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Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers

Narod, SA; Dube, MP; Klijn, J; Lubinski, J; Lynch, HT; Ghadirian, P; Provencher, D; Heimdal, K; Moller, P and Robson, M, et al. (2002) In Journal of the National Cancer Institute 94(23). p.1773-1779
Abstract
Background: Oral contraceptive use has been associated with an increase in the risk of breast cancer in young women. We examined whether this association is seen in women at high risk of breast cancer because they carry a mutation in one of two breast cancer susceptibility genes, BRCA1 and BRCA2. Methods: We performed a matched case-control study on 1311 pairs of women with known deleterious BRCA1 and/or BRCA2 mutations recruited from 52 centers in 11 countries. Women who had been diagnosed with breast cancer were matched to control subjects by year of birth, country of residence, mutation (BRCA1 or BRCA2), and history of ovarian cancer. All study subjects completed a questionnaire about oral contraceptive use. Odds ratios (ORs) and 95%... (More)
Background: Oral contraceptive use has been associated with an increase in the risk of breast cancer in young women. We examined whether this association is seen in women at high risk of breast cancer because they carry a mutation in one of two breast cancer susceptibility genes, BRCA1 and BRCA2. Methods: We performed a matched case-control study on 1311 pairs of women with known deleterious BRCA1 and/or BRCA2 mutations recruited from 52 centers in 11 countries. Women who had been diagnosed with breast cancer were matched to control subjects by year of birth, country of residence, mutation (BRCA1 or BRCA2), and history of ovarian cancer. All study subjects completed a questionnaire about oral contraceptive use. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived by conditional logistic regression. All statistical tests were two-sided. Results: Among BRCA2 mutation carriers, ever use of oral contraceptives was not associated with an increased risk of breast cancer (OR = 0.94, 95% CI = 0.72 to 1.24). For BRCAI mutation carriers, ever use of oral contraceptives was associated With a modestly increased risk of breast cancer (OR = 1.20, 95 % CI = 1.02 to 1.40). However, compared with BRCA1 mutation carriers who never used oral contraceptives, those who used oral contraceptives for at least 5 years had an increased risk of breast cancer (OR = 1.33, 95% CI = 1.11 to 1.60), as did those who used oral contraceptives before age 30 (OR = 1.29, 95% CI = 1.09 to 1.52), those who were diagnosed with breast cancer before age 40 (OR = 1.38, 95% CI = 1.11 to 1.72), and those who first used oral contraceptives before 1975 (OR = 1.42, 95 % CI = 1.17 to 1.75). Conclusions: Among BRCA1 mutation carriers, women who first used oral contraceptives before 1975, who used them before age 30, or who used them for 5 or more years may have an increased risk of early-onset breast cancer. Oral contraceptives do not appear to be associated with risk of breast cancer in BRCA2 carriers, but data for BRCA2 carriers are limited. (Less)
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Journal of the National Cancer Institute
volume
94
issue
23
pages
1773 - 1779
publisher
Oxford University Press
external identifiers
  • pmid:12464649
  • wos:000179507300010
  • scopus:0037021659
ISSN
1460-2105
DOI
10.1093/jnci/94.23.1773
language
English
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yes
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73cf4f9e-5bcd-4ccf-8d4d-c682499dc63a (old id 322299)
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2007-11-16 10:02:29
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2017-09-24 04:21:12
@article{73cf4f9e-5bcd-4ccf-8d4d-c682499dc63a,
  abstract     = {Background: Oral contraceptive use has been associated with an increase in the risk of breast cancer in young women. We examined whether this association is seen in women at high risk of breast cancer because they carry a mutation in one of two breast cancer susceptibility genes, BRCA1 and BRCA2. Methods: We performed a matched case-control study on 1311 pairs of women with known deleterious BRCA1 and/or BRCA2 mutations recruited from 52 centers in 11 countries. Women who had been diagnosed with breast cancer were matched to control subjects by year of birth, country of residence, mutation (BRCA1 or BRCA2), and history of ovarian cancer. All study subjects completed a questionnaire about oral contraceptive use. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived by conditional logistic regression. All statistical tests were two-sided. Results: Among BRCA2 mutation carriers, ever use of oral contraceptives was not associated with an increased risk of breast cancer (OR = 0.94, 95% CI = 0.72 to 1.24). For BRCAI mutation carriers, ever use of oral contraceptives was associated With a modestly increased risk of breast cancer (OR = 1.20, 95 % CI = 1.02 to 1.40). However, compared with BRCA1 mutation carriers who never used oral contraceptives, those who used oral contraceptives for at least 5 years had an increased risk of breast cancer (OR = 1.33, 95% CI = 1.11 to 1.60), as did those who used oral contraceptives before age 30 (OR = 1.29, 95% CI = 1.09 to 1.52), those who were diagnosed with breast cancer before age 40 (OR = 1.38, 95% CI = 1.11 to 1.72), and those who first used oral contraceptives before 1975 (OR = 1.42, 95 % CI = 1.17 to 1.75). Conclusions: Among BRCA1 mutation carriers, women who first used oral contraceptives before 1975, who used them before age 30, or who used them for 5 or more years may have an increased risk of early-onset breast cancer. Oral contraceptives do not appear to be associated with risk of breast cancer in BRCA2 carriers, but data for BRCA2 carriers are limited.},
  author       = {Narod, SA and Dube, MP and Klijn, J and Lubinski, J and Lynch, HT and Ghadirian, P and Provencher, D and Heimdal, K and Moller, P and Robson, M and Offit, K and Isaacs, C and Weber, B and Friedman, E and Gershoni-Baruch, R and Rennert, G and Pasini, B and Wagner, T and Daly, M and Garber, JE and Neuhausen, SL and Ainsworth, P and Olsson, Håkan and Evans, G and Osborne, M and Couch, F and Foulkes, WD and Warner, E and Kim-Sing, C and Olopade, O and Tung, N and Saal, HM and Weitzel, J and Merajver, S and Gauthier-Villars, M and Jernström, Helena and Sun, P and Brunet, JS},
  issn         = {1460-2105},
  language     = {eng},
  number       = {23},
  pages        = {1773--1779},
  publisher    = {Oxford University Press},
  series       = {Journal of the National Cancer Institute},
  title        = {Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers},
  url          = {http://dx.doi.org/10.1093/jnci/94.23.1773},
  volume       = {94},
  year         = {2002},
}