Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study
Lieske H Schrijver
(1)
,
Håkan Olsson
(2)
,
Kelly-Anne Phillips
(3, 4)
,
Mary Beth Terry
(5)
,
David E Goldgar
(6)
,
Karin Kast
(7)
,
Christoph Engel
(8, 9)
,
Thea M Mooij
(1)
,
Julian Adlard
(10)
,
Daniel Barrowdale
(11)
,
Rosemarie Davidson
(12)
,
Ros Eeles
(13)
,
Steve Ellis
(11)
,
D Gareth Evans
(14)
,
Debra Frost
(11)
,
Louise Izatt
(15)
,
Mary E Porteous
(16)
,
Lucy E Side
(17)
,
Lisa Walker
(18)
,
Pascaline Berthet
(19)
,
Valérie Bonadona
(20)
,
Dominique Leroux
(21, 22)
,
Emmanuelle Mouret-Fourme
(23)
,
Laurence Venat-Bouvet
(24)
,
Saundra S Buys
(25)
,
Melissa C Southey
(26)
,
Esther M John
(27, 28)
,
Wendy K Chung
(29)
,
Mary B Daly
(30)
,
Anita Bane
(31, 32)
,
Christi J van Asperen
(33)
,
Encarna B Gómez Garcia
(34)
,
Marian J E Mourits
(35)
,
Theo a M van Os
(36)
,
Marie-José Roos-Blom
(1)
,
Michael L Friedlander
(37, 38)
,
Sue-Anne Mclachlan
(4, 39)
,
Christian F Singer
(40)
,
Yen y Tan
(40)
,
Lenka Foretova
(41)
,
Marie Navratilova
(41, 42)
,
Anne-Marie Gerdes
(43)
,
Trinidad Caldes
(44)
,
Jacques Simard
(45)
,
Edith Olah
(46)
,
Anna Jakubowska
(47)
,
Brita Arver
(32)
,
Ana Osorio
(48)
,
Catherine Noguès
(49)
,
Nadine Andrieu
(50)
,
Douglas F Easton
(11)
,
Flora E van Leeuwen
(1)
,
John L Hopper
(4)
,
Roger L Milne
(4, 51)
,
Antonis C Antoniou
(11)
,
Matti A Rookus
(1)
1
NKI -
Netherlands Cancer Institute
2 Skane University Hospital [Lund]
3 Lund University [Lund]
4 University of Melbourne
5 Columbia Mailman School of Public Health
6 University of Utah School of Medicine [Salt Lake City]
7 TU Dresden - Technische Universität Dresden = Dresden University of Technology
8 Department of Clinical Sciences [Lund]
9 Leipzig University
10 Chapel Allerton Hospital
11 CAM - University of Cambridge [UK]
12 Queen Elizabeth University Hospital (Glasgow)
13 Royal Marsden NHS Foundation Trust
14 University of Manchester [Manchester]
15 Guy's and St Thomas NHS Foundation Trust [London]
16 Western General Hospital [Edinburgh, UK]
17 GOSHC - Great Ormond Street Hospital for Children NHS Foundation Trust [London, UK]
18 Churchill Hospital [Breast Care Unit]
19 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
20 UCBL - Université Claude Bernard Lyon 1
21 CHU - Centre Hospitalier Universitaire [Grenoble]
22 hôpital couple-enfant [CHU Grenoble Alpes]
23 Hôpital René HUGUENIN (Saint-Cloud)
24 Hôpital Dupuytren [CHU Limoges]
25 Huntsman Cancer Institute [Salt Lake City]
26 Monash University [Melbourne]
27 Stanford University School of Medicine [CA, USA]
28 California Sciences Institute
29 Columbia University [New York]
30 Fox Chase Cancer Center
31 McMaster University [Hamilton, Ontario]
32 Karolinska Institutet [Stockholm]
33 Leiden University Medical Center (LUMC)
34 GROW - School for Oncology and Developmental Biology [Maastricht]
35 UMCG - University Medical Center Groningen [Groningen]
36 AMC - Academic Medical Center - Academisch Medisch Centrum [Amsterdam]
37 UNSW - University of New South Wales [Sydney]
38 Prince of Wales Hospital
39 St. Vincent's Hospital, Sydney
40 Medizinische Universität Wien = Medical University of Vienna
41 MMCI - Masaryk Memorial Cancer Institute
42 University Hospital of Cologne [Cologne]
43 Copenhagen University Hospital
44 IdISSC - Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain]
45 ULaval - Université Laval [Québec]
46 National Institute of Oncology [Budapest, Hungary]
47 PUM - Pomeranian Medical University [Szczecin]
48 Spanish National Cancer Centre
49 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
50 Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe
51 Cancer Epidemiology Centre & Cancer Council Victoria [Melbourne, Australia]
2 Skane University Hospital [Lund]
3 Lund University [Lund]
4 University of Melbourne
5 Columbia Mailman School of Public Health
6 University of Utah School of Medicine [Salt Lake City]
7 TU Dresden - Technische Universität Dresden = Dresden University of Technology
8 Department of Clinical Sciences [Lund]
9 Leipzig University
10 Chapel Allerton Hospital
11 CAM - University of Cambridge [UK]
12 Queen Elizabeth University Hospital (Glasgow)
