Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers

Steven A. Narod, Marie Pierre Dubé, Jan Klijn, Jan Lubinski, Henry T. Lynch, Parviz Ghadirian, Daine Provencher, Ketil Heimdal, Pal Moller, Mark Robson, Kenneth Offit, Claudine Isaacs, Barbara Weber, Eitan Friedman, Ruth Gershoni-Baruch, Gad Rennert, Barbara Pasini, Theresa Wagner, Mary Daly, Judy E. GarberSusan L. Neuhausen, Peter Ainsworth, Hakan Olsson, Gareth Evans, Michael Osborne, Fergus Couch, William D. Foulkes, Ellen Warner, Charmaine Kim-Sing, Olufunmilayo Olopade, Nadine Tung, Howard M. Saal, Jeffrey Weitzel, Sofia Merajver, Marion Gauthier-Villars, Helena Jernstrom, Ping Sun, Jean Sebastien Brunet

Research output: Contribution to journalArticle

289 Citations (Scopus)

Abstract

Background: Oral contraceptive use has been associated with an increase in the risk of breast cancer in young women. We examined whether this association is seen in women at high risk of breast cancer because they carry a mutation in one of two breast cancer susceptibility genes, BRCA1 and BRCA2. Methods: We performed a matched case-control study on 1311 pairs of women with known deleterious BRCA1 and/or BRCA2 mutations recruited from 52 centers in 11 countries. Women who had been diagnosed with breast cancer were matched to control subjects by year of birth, country of residence, mutation (BRCA1 or BRCA2), and history of ovarian cancer. All study subjects completed a questionnaire about oral contraceptive use. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived by conditional logistic regression. All statistical tests were two-sided. Results: Among BRCA2 mutation carriers, ever use of oral contraceptives was not associated with an increased risk of breast cancer (OR = 0.94, 95% CI = 0.72 to 1.24). For BRCA1 mutation carriers, ever use of oral contraceptives was associated with a modestly increased risk of breast cancer (OR = 1.20, 95 % CI = 1.02 to 1.40). However, compared with BRCA1 mutation carriers who never used oral contraceptives, those who used oral contraceptives for at least 5 years had an increased risk of breast cancer (OR = 1.33, 95% CI = 1.11 to 1.60), as did those who used oral contraceptives before age 30 (OR = 1.29, 95% CI = 1.09 to 1.52), those who were diagnosed with breast cancer before age 40 (OR = 1.38, 95% CI = 1.11 to 1.72), and those who first used oral contraceptives before 1975 (OR = 1.42, 95 % CI = 1. 17 to 1.75). Conclusions: Among BRCA1 mutation carriers, women who first used oral contraceptives before 1975, who used them before age 30, or who used them for 5 or more years may have an increased risk of early-onset breast cancer. Oral contraceptives do not appear to be associated with risk of breast cancer in BRCA2 carriers, but data for BRCA2 carriers are limited.

Original languageEnglish
Pages (from-to)1773-1779
Number of pages7
JournalJournal of the National Cancer Institute
Volume94
Issue number23
StatePublished - Dec 4 2002

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Oral Contraceptives
Breast Neoplasms
Mutation
Odds Ratio
Confidence Intervals
Neoplasm Genes
Ovarian Neoplasms
Case-Control Studies
Logistic Models
Parturition

All Science Journal Classification (ASJC) codes

  • Cancer Research
  • Oncology

Cite this

Narod, S. A., Dubé, M. P., Klijn, J., Lubinski, J., Lynch, H. T., Ghadirian, P., ... Brunet, J. S. (2002). Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Journal of the National Cancer Institute, 94(23), 1773-1779.

Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. / Narod, Steven A.; Dubé, Marie Pierre; Klijn, Jan; Lubinski, Jan; Lynch, Henry T.; Ghadirian, Parviz; Provencher, Daine; Heimdal, Ketil; Moller, Pal; Robson, Mark; Offit, Kenneth; Isaacs, Claudine; Weber, Barbara; Friedman, Eitan; Gershoni-Baruch, Ruth; Rennert, Gad; Pasini, Barbara; Wagner, Theresa; Daly, Mary; Garber, Judy E.; Neuhausen, Susan L.; Ainsworth, Peter; Olsson, Hakan; Evans, Gareth; Osborne, Michael; Couch, Fergus; Foulkes, William D.; Warner, Ellen; Kim-Sing, Charmaine; Olopade, Olufunmilayo; Tung, Nadine; Saal, Howard M.; Weitzel, Jeffrey; Merajver, Sofia; Gauthier-Villars, Marion; Jernstrom, Helena; Sun, Ping; Brunet, Jean Sebastien.

In: Journal of the National Cancer Institute, Vol. 94, No. 23, 04.12.2002, p. 1773-1779.

Research output: Contribution to journalArticle

Narod, SA, Dubé, MP, Klijn, J, Lubinski, J, Lynch, HT, Ghadirian, P, Provencher, D, Heimdal, K, Moller, P, Robson, M, Offit, K, Isaacs, C, Weber, B, Friedman, E, Gershoni-Baruch, R, Rennert, G, Pasini, B, Wagner, T, Daly, M, Garber, JE, Neuhausen, SL, Ainsworth, P, Olsson, H, Evans, G, Osborne