Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study.
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ICR Authors
Authors
Schrijver, LH
Olsson, H
Phillips, K-A
Terry, MB
Goldgar, DE
Kast, K
Engel, C
Mooij, TM
Adlard, J
Barrowdale, D
Davidson, R
Eeles, R
Ellis, S
Evans, DG
Frost, D
Izatt, L
Porteous, ME
Side, LE
Walker, L
Berthet, P
Bonadona, V
Leroux, D
Mouret-Fourme, E
Venat-Bouvet, L
Buys, SS
Southey, MC
John, EM
Chung, WK
Daly, MB
Bane, A
van Asperen, CJ
Gómez Garcia, EB
Mourits, MJE
van Os, TAM
Roos-Blom, M-J
Friedlander, ML
McLachlan, S-A
Singer, CF
Tan, YY
Foretova, L
Navratilova, M
Gerdes, A-M
Caldes, T
Simard, J
Olah, E
Jakubowska, A
Arver, B
Osorio, A
Noguès, C
Andrieu, N
Easton, DF
van Leeuwen, FE
Hopper, JL
Milne, RL
Antoniou, AC
Rookus, MA
EMBRACE, GENEPSO, BCFR, HEBON, kConFab, and IBCCS,
Olsson, H
Phillips, K-A
Terry, MB
Goldgar, DE
Kast, K
Engel, C
Mooij, TM
Adlard, J
Barrowdale, D
Davidson, R
Eeles, R
Ellis, S
Evans, DG
Frost, D
Izatt, L
Porteous, ME
Side, LE
Walker, L
Berthet, P
Bonadona, V
Leroux, D
Mouret-Fourme, E
Venat-Bouvet, L
Buys, SS
Southey, MC
John, EM
Chung, WK
Daly, MB
Bane, A
van Asperen, CJ
Gómez Garcia, EB
Mourits, MJE
van Os, TAM
Roos-Blom, M-J
Friedlander, ML
McLachlan, S-A
Singer, CF
Tan, YY
Foretova, L
Navratilova, M
Gerdes, A-M
Caldes, T
Simard, J
Olah, E
Jakubowska, A
Arver, B
Osorio, A
Noguès, C
Andrieu, N
Easton, DF
van Leeuwen, FE
Hopper, JL
Milne, RL
Antoniou, AC
Rookus, MA
EMBRACE, GENEPSO, BCFR, HEBON, kConFab, and IBCCS,
Document Type
Journal Article
Date
2018-04-01
Date Accepted
2018-04-24
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.
Citation
JNCI cancer spectrum, 2018, 2 (2), pp. pky023 - ?
Source Title
Publisher
OXFORD UNIV PRESS
ISSN
2515-5091
eISSN
2515-5091
Research Team
Oncogenetics