Family History among Iraqi Patients Diagnosed with Breast Cancer

Breast cancer is the most common cancer affecting women in Iraq. Although a positive family history is a well established risk factor for the disease, yet the clinical and pathological characteristics of familial breast cancer remain a controversial issue. Aim To correlate the family history of breast cancer with the clinico-pathological characteristics among Iraqi patients diagnosed with the disease. Patients and Methods This comparative retrospective study involved 204 female patients who reported a family history of breast cancer out of 1081 diagnosed with the disease. All data was extracted from an established information system database, developed by the Director of the National Cancer Research Center/Baghdad University, over a 2-years period from July 2014 to June 2016. The recorded information included relevant data pertaining to family history, clinical presentation, diagnostic, clinical and pathologic findings. The family history was considered positive when the patient had one or more relatives diagnosed as breast cancer within three generations. Results Family history of cancer was registered in 30 % of Iraqi patients affected with breast cancer, in 18.5 % the involved site was the breast. Among those 156 patients had one affected relative (76.5 %), 39 had two involved relatives (19.1 %) while a first degree relative was noted in 43.7 %. The peak age frequency at the time of diagnoses was in the fifth decade of life. About 88 % were married, 18.1 % were nullipara and 15 % had their first child born after the age of 35 years. History of lactation and hormonal intake was demonstrated in 54.5 % and 22.5 % respectively. Bilateral breast cancer was detected in 7.4 %, the main histological type was infiltrative ductal carcinoma (77.8 %). Positive lymph node involvement was observed in 65 % of the patients in whom 42 % presented at stages III and IV. Esrogen and Progesterone receptor positive activities were diagnosed immunohistochemically in 63.2 % and 65 % of tumor specimens respectively, 29.1 % exhibited Her2 over expression. Conclusions and Recommendations The characteristics of patients with positive family history of breast cancer did not reveal distinct clinical markers for their identification. Careful screening and regular follow up of the target population along with promoting public education on breast health care seem to be essential approaches to identify high risk groups for breast cancer control in Iraq.