13 Royal Marsden NHS Foundation Trust
14 University of Manchester [Manchester]
15 Guy's and St Thomas NHS Foundation Trust [London]
16 Western General Hospital [Edinburgh, UK]
17 GOSHC - Great Ormond Street Hospital for Children NHS Foundation Trust [London, UK]
18 Churchill Hospital [Breast Care Unit]
19 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
20 UCBL - Université Claude Bernard Lyon 1
21 CHU - Centre Hospitalier Universitaire [Grenoble]
22 hôpital couple-enfant [CHU Grenoble Alpes]
23 Hôpital René HUGUENIN (Saint-Cloud)
24 Hôpital Dupuytren [CHU Limoges]
25 Huntsman Cancer Institute [Salt Lake City]
26 Monash University [Melbourne]
27 Stanford University School of Medicine [CA, USA]
28 California Sciences Institute
29 Columbia University [New York]
30 Fox Chase Cancer Center
31 McMaster University [Hamilton, Ontario]
32 Karolinska Institutet [Stockholm]
33 Leiden University Medical Center (LUMC)
34 GROW - School for Oncology and Developmental Biology [Maastricht]
35 UMCG - University Medical Center Groningen [Groningen]
36 AMC - Academic Medical Center - Academisch Medisch Centrum [Amsterdam]
37 UNSW - University of New South Wales [Sydney]
38 Prince of Wales Hospital
39 St. Vincent's Hospital, Sydney
40 Medizinische Universität Wien = Medical University of Vienna
41 MMCI - Masaryk Memorial Cancer Institute
42 University Hospital of Cologne [Cologne]
43 Copenhagen University Hospital
44 IdISSC - Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain]
45 ULaval - Université Laval [Québec]
46 National Institute of Oncology [Budapest, Hungary]
47 PUM - Pomeranian Medical University [Szczecin]
48 Spanish National Cancer Centre
49 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
50 Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe
51 Cancer Epidemiology Centre & Cancer Council Victoria [Melbourne, Australia]
Daniel Barrowdale
- Function : Author
- PersonId : 768869
- ORCID : 0000-0003-1661-3939
Jacques Simard
- Function : Author
- PersonId : 757778
- ORCID : 0000-0001-6906-3390
Anna Jakubowska
- Function : Author
- PersonId : 762556
- ORCID : 0000-0002-5650-0501
Abstract
Background: For BRCA1 and BRCA2 mutation carriers, the association between oral contraceptive preparation (OCP) use and breast cancer (BC) risk is still unclear.
Methods: Breast camcer risk associations were estimated from OCP data on 6030 BRCA1 and 3809 BRCA2 mutation carriers using age-dependent Cox regression, stratified by study and birth cohort. Prospective, left-truncated retrospective and full-cohort retrospective analyses were performed.
Results: For BRCA1 mutation carriers, OCP use was not associated with BC risk in prospective analyses (hazard ratio [HR] = 1.08, 95% confidence interval [CI] = 0.75 to 1.56), but in the left-truncated and full-cohort retrospective analyses, risks were increased by 26% (95% CI = 6% to 51%) and 39% (95% CI = 23% to 58%), respectively. For BRCA2 mutation carriers, OCP use was associated with BC risk in prospective analyses (HR = 1.75, 95% CI = 1.03 to 2.97), but retrospective analyses were inconsistent (left-truncated: HR = 1.06, 95% CI = 0.85 to 1.33; full cohort: HR = 1.52, 95% CI = 1.28 to 1.81). There was evidence of increasing risk with duration of use, especially before the first full-term pregnancy (BRCA1: both retrospective analyses, P < .001 and P = .001, respectively; BRCA2: full retrospective analysis, P = .002).
Conclusions: Prospective analyses did not show that past use of OCP is associated with an increased BC risk for BRCA1 mutation carriers in young middle-aged women (40-50 years). For BRCA2 mutation carriers, a causal association is also not likely at those ages. Findings between retrospective and prospective analyses were inconsistent and could be due to survival bias or a true association for younger women who were underrepresented in the prospective cohort. Given the uncertain safety of long-term OCP use for BRCA1/2 mutation carriers, indications other than contraception should be avoided and nonhormonal contraceptive methods should be discussed.
Domains
Life Sciences [q-bio]
Origin : Publication funded by an institution