Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles JNCI Cancer Spectrum Year : 2021

Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study

1 NKI - Netherlands Cancer Institute
2 Skane University Hospital [Lund]
3 University of Melbourne
4 Columbia Mailman School of Public Health
5 School of Medicine [University of Utah, Salt Lake City]
6 TU Dresden - Technische Universität Dresden = Dresden University of Technology
7 Department of Clinical Sciences [Lund]
8 Leipzig University / Universität Leipzig
9 Chapel Allerton Hospital
10 CAM - University of Cambridge [UK]
11 Queen Elizabeth University Hospital (Glasgow)
12 Royal Marsden NHS Foundation Trust
13 University of Manchester [Manchester]
14 Guy's and St Thomas NHS Foundation Trust [London]
15 Western General Hospital [Edinburgh, UK]
16 GOSHC - Great Ormond Street Hospital for Children NHS Foundation Trust [London, UK]
17 Churchill Hospital [Breast Care Unit]
18 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
19 UCBL - Université Claude Bernard Lyon 1
20 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
21 hôpital couple-enfant [CHU Grenoble Alpes]
22 Hôpital René Huguenin [Saint-Cloud]
23 Hôpital Dupuytren [CHU Limoges]
24 Huntsman Cancer Institute [Salt Lake City]
25 Monash University [Melbourne]
26 Stanford University
27 California Sciences Institute
28 Columbia University [New York]
29 Fox Chase Cancer Center
30 McMaster University [Hamilton, Ontario]
31 Karolinska Institutet [Stockholm]
32 LUMC - Leiden University Medical Center
33 GROW - School for Oncology and Developmental Biology [Maastricht]
34 UMCG - University Medical Center Groningen [Groningen]
35 AMC - Academic Medical Center - Academisch Medisch Centrum [Amsterdam]
36 UNSW - University of New South Wales [Sydney]
37 Prince of Wales Hospital
38 St. Vincent's Hospital, Sydney
39 Medizinische Universität Wien = Medical University of Vienna
40 MMCI - Masaryk Memorial Cancer Institute
41 University Hospital of Cologne [Cologne]
42 Copenhagen University Hospital
43 IdISSC - Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain]
44 ULaval - Université Laval [Québec]
45 National Institute of Oncology [Budapest, Hungary]
46 PUM - Pomeranian Medical University [Szczecin]
47 Spanish National Cancer Centre
48 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
49 Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe
50 Cancer Epidemiology Centre & Cancer Council Victoria [Melbourne, Australia]
Daniel Barrowdale
Jacques Simard
Matti A Rookus
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Abstract

Background: For BRCA1 and BRCA2 mutation carriers, the association between oral contraceptive preparation (OCP) use and breast cancer (BC) risk is still unclear. Methods: Breast camcer risk associations were estimated from OCP data on 6030 BRCA1 and 3809 BRCA2 mutation carriers using age-dependent Cox regression, stratified by study and birth cohort. Prospective, left-truncated retrospective and full-cohort retrospective analyses were performed. Results: For BRCA1 mutation carriers, OCP use was not associated with BC risk in prospective analyses (hazard ratio [HR] = 1.08, 95% confidence interval [CI] = 0.75 to 1.56), but in the left-truncated and full-cohort retrospective analyses, risks were increased by 26% (95% CI = 6% to 51%) and 39% (95% CI = 23% to 58%), respectively. For BRCA2 mutation carriers, OCP use was associated with BC risk in prospective analyses (HR = 1.75, 95% CI = 1.03 to 2.97), but retrospective analyses were inconsistent (left-truncated: HR = 1.06, 95% CI = 0.85 to 1.33; full cohort: HR = 1.52, 95% CI = 1.28 to 1.81). There was evidence of increasing risk with duration of use, especially before the first full-term pregnancy (BRCA1: both retrospective analyses, P < .001 and P = .001, respectively; BRCA2: full retrospective analysis, P = .002). Conclusions: Prospective analyses did not show that past use of OCP is associated with an increased BC risk for BRCA1 mutation carriers in young middle-aged women (40-50 years). For BRCA2 mutation carriers, a causal association is also not likely at those ages. Findings between retrospective and prospective analyses were inconsistent and could be due to survival bias or a true association for younger women who were underrepresented in the prospective cohort. Given the uncertain safety of long-term OCP use for BRCA1/2 mutation carriers, indications other than contraception should be avoided and nonhormonal contraceptive methods should be discussed.
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inserm-03342591 , version 1 (13-09-2021)

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Lieske H Schrijver, Håkan Olsson, Kelly-Anne Phillips, Mary Beth Terry, David E Goldgar, et al.. Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study. JNCI Cancer Spectrum, 2021, 2 (2), pky023. ⟨10.1093/jncics/pky023⟩. ⟨inserm-03342591⟩
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