Joanne Kotsopoulos1, Jacek Gronwald2, Jeanna M McCuaig3, Beth Y Karlan4, Andrea Eisen5, Nadine Tung6, Louise Bordeleau7, Leigha Senter8, Charis Eng9, Fergus Couch10, Robert Fruscio11, Jeffrey N Weitzel12, Olufunmilayo Olopade13, Christian F Singer14, Tuya Pal15, William D Foulkes16, Susan L Neuhausen17, Ping Sun18, Jan Lubinski2, Steven A Narod19. 1. Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 2. Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland. 3. Division of Gynecologic Oncology, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada. 4. Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. 5. Toronto-Sunnybrook Regional Cancer Center, Toronto, ON, Canada. 6. Beth Israel Deaconess Medical Center, Boston, MA, USA. 7. Department of Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, ON, Canada. 8. Division of Human Genetics, the Ohio State University Medical Center, Comprehensive Cancer Center, Columbus, OH, USA. 9. Genomic Medicine Institute, Cleveland Clinic Lerner Research Institute, Center for Personalised Genetic Healthcare, Cleveland Clinic Community Care and Population Health, Cleveland, OH, USA. 10. Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. 11. Department of Medicine and Surgery, University of Milan Bicocca, Monza, Italy. 12. Division of Clinical Cancer Genomics, Department of Population Sciences, City of Hope, Duarte, CA, USA. 13. Department of Medicine and Human Genetics, University of Chicago, Chicago, IL, USA. 14. Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 15. Department of Medicine, Vanderbilt University, Nashville, TN, USA. 16. Program in Cancer Genetics, Department of Oncology and Human Genetics, McGill University, Montréal, QC, Canada. 17. Division of Biomarkers of Early Detection and Prevention, Department of Population Sciences, City of Hope, Duarte, CA, USA. 18. Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada. 19. Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Electronic address: steven.narod@wchospital.ca.
Abstract
OBJECTIVE: BRCA mutation carriers face a high lifetime risk of developing ovarian cancer. The strong inverse association between breastfeeding and the risk of ovarian cancer is established in the general population but is less well studied among women with a germline BRCA1 or BRCA2 mutation. METHOD: Thus, we conducted a matched case-control analysis to evaluate the association between breastfeeding history and the risk of developing ovarian cancer. After matching for year of birth, country of residence, BRCA gene and personal history of breast cancer, a total of 1650 cases and 2702 controls were included in the analysis. Conditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) associated with various breastfeeding exposures. RESULTS: A history of ever-breastfeeding was associated with a 23% reduction in risk (OR = 0.77; 95%CI 0.66-0.90; P = 0.001). The protective effect increased with breastfeeding from one month to seven months after which the association was relatively stable. Compared to women who never breastfed, breastfeeding for seven or more months was associated with a 32% reduction in risk (OR = 0.68; 95%CI 0.57-0.81; P < 0.0001) and did not vary by BRCA gene or age at diagnosis. The combination of breastfeeding and oral contraceptive use was strongly protective (0.47; 95%CI 0.37-0.58; P < 0.0001). CONCLUSIONS: These findings support a protective effect of breastfeeding for at least seven months among women with a BRCA1 or BRCA2 mutation, that is independent of oral contraceptive use.
OBJECTIVE:BRCA mutation carriers face a high lifetime risk of developing ovarian cancer. The strong inverse association between breastfeeding and the risk of ovarian cancer is established in the general population but is less well studied among women with a germline BRCA1 or BRCA2 mutation. METHOD: Thus, we conducted a matched case-control analysis to evaluate the association between breastfeeding history and the risk of developing ovarian cancer. After matching for year of birth, country of residence, BRCA gene and personal history of breast cancer, a total of 1650 cases and 2702 controls were included in the analysis. Conditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) associated with various breastfeeding exposures. RESULTS: A history of ever-breastfeeding was associated with a 23% reduction in risk (OR = 0.77; 95%CI 0.66-0.90; P = 0.001). The protective effect increased with breastfeeding from one month to seven months after which the association was relatively stable. Compared to women who never breastfed, breastfeeding for seven or more months was associated with a 32% reduction in risk (OR = 0.68; 95%CI 0.57-0.81; P < 0.0001) and did not vary by BRCA gene or age at diagnosis. The combination of breastfeeding and oral contraceptive use was strongly protective (0.47; 95%CI 0.37-0.58; P < 0.0001). CONCLUSIONS: These findings support a protective effect of breastfeeding for at least seven months among women with a BRCA1 or BRCA2 mutation, that is independent of oral contraceptive use.
Authors: Fadil M Hannan; Taha Elajnaf; Laura N Vandenberg; Stephen H Kennedy; Rajesh V Thakker Journal: Nat Rev Endocrinol Date: 2022-10-03 Impact factor: 47.564
Authors: Hussam Rostom; Xin Meng; Helen Price; Alexandria Fry; Taha Elajnaf; Robert Humphrey; Nishan Guha; Tim James; Stephen H Kennedy; Fadil M Hannan Journal: BMJ Open Date: 2022-08-30 Impact factor: 3.006