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Haile RW , Thomas DC , McGuire V , Felberg A , John EM , Milne RL , Hopper JL , Jenkins MA , Levine AJ , Daly MM , Buys SS , Senie RT , Andrulis IL , Knight JA , Godwin AK , Southey M , McCredie MR , Giles GG , Andrews L , Tucker K , Miron A , Apicella C , Tesoriero A , Bane A , Pike MC , Whittemore AS
BRCA1 and BRCA2 mutation carriers, oral contraceptive use, and breast cancer before age 50
Cancer Epidemiol Biomarkers Prev. 2006 Oct;15(10) :1863-70
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Abstract
BACKGROUND: Understanding the effect of oral contraceptives on risk of breast cancer in BRCA1 or BRCA2 mutation carriers is important because oral contraceptive use is a common, modifiable practice. METHODS: We studied 497 BRCA1 and 307 BRCA2 mutation carriers, of whom 195 and 128, respectively, had been diagnosed with breast cancer. Case-control analyses were conducted using unconditional logistic regression with adjustments for family history and familial relationships and were restricted to subjects with a reference age under 50 years. RESULTS: For BRCA1 mutation carriers, there was no significant association between risk of breast cancer and use of oral contraceptives for at least 1 year [odds ratio (OR), 0.77; 95% confidence interval (95% CI), 0.53-1.12] or duration of oral contraceptive use (P(trend) = 0.62). For BRCA2 mutation carriers, there was no association with use of oral contraceptives for at least 1 year (OR, 1.62; 95% CI, 0.90-2.92); however, there was an association of elevated risk with oral contraceptive use for at least 5 years (OR, 2.06; 95% CI, 1.08-3.94) and with duration of use (OR(trend) per year of use, 1.08; P = 0.008). Similar results were obtained when we considered only use of oral contraceptives that first started in 1975 or later. CONCLUSIONS: We found no evidence overall that use of oral contraceptives for at least 1 year is associated with breast cancer risk for BRCA1 and BRCA2 mutation carriers before age 50. For BRCA2 mutation carriers, use of oral contraceptives may be associated with an increased risk of breast cancer among women who use them for at least 5 years. Further studies reporting results separately for BRCA1 and BRCA2 mutation carriers are needed to resolve this important issue.
Notes
Haile, Robert W Thomas, Duncan C McGuire, Valerie Felberg, Anna John, Esther M Milne, Roger L Hopper, John L Jenkins, Mark A Levine, A Joan Daly, Mary M Buys, Saundra S Senie, Ruby T Andrulis, Irene L Knight, Julia A Godwin, Andrew K Southey, Melissa McCredie, Margaret R E Giles, Graham G Andrews, Lesley Tucker, Katherine Miron, Alexander Apicella, Carmel Tesoriero, Andrea Bane, Anita Pike, Malcolm C kConFab Investigators Ontario Cancer Genetics Network Investigators Whittemore, Alice S CA-95-003/CA/United States NCI Multicenter Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't United States Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology Cancer Epidemiol Biomarkers Prev. 2006 Oct;15(10):1863-70. Epub 2006 Oct 4.