Abstract
Background: To evaluate the effect of the cumulative number of ovulatory cycles and its contributing components on the risk of breast cancer among BRCA mutation carriers. Methods: We conducted a matched case-control study on 2,854 pairs of women with a BRCA1 or BRCA2 mutation. Conditional logistic regression was used to estimate the association between the number of ovulatory cycles and various exposures and the risk of breast cancer. Information from a subset of these women enrolled in a prospective cohort study was used to calculate age-specific breast cancer rates. Results: The annual risk of breast cancer decreased with the number of ovulatory cycles experienced (ρ =-0.69; P = 0.03). Age at menarche and duration of breastfeeding were inversely related with risk of breast cancer among BRCA1 (Ptrend <0.0001) but not among BRCA2 (Ptrend ≥ 0.28) mutation carriers. The reduction in breast cancer risk associated with surgical menopause [OR, 0.52; 95% confidence interval (CI), 0.40-0.66; Ptrend <0.0001] was greater than that associated with natural menopause (OR, 0.81; 95% CI, 0.62-1.07; P trend = 0.14). There was a highly significant reduction in breast cancer risk among women who had an oophorectomy after natural menopause (OR, 0.13; 95% CI, 0.02-0.54; P = 0.006). Conclusions: These data challenge the hypothesis that breast cancer risk can be predicted by the lifetime number of ovulatory cycles in women with a BRCA mutation. Both pre- and postmenopausal oophorectomy protect against breast cancer. Impact: Understanding the basis for the protective effect of oophorectomy has important implications for chemoprevention.
Original language | English |
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Pages (from-to) | 1089-1096 |
Number of pages | 8 |
Journal | Cancer Epidemiology Biomarkers and Prevention |
Volume | 21 |
Issue number | 7 |
DOIs | |
State | Published - Jul 2012 |
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All Science Journal Classification (ASJC) codes
- Epidemiology
- Oncology
Cite this
Oophorectomy after menopause and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. / Kotsopoulos, Joanne; Lubinski, Jan; Lynch, Henry T.; Kim-Sing, Charmaine; Neuhausen, Susan; Demsky, Rochelle; Foulkes, William D.; Ghadirian, Parviz; Tung, Nadine; Ainsworth, Peter; Senter, Leigha; Karlan, Beth; Eisen, Andrea; Eng, Charis; Weitzel, Jeffrey; Gilchrist, Dawna M.; Blum, Joanne L.; Zakalik, Dana; Singer, Christian; Fallen, Taya; Ginsburg, Ophira; Huzarski, Tomasz; Sun, Ping; Narod, Steven A.
In: Cancer Epidemiology Biomarkers and Prevention, Vol. 21, No. 7, 07.2012, p. 1089-1096.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Oophorectomy after menopause and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers
AU - Kotsopoulos, Joanne
AU - Lubinski, Jan
AU - Lynch, Henry T.
AU - Kim-Sing, Charmaine
AU - Neuhausen, Susan
AU - Demsky, Rochelle
AU - Foulkes, William D.
AU - Ghadirian, Parviz
AU - Tung, Nadine
AU - Ainsworth, Peter
AU - Senter, Leigha
AU - Karlan, Beth
AU - Eisen, Andrea
AU - Eng, Charis
AU - Weitzel, Jeffrey
AU - Gilchrist, Dawna M.
AU - Blum, Joanne L.
AU - Zakalik, Dana
AU - Singer, Christian
AU - Fallen, Taya
AU - Ginsburg, Ophira
AU - Huzarski, Tomasz
AU - Sun, Ping
AU - Narod, Steven A.
PY - 2012/7
Y1 - 2012/7
N2 - Background: To evaluate the effect of the cumulative number of ovulatory cycles and its contributing components on the risk of breast cancer among BRCA mutation carriers. Methods: We conducted a matched case-control study on 2,854 pairs of women with a BRCA1 or BRCA2 mutation. Conditional logistic regression was used to estimate the association between the number of ovulatory cycles and various exposures and the risk of breast cancer. Information from a subset of these women enrolled in a prospective cohort study was used to calculate age-specific breast cancer rates. Results: The annual risk of breast cancer decreased with the number of ovulatory cycles experienced (ρ =-0.69; P = 0.03). Age at menarche and duration of breastfeeding were inversely related with risk of breast cancer among BRCA1 (Ptrend <0.0001) but not among BRCA2 (Ptrend ≥ 0.28) mutation carriers. The reduction in breast cancer risk associated with surgical menopause [OR, 0.52; 95% confidence interval (CI), 0.40-0.66; Ptrend <0.0001] was greater than that associated with natural menopause (OR, 0.81; 95% CI, 0.62-1.07; P trend = 0.14). There was a highly significant reduction in breast cancer risk among women who had an oophorectomy after natural menopause (OR, 0.13; 95% CI, 0.02-0.54; P = 0.006). Conclusions: These data challenge the hypothesis that breast cancer risk can be predicted by the lifetime number of ovulatory cycles in women with a BRCA mutation. Both pre- and postmenopausal oophorectomy protect against breast cancer. Impact: Understanding the basis for the protective effect of oophorectomy has important implications for chemoprevention.
AB - Background: To evaluate the effect of the cumulative number of ovulatory cycles and its contributing components on the risk of breast cancer among BRCA mutation carriers. Methods: We conducted a matched case-control study on 2,854 pairs of women with a BRCA1 or BRCA2 mutation. Conditional logistic regression was used to estimate the association between the number of ovulatory cycles and various exposures and the risk of breast cancer. Information from a subset of these women enrolled in a prospective cohort study was used to calculate age-specific breast cancer rates. Results: The annual risk of breast cancer decreased with the number of ovulatory cycles experienced (ρ =-0.69; P = 0.03). Age at menarche and duration of breastfeeding were inversely related with risk of breast cancer among BRCA1 (Ptrend <0.0001) but not among BRCA2 (Ptrend ≥ 0.28) mutation carriers. The reduction in breast cancer risk associated with surgical menopause [OR, 0.52; 95% confidence interval (CI), 0.40-0.66; Ptrend <0.0001] was greater than that associated with natural menopause (OR, 0.81; 95% CI, 0.62-1.07; P trend = 0.14). There was a highly significant reduction in breast cancer risk among women who had an oophorectomy after natural menopause (OR, 0.13; 95% CI, 0.02-0.54; P = 0.006). Conclusions: These data challenge the hypothesis that breast cancer risk can be predicted by the lifetime number of ovulatory cycles in women with a BRCA mutation. Both pre- and postmenopausal oophorectomy protect against breast cancer. Impact: Understanding the basis for the protective effect of oophorectomy has important implications for chemoprevention.
UR - http://www.scopus.com/inward/record.url?scp=84863596964&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863596964&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-12-0201
DO - 10.1158/1055-9965.EPI-12-0201
M3 - Article
C2 - 22564871
AN - SCOPUS:84863596964
VL - 21
SP - 1089
EP - 1096
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
SN - 1055-9965
IS - 7
ER -