36 Breast Diseases: A Year Book®

Quarterly36 Vol 19 No 1 2008

breast cancer event (adjusted hazard ratio,0.96; 95% confidence interval, 0.80-1.14;P = .63), and 155 intervention groupwomen (10.1%) vs 160 comparisongroup women (10.3%) died (adjustedhazard ratio, 0.91; 95% confidence inter-val, 0.72-1.15; P = .43). No significant in-

teractions were observed between dietgroup and baseline demographics, char-acteristics of the original tumor, baselinedietary pattern, or breast cancer treatment.

Conclusion.—Among survivors ofearly stage breast cancer, adoption of adiet that was very high in vegetables, fruit,

and fiber and low in fat did not reduce ad-ditional breast cancer events or mortalityduring a 7.3-year follow-up period.

Please see expert perspective byChlebowski.

Increased Risk of BreastCancer Associated WithCHEK2*1100delCWeischer M, Bojesen SE, Tybjærg-HansenA, et al (Herlev Univ, Denmark;Copenhagen Univ; Bispebjerg Univ,Denmark; et al)

J Clin Oncol 25:57-63, 2007

Purpose.—CHEK2*1100delC het-erozygosity has been associated with in-creased risk of breast, prostate, and colo-rectal cancer in case-control studies. We tested the hypothesis that CHEK2*1100delC heterozygosity in the generalpopulation increases the risk of cancer ingeneral, and breast, prostate, and colorec-tal cancer in particular.

Patients and Methods.—We per-formed a prospective study of 9,231 indi-viduals from the Danish general popula-tion, who were observed for 34 years, andwe performed a case-control study in-cluding 1,101 cases of breast cancer and4,665 controls.

Results.—Of the general population,0.5% were heterozygotes and 99.5%were noncarriers. In the prospectivestudy, multifactorially adjusted hazard ra-tios by CHEK2*1100delC heterozygosi-ty versus noncarriers were 1.2 (95% CI,0.7 to 2.1) for all cancers, 3.2 (95% CI,1.0 to 9.9) for breast cancer, 2.3 (95% CI, 0.6 to 9.5) for prostate cancer, and 1.6(95% CI, 0.4 to 6.5) for colorectal cancer.In the case-control study, age-matchedodds ratio for breast cancer by

CHEK2*1100delC heterozygosity versusnoncarriers was 2.6 (95% CI, 1.3 to 5.4).The absolute 10-year risk of breast cancerin CHEK2*1100delC heterozygotesamounted to 24% in women older than 60years undergoing hormone replacementtherapy, with a body mass index of 25kg/m2 or higher.

Conclusion.—CHEK2*1100delCheterozygosity is associated with a three-fold risk of breast cancer in women in thegeneral population.

Please see expert perspective byWeischer, Bojesen, and Nordestgaard.

Breast Cancer Survival andTumor Characteristics inPremenopausal WomenCarrying the CHEK2*1100delCGermline Mutation Schmidt MK, Tollenaar RAEM, de KempSR, et al (The Netherlands Cancer Inst,Amsterdam; Leiden Univ, The Netherlands)

J Clin Oncol 25:64-69, 2007

Purpose.—Women carrying aCHEK2*1100delC germline mutationhave an increased risk of developing

breast cancer. This study aims to deter-mine the proportion of CHEK2*1100 delCcarriers in a premenopausal breast cancerpopulation, unselected for family historyof breast cancer, and to investigate tumorcharacteristics and disease outcome withsufficient follow-up.

Patients and Methods.—We identi-fied a retrospective cohort of 1,479 pa-tients, who received surgery for invasivebreast cancer between 1970 and 1994. Allpatients were diagnosed before age 50.Paraffin-embedded tissue blocks werecollected for DNA isolation (normal tis-sue), subsequent CHEK2*1100delC

analysis, and tumor revision. Median follow-up was 10.1 years.

Results.—We detected a CHEK2*1100delC germline mutation in 54 pa-tients (3.7%). Tumor characteristics ofCHEK2*1100delC carriers did not differsignificantly from those of noncarriers.CHEK2*1100delC carriers had a two-fold increased risk (hazard ratio [HR],2.1; 95% CI, 1.0 to 4.3; P = .049) of de-veloping a second breast cancer and theyhad worse recurrence-free survival (HR,1.7; 95% CI, 1.2 to 2.4; P = .006) andworse breast cancer-specific survival(HR, 1.4; 95% CI, 1.0 to 2.1; P = .072)