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母乳喂养与携带 BRCA1 或 BRCA2 突变的女性上皮性卵巢癌风险的关系。

Breastfeeding and the risk of epithelial ovarian cancer among women with a BRCA1 or BRCA2 mutation.

机构信息

Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland.

出版信息

Gynecol Oncol. 2020 Dec;159(3):820-826. doi: 10.1016/j.ygyno.2020.09.037. Epub 2020 Sep 30.


DOI:10.1016/j.ygyno.2020.09.037
PMID:33010967
Abstract

OBJECTIVE: BRCA mutation carriers face a high lifetime risk of developing ovarian cancer. The strong inverse association between breastfeeding and the risk of ovarian cancer is established in the general population but is less well studied among women with a germline BRCA1 or BRCA2 mutation. METHOD: Thus, we conducted a matched case-control analysis to evaluate the association between breastfeeding history and the risk of developing ovarian cancer. After matching for year of birth, country of residence, BRCA gene and personal history of breast cancer, a total of 1650 cases and 2702 controls were included in the analysis. Conditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) associated with various breastfeeding exposures. RESULTS: A history of ever-breastfeeding was associated with a 23% reduction in risk (OR = 0.77; 95%CI 0.66-0.90; P = 0.001). The protective effect increased with breastfeeding from one month to seven months after which the association was relatively stable. Compared to women who never breastfed, breastfeeding for seven or more months was associated with a 32% reduction in risk (OR = 0.68; 95%CI 0.57-0.81; P < 0.0001) and did not vary by BRCA gene or age at diagnosis. The combination of breastfeeding and oral contraceptive use was strongly protective (0.47; 95%CI 0.37-0.58; P < 0.0001). CONCLUSIONS: These findings support a protective effect of breastfeeding for at least seven months among women with a BRCA1 or BRCA2 mutation, that is independent of oral contraceptive use.

摘要

目的:BRCA 基因突变携带者面临着较高的终生卵巢癌发病风险。母乳喂养与卵巢癌风险之间呈强烈负相关,这在普通人群中已得到证实,但在携带种系 BRCA1 或 BRCA2 突变的女性中研究较少。

方法:因此,我们进行了一项匹配病例对照分析,以评估母乳喂养史与发生卵巢癌风险之间的关系。在按出生年份、居住国、BRCA 基因和个人乳腺癌史匹配后,共有 1650 例病例和 2702 例对照纳入分析。采用条件逻辑回归估计与各种母乳喂养暴露相关的优势比(OR)和 95%置信区间(CI)。

结果:有过母乳喂养史的患者卵巢癌发病风险降低 23%(OR=0.77;95%CI 0.66-0.90;P=0.001)。这种保护作用随着母乳喂养时间从一个月增加到七个月而增加,此后相关性相对稳定。与从未母乳喂养的女性相比,母乳喂养七个月或以上的患者卵巢癌发病风险降低 32%(OR=0.68;95%CI 0.57-0.81;P<0.0001),且不受 BRCA 基因或诊断时年龄的影响。母乳喂养与口服避孕药联合使用具有很强的保护作用(OR=0.47;95%CI 0.37-0.58;P<0.0001)。

结论:这些发现支持 BRCA1 或 BRCA2 突变携带者至少母乳喂养七个月具有保护作用,且与口服避孕药的使用无关。

相似文献

[1]
Breastfeeding and the risk of epithelial ovarian cancer among women with a BRCA1 or BRCA2 mutation.

Gynecol Oncol. 2020-12

[2]
Factors influencing ovulation and the risk of ovarian cancer in BRCA1 and BRCA2 mutation carriers.

Int J Cancer. 2015-9-1

[3]
Reproductive risk factors for ovarian cancer in carriers of BRCA1 or BRCA2 mutations: a case-control study.

Lancet Oncol. 2007-1

[4]
Oral contraceptive use and ovarian cancer risk for BRCA1/2 mutation carriers: an international cohort study.

Am J Obstet Gynecol. 2021-7

[5]
Contraceptive use and the risk of ovarian cancer among women with a BRCA1 or BRCA2 mutation.

Gynecol Oncol. 2022-3

[6]
Breastfeeding and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers.

Breast Cancer Res. 2012-3-9

[7]
The preventive effect of breastfeeding against ovarian cancer in BRCA1 and BRCA2 mutation carriers: A systematic review and meta-analysis.

Gynecol Oncol. 2021-10

[8]
Association between the cervicovaginal microbiome, BRCA1 mutation status, and risk of ovarian cancer: a case-control study.

Lancet Oncol. 2019-7-9

[9]
Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2 mutations: a case-control study.

Lancet. 2001-5-12

[10]
Fertility treatments and invasive epithelial ovarian cancer risk in Jewish Israeli BRCA1 or BRCA2 mutation carriers.

Fertil Steril. 2015-3-16

引用本文的文献

[1]
Oncolactation for Patients with Breast Cancer: Executive Summary from the American Society of Breast Surgeons.

Ann Surg Oncol. 2025-7-8

[2]
Fertility Preservation in BRCA1/2 Germline Mutation Carriers: An Overview.

Life (Basel). 2024-5-10

[3]
Human Milk-The Biofluid That Nourishes Infants from the First Day of Life.

Foods. 2024-4-24

[4]
Global epidemiology of epithelial ovarian cancer.

Nat Rev Clin Oncol. 2024-5

[5]
Variation in maternal lactation practices associated with changes in diurnal maternal inflammation.

Sci Rep. 2024-2-22

[6]
Physical Activity During Adolescence and Early-adulthood and Ovarian Cancer Among Women with a BRCA1 or BRCA2 Mutation.

Cancer Res Commun. 2023-11-28

[7]
Executive Summary of the Ovarian Cancer Evidence Review Conference.

Obstet Gynecol. 2023-7-1

[8]
The Role of Natural and Semi-Synthetic Compounds in Ovarian Cancer: Updates on Mechanisms of Action, Current Trends and Perspectives.

Molecules. 2023-2-22

[9]
Protocol for an observational study investigating hormones triggering the onset of sustained lactation: the INSIGHT study.

BMJ Open. 2022-8-30

[10]
What is new about ovarian malignancies?

Contemp Oncol (Pozn). 2021

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