The Influence of Number and Timing of Pregnancies on Breast Cancer Risk for Women With BRCA1 or BRCA2 Mutations
Mary Beth Terry
(1)
,
Yuyan Liao
(1)
,
Karin Kast
(2)
,
Antonis C. Antoniou
(3)
,
Jasmine Mcdonald
,
Thea Mooij
,
Christoph Engel
(4)
,
Catherine Noguès
(5)
,
Bruno Buecher
(6)
,
Veronique Mari
(7)
,
Jessica Moretta-Serra
,
Laurence Gladieff
(8)
,
Elisabeth Luporsi
(9)
,
Daniel Barrowdale
(3)
,
Debra Frost
(3)
,
Alex Henderson
(10)
,
Carole Brewer
(11)
,
D Gareth Evans
(12)
,
Diana Eccles
(13)
,
Jackie Cook
(14)
,
Kai-Ren Ong
(15)
,
Louise Izatt
(16)
,
Munaza Ahmed
(12)
,
Patrick Morrison
(17)
,
Charlotte Dommering
(18)
,
Jan Oosterwijk
(19)
,
Margreet Ausems
(20)
,
Mieke Kriege
(21)
,
Saundra Buys
(22)
,
Irene Andrulis
(23)
,
Esther M. John
(24)
,
Mary B. Daly
(25)
,
Michael Friedlander
(26)
,
Sue Anne Mclachlan
,
Ana Osorio
(27)
,
Trinidad Caldés
(28)
,
Anna Jakubowska
(29)
,
Jacques Simard
(30)
,
Christian Singer
(31)
,
Yen Tan
,
Edith Olah
(32)
,
Marie Navratilova
,
Lenka Foretova
(33)
,
Anne-Marie Gerdes
(34)
,
Marie-José Roos-Blom
,
Brita Arver
(35)
,
Håkan Olsson
(36)
,
Rita Schmutzler
(37)
,
John Hopper
(38)
,
Flora E. van Leeuwen
(39)
,
David E. Goldgar
(40)
,
Roger L Milne
(41)
,
Douglas Easton
(42)
,
Matti A. Rookus
(43)
,
Nadine N. Andrieu
(44)
1
Department of Epidemiology [Columbia University]
2 Department of Gynaecology and Obstetrics
3 Centre for Cancer Genetic Epidemiology
4 IMISE - Institute for Medical Informatics, Statistics and Epidemiology [Leipzig]
5 CRLCC René Huguenin - CRLCC René Huguenin
6 Service de Génétique Oncologique
7 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
8 ICR - Institut Claudius Regaud
9 CAV - Centre Alexis Vautrin
10 Newcastle Upon Tyne Hospitals NHS Trust
11 Department of Clinical Genetics
12 St Mary's Hospital
13 Wessex Clinical Genetics Service
14 Sheffield Clinical Genetics Service
15 West Midlands Regional Genetics Service
16 Clinical Genetics
17 Northern Ireland Regional Genetics Centre
18 Department of Clinical Genetics and Human Genetics
19 Department of Genetics
20 Department of Medical Genetics
21 Department of Clinical Genetics
22 Department of Internal Medicine
23 Department of Laboratory Medicine and Pathobiology
24 Department of Epidemiology
25 Division of Population Science
26 Dept of Medical Oncology, Division of Medicine
27 Human Genetics Group
28 Molecular Oncology Laboratory
29 Department of Genetics and Pathology
30 Laboratoire de Génomique des Cancers
31 Division of Special Gynecology
32 National Institute of Oncology
33 MUNI - Masaryk University [Brno]
34 Department of Clinical Genetics
35 Radiumhemmet
36 Department of Oncology
37 Division of Molecular Gyneco-Oncology, Department of Gynaecology and Obstetrics, Clinical Center Un
38 University of Melbourne
39 Departments of Epidemiology and Molecular Pathology
40 Department of Dermatology
41 Cancer Epidemiology Centre
42 Centre for Cancer Genetic Epidemiology [Cambridge]
43 Department of Epidemiology
44 UMR Innovation - Innovation et Développement dans l'Agriculture et l'Alimentation
2 Department of Gynaecology and Obstetrics
3 Centre for Cancer Genetic Epidemiology
4 IMISE - Institute for Medical Informatics, Statistics and Epidemiology [Leipzig]
5 CRLCC René Huguenin - CRLCC René Huguenin
6 Service de Génétique Oncologique
7 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
8 ICR - Institut Claudius Regaud
9 CAV - Centre Alexis Vautrin
10 Newcastle Upon Tyne Hospitals NHS Trust
11 Department of Clinical Genetics
12 St Mary's Hospital
13 Wessex Clinical Genetics Service
14 Sheffield Clinical Genetics Service
15 West Midlands Regional Genetics Service
16 Clinical Genetics
17 Northern Ireland Regional Genetics Centre
18 Department of Clinical Genetics and Human Genetics
19 Department of Genetics
20 Department of Medical Genetics
21 Department of Clinical Genetics
