Abstract
The incidence of breast cancer rises steeply between ages 25 and 50, and more slowly thereafter. In contrast, the incidence in the unaffected (contralateral) breast of women who have had breast cancer remains constant at about 0.7% per year for at least the next 20 years after diagnosis, irrespective of age at first diagnosis. The incidence in relatives of the patients seems to show a similar pattern. The incidence in a prospective study of monozygotic twins of patients was approximately constant at 1.3% per year (77 cases), again about 0.7% per breast. At ages older than a patient's age at diagnosis, her mother and sisters have an incidence of 0.3–0.4% per year. Above the index patient's age at diagnosis, the rate in relatives shows no temporal trend and is independent of the patient's age at diagnosis. A statistically simple explanation is that incidence in susceptible women increases to a high constant level by a predetermined age that varies between families, but this seems inconsistent with conventional models of carcinogenesis and susceptibility. The very high incidence in monozygotic twins of patients indicates that a high proportion, and perhaps the majority, of breast cancers arise in a susceptible minority of women.
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Acknowledgements
We thank the women who participated, J. Cairns for discussions and the UK National Case Control Study Group. The UK case control studies were funded by the Cancer Research Campaign, the Imperial Cancer Research Fund and the Medical Research Council. The US twin studies were supported by grants R01CA32262 and R35CA42581 from the National Institute of Health. J.P. is supported by the Cancer Research Campaign.
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Peto, J., Mack, T. High constant incidence in twins and other relatives of women with breast cancer. Nat Genet 26, 411–414 (2000). https://doi.org/10.1038/82533
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DOI: https://doi.org/10.1038/82533
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