Jernström H, Lubinski J, Lynch H T, Ghadirian P, Neuhausen S, Isaacs C, Weber B L, Horsman D, Rosen B, Foulkes W D, Friedman E, Gershoni-Baruch R, Ainsworth P, Daly M, Garber J, Olsson H, Sun P, Narod S A
Jubileum Institute, Department of Oncology, Lund University Hospital, Lund, Sweden.
J Natl Cancer Inst. 2004 Jul 21;96(14):1094-8. doi: 10.1093/jnci/djh211.
Several studies have reported that the risk of breast cancer decreases with increasing duration of breast-feeding. Whether breast-feeding is associated with a reduced risk of hereditary breast cancer in women who carry deleterious BRCA1 and BRCA2 mutations is currently unknown.
We conducted a case-control study of women with deleterious mutations in either the BRCA1 or the BRCA2 gene. Study participants, drawn from an international cohort, were matched on the basis of BRCA mutation (BRCA1 [n = 685] or BRCA2 [n = 280]), year of birth (+/-2 years), and country of residence. The study involved 965 case subjects diagnosed with breast cancer and 965 control subjects who had no history of breast or ovarian cancer. Information on pregnancies and breast-feeding practices was derived from a questionnaire administered to the women during the course of genetic counseling. Conditional logistic regression analyses were used to estimate odds ratios (ORs) for the risk of breast cancer. All statistical tests were two-sided.
Among women with BRCA1 mutations, the mean total duration of breast-feeding was statistically significantly shorter for case subjects than for control subjects (6.0 versus 8.7 months, respectively; mean difference = 2.7 months, 95% confidence interval [CI] = 1.4 to 4.0; P<.001). The total duration of breast-feeding was associated with a reduced risk of breast cancer (for each month of breast-feeding, OR = 0.98, 95% CI = 0.97 to 0.99; P(trend)<.001). Women with BRCA1 mutations who breast-fed for more than 1 year were less likely to have breast cancer than those who never breast-fed (OR = 0.55, 95% CI = 0.38 to 0.80; P =.001), although no such association was seen for BRCA2 (OR = 0.95, 95% CI = 0.56 to 1.59; P =.83).
Women with deleterious BRCA1 mutations who breast-fed for a cumulative total of more than 1 year had a statistically significantly reduced risk of breast cancer.
多项研究报告称，乳腺癌风险会随着母乳喂养时间的延长而降低。目前尚不清楚母乳喂养是否与携带有害BRCA1和BRCA2突变的女性患遗传性乳腺癌风险降低有关。
我们对BRCA1或BRCA2基因存在有害突变的女性进行了一项病例对照研究。研究参与者来自一个国际队列，根据BRCA突变（BRCA1 [n = 685]或BRCA2 [n = 280]）、出生年份（±2年）和居住国家进行匹配。该研究纳入了965例被诊断为乳腺癌的病例受试者和965例无乳腺癌或卵巢癌病史的对照受试者。关于怀孕和母乳喂养情况的信息来自于在遗传咨询过程中向这些女性发放的问卷。采用条件逻辑回归分析来估计患乳腺癌风险的比值比（OR）。所有统计检验均为双侧检验。
在携带BRCA1突变的女性中，病例受试者的母乳喂养总时长在统计学上显著短于对照受试者（分别为6.0个月和8.7个月；平均差值 = 2.7个月，95%置信区间[CI] = 1.4至4.0；P <.001）。母乳喂养总时长与患乳腺癌风险降低相关（每母乳喂养1个月，OR = 0.98，95% CI = 0.97至0.99；P（趋势）<.001）。携带BRCA1突变且母乳喂养超过1年的女性患乳腺癌的可能性低于从未母乳喂养的女性（OR = 0.55，95% CI = 0.38至0.80；P =.001），不过在携带BRCA2突变的女性中未观察到这种关联（OR = 0.95，95% CI = 0.56至1.59；P =.83）。
累计母乳喂养超过1年的携带有害BRCA1突变的女性患乳腺癌的风险在统计学上显著降低。
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