22 Department of Internal Medicine
23 Department of Laboratory Medicine and Pathobiology
24 Department of Epidemiology
25 Division of Population Science
26 Dept of Medical Oncology, Division of Medicine
27 Human Genetics Group
28 Molecular Oncology Laboratory
29 Department of Genetics and Pathology
30 Laboratoire de Génomique des Cancers
31 Division of Special Gynecology
32 National Institute of Oncology
33 MUNI - Masaryk University [Brno]
34 Department of Clinical Genetics
35 Radiumhemmet
36 Department of Oncology
37 Division of Molecular Gyneco-Oncology, Department of Gynaecology and Obstetrics, Clinical Center Un
38 University of Melbourne
39 Departments of Epidemiology and Molecular Pathology
40 Department of Dermatology
41 Cancer Epidemiology Centre
42 Centre for Cancer Genetic Epidemiology [Cambridge]
43 Department of Epidemiology
44 UMR Innovation - Innovation et Développement dans l'Agriculture et l'Alimentation
Jasmine Mcdonald
- Fonction : Auteur
Thea Mooij
- Fonction : Auteur
Catherine Noguès
- Fonction : Auteur
- PersonId : 21280
- IdHAL : catherine-nogues
- ORCID : 0000-0002-5768-6299
- IdRef : 030671175
Jessica Moretta-Serra
- Fonction : Auteur
Daniel Barrowdale
- Fonction : Auteur
- PersonId : 768869
- ORCID : 0000-0003-1661-3939
Irene Andrulis
- Fonction : Auteur
- PersonId : 920702
Sue Anne Mclachlan
- Fonction : Auteur
Trinidad Caldés
- Fonction : Auteur
- PersonId : 762555
- ORCID : 0000-0002-1038-5392
Anna Jakubowska
- Fonction : Auteur
- PersonId : 762556
- ORCID : 0000-0002-5650-0501
Jacques Simard
- Fonction : Auteur
- PersonId : 757778
- ORCID : 0000-0001-6906-3390
Yen Tan
- Fonction : Auteur
Marie Navratilova
- Fonction : Auteur
Marie-José Roos-Blom
- Fonction : Auteur
Douglas Easton
- Fonction : Auteur
- PersonId : 782295
- ORCID : 0000-0003-2444-3247
Résumé
BACKGROUND:
Full-term pregnancy (FTP) is associated with a reduced breast cancer (BC) risk over time, but women are at increased BC risk in the immediate years following an FTP. No large prospective studies, however, have examined whether the number and timing of pregnancies are associated with BC risk for BRCA1 and BRCA2 mutation carriers.
METHODS:
Using weighted and time-varying Cox proportional hazards models, we investigated whether reproductive events are associated with BC risk for mutation carriers using a retrospective cohort (5707 BRCA1 and 3525 BRCA2 mutation carriers) and a prospective cohort (2276 BRCA1 and 1610 BRCA2 mutation carriers), separately for each cohort and the combined prospective and retrospective cohort.
RESULTS:
For BRCA1 mutation carriers, there was no overall association with parity compared with nulliparity (combined hazard ratio [HRc] = 0.99, 95% confidence interval [CI] = 0.83 to 1.18). Relative to being uniparous, an increased number of FTPs was associated with decreased BC risk (HRc = 0.79, 95% CI = 0.69 to 0.91; HRc = 0.70, 95% CI = 0.59 to 0.82; HRc = 0.50, 95% CI = 0.40 to 0.63, for 2, 3, and ≥4 FTPs, respectively, P trend < .0001) and increasing duration of breastfeeding was associated with decreased BC risk (combined cohort P trend = .0003). Relative to being nulliparous, uniparous BRCA1 mutation carriers were at increased BC risk in the prospective analysis (prospective hazard ration [HRp] = 1.69, 95% CI = 1.09 to 2.62). For BRCA2 mutation carriers, being parous was associated with a 30% increase in BC risk (HRc = 1.33, 95% CI = 1.05 to 1.69), and there was no apparent decrease in risk associated with multiparity except for having at least 4 FTPs vs. 1 FTP (HRc = 0.72, 95% CI = 0.54 to 0.98).
CONCLUSIONS:
These findings suggest differential associations with parity between BRCA1 and BRCA2 mutation carriers with higher risk for uniparous BRCA1 carriers and parous BRCA2 carriers.
| Origine | Publication financée par une institution |
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