Department of Obstetrics and Gynecology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
Biostatistics Collaboration Team, Research Core Center, National Cancer Center, Goyang, Republic of Korea; Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea.
Gynecol Oncol. 2021 Oct;163(1):142-147. doi: 10.1016/j.ygyno.2021.07.028. Epub 2021 Jul 23.
OBJECTIVE: A recent study showed that even a few months of breastfeeding is associated with a significant decrease in the risk of ovarian cancer in the general population. This study aimed to perform a systematic review and meta-analysis to determine the significance of the length of the breastfeeding period on ovarian cancer risk in BRCA1/2 mutation carriers. METHODS: PubMed, EMBASE, and Cochrane databases were searched up to June 1, 2021. We included case-control and cohort studies that contained information on breastfeeding and the risk of ovarian cancer in BRCA1/2 mutation carriers. Odds ratios (OR) were meta-analytically pooled using a fixed-effects model.dd RESULTS: Five studies, including one cohort study and four case-control studies, were included in this meta-analysis. Of the 14,601 BRCA1/2 mutation carriers, the overall pooled OR of ever having performed breastfeeding in patients who had ovarian cancer was 0.767 (95% confidence interval [CI], 0.688-0.856) and 0.817 (95% CI, 0.650-1.028) for patients with BRCA1 and BRCA2 mutation, respectively. Breastfeeding for >1 year acted as a protective factor in both BRCA1 [OR: 0.787 (95% CI, 0.682-0.907)] and BRCA2 [OR: 0.567 (95% CI, 0.400-0.802)] mutation carriers. No significant heterogeneity was present (I2 = 0%), and the funnel plot was also properly distributed, showing no publication bias. CONCLUSIONS: Breastfeeding is a preventive, modifiable factor for ovarian cancer in BRCA1/2 mutation carriers. Ever having performed breastfeeding was significantly preventive for ovarian cancer in the BRCA1 mutation carriers, however a period of 1 year or more of breastfeeding is required for a reduced ovarian cancer risk in BRCA2 mutation carriers.
目的:最近的一项研究表明,即使母乳喂养几个月,也与普通人群卵巢癌风险的显著降低有关。本研究旨在进行系统评价和荟萃分析,以确定母乳喂养时间长度对 BRCA1/2 突变携带者卵巢癌风险的意义。
方法:检索了 PubMed、EMBASE 和 Cochrane 数据库,截至 2021 年 6 月 1 日。我们纳入了包含 BRCA1/2 突变携带者母乳喂养与卵巢癌风险信息的病例对照研究和队列研究。使用固定效应模型进行荟萃分析汇总比值比(OR)。
结果:本荟萃分析纳入了 5 项研究,包括 1 项队列研究和 4 项病例对照研究。在 14601 名 BRCA1/2 突变携带者中,患有卵巢癌的患者中曾进行过母乳喂养的总体汇总 OR 为 0.767(95%置信区间 [CI],0.688-0.856)和 0.817(95% CI,0.650-1.028),分别为 BRCA1 和 BRCA2 突变患者。对于 BRCA1 [OR:0.787(95% CI,0.682-0.907)]和 BRCA2 [OR:0.567(95% CI,0.400-0.802)]突变携带者,母乳喂养 >1 年均为保护因素。无显著异质性(I2=0%),漏斗图也分布合理,表明无发表偏倚。
结论:母乳喂养是 BRCA1/2 突变携带者卵巢癌的一种预防、可改变的因素。曾进行过母乳喂养与 BRCA1 突变携带者的卵巢癌显著预防相关,然而,BRCA2 突变携带者需要 1 年或更长时间的母乳喂养才能降低卵巢癌风险。
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