Oral contraceptives and breast cancer risk in the international BRCA1/2 carrier cohort study:: A report from EMBRACE, GENEPSO, GEO-HEBON, and the IBCCS Collaborating Group

被引:103
作者
Brohet, Richard M.
Goldgar, David E.
Easton, Douglas F.
Antoniou, Antonis C.
Andrieu, Nadine
Chang-Claude, Jenny
Peock, Susan
Eeles, Rosalind A.
Cook, Margaret
Chu, Carol
Nogues, Catherine
Lasset, Christine
Berthet, Pascaline
Meijers-Heijboer, Hanne
Gerdes, Anne-Marie
Olsson, Hakan
Caldes, Trinidad
van Leeuwen, Flora E.
Rookus, Matti A.
机构
[1] Free Univ Amsterdam, Netherlands Canc Inst, Dept Epidemiol, Amsterdam, Netherlands
[2] Erasme Univ Hosp, Rotterdam, Netherlands
[3] Int Agcy Res Canc, Ctr Leon Berard, Dept Genet Epidemiol, F-69372 Lyon, France
[4] INSERM, Inst Curie, Serv Biostat, U 794, Paris, France
[5] Ctr Rene Huguenin, St Cloud, France
[6] Ctr Francois Baclesse, F-14021 Caen, France
[7] Univ Utah, Sch Med, Dept Dermatol, Salt Lake City, UT USA
[8] Univ Cambridge, Dept Publ Hlth & Primary Care, Genet Epidemiol Unit, Cambridge, England
[9] Royal Marsden Hosp, London SW3 6JJ, England
[10] Reg Genet Serv, Leeds, W Yorkshire, England
[11] German Canc Res Ctr, Div Canc Epidemiol, D-6900 Heidelberg, Germany
[12] Odense Univ Hosp, DK-5000 Odense, Denmark
[13] Univ Lund Hosp, S-22185 Lund, Sweden
[14] Hosp Clin San Carlos, Madrid, Spain
关键词
D O I
10.1200/JCO.2007.11.1179
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose Earlier studies have shown that endogenous gonadal hormones play an important role in the etiology of breast cancer among BRCA1/ 2 mutation carriers. So far, little is known about the safety of exogenous hormonal use in mutation carriers. In this study, we examined the association between oral contraceptive use and risk of breast cancer among BRCA1/ 2 carriers. Patients and Methods In the International BRCA1/ 2 Carrier Cohort study ( IBCCS), a retrospective cohort of 1,593 BRCA1/ 2 mutation carriers was analyzed with a weighted Cox regression analysis. Results We found an increased risk of breast cancer for BRCA1/ 2 mutation carriers who ever used oral contraceptives ( adjusted hazard ratio [ HR] = 1.47; 95% CI, 1.16 to 1.87). HRs did not vary according to time since stopping use, age at start, or calendar year at start. However, a longer duration of use, especially before first full- term pregnancy, was associated with an increased risk of breast cancer for both BRCA1 and BRCA2 mutation carriers ( 4 or more years of use before first full-term pregnancy: HR = 1.49 [ 95% CI, 1.05 to 2.11] for BRCA1 carriers and HR = 2.58 [ 95% CI, 1.21 to 5.49] for BRCA2 carriers). Conclusion No evidence was found among BRCA1/ 2 mutation carriers that current use of oral contraceptives is associated with risk of breast cancer more strongly than is past use, as is found in the general population. However, duration of use, especially before first full- term pregnancy, may be associated with an increasing risk of breast cancer among both BRCA1 and BRCA2 mutation carriers.
引用
收藏
页码:3831 / 3836
页数:6
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