malone KE, Daling JR, Doody DR, O’Brien C, Resler A, Ostrander EA, et al. Family history of breast cancer in relation to tumor characteristics and mortality in a population-based study of young women with invasive breast cancer. Cancer Epidemiol Biomarkers Prev. 2011;20(12):2560–71. doi:.
  9. Jannot AS, Usel M, Bouchardy C, Schubert H, Rapiti E. Breast cancer family history leads to early breast cancer detection and optimal management. Cancer Causes Control. 2017;28(9):921–8. doi:.
  10. Verkooijen HM, Hartman M, Usel M, Benhamou S, Neyroud-Caspar I, Czene K, et al. Breast cancer prognosis is inherited independently of patient, tumor and treatment characteristics. Int J Cancer. 2012;130(9):2103–10. doi:.
  11. Lindström LS, Li J, Lee M, Einbeigi Z, Hartman M, Hall P, et al. Prognostic information of a previously diagnosed sister is an independent prognosticator for a newly diagnosed sister with breast cancer. Ann Oncol. 2014;25(10):1966–72. doi:.
  12. Ménard S, Fortis S, Castiglioni F, Agresti R, Balsari A. HER2 as a prognostic factor in breast cancer. Oncology. 2001;61(Suppl 2):67–72. doi:.
  13. Bouchardy C, Benhamou S, Schaffar R, Verkooijen HM, Fioretta G, Schubert H, et al. Lung cancer mortality risk among breast cancer patients treated with anti-estrogens. Cancer. 2011;117(6):1288–95. doi:.
  14. International Agency for Research on Cancer. Cancer incidence in five continents, Vol IX. IARC Scientific Publications no 160. Lyon, France: IARC; 2008.
  15. Fritz A, Percy C, Jack A, Shanmugaratnam K, Sobin L, Parkin DM, et al., eds. ICD‐O international classification of diseases for oncology. 3rd edn. Geneva: World Health Organization, 2000.
  16. Autorisation de la commission d'experts du secret professionnel en matière de recherche médicale: 2018.
  17. Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ. WHO classification of tumors of the Breast. Lyon: IARC, 2012.
  18. Allred DC, Harvey JM, Berardo M, Clark GM. Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol. 1998;11(2):155–68.
  19. Dowsett M, Nielsen TO, A’Hern R, Bartlett J, Coombes RC, Cuzick J, et al.; International Ki-67 in Breast Cancer Working Group. Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group. J Natl Cancer Inst. 2011;103(22):1656–64. doi:.
  20. Wolff AC, Hammond ME, Hicks DG, Dowsett M, McShane LM, Allison KH, et al.; American Society of Clinical Oncology; College of American Pathologists. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol. 2013;31(31):3997–4013. doi:.
  21. Babaei M, Fallah M, Sundquist K, Hemminki K. Histological concordance in familial central nervous system tumors: Evidence from nationwide Swedish Family-Cancer Database. Cancer Epidemiol. 2015;39(3):334–9. doi:.
  22. Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005;37(5):360–3.
  23. Klein JP, Moeschberger ML. Survival analysis: techniques for censored and truncated data. New York: Springer, 2003.
  24. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53(282):457–81. doi:.
  25. Hemminki K, Ji J, Försti A, Sundquist J, Lenner P. Survival in breast cancer is familial. Breast Cancer Res Treat. 2008;110(1):177–82. doi:.

Most read articles by the same author(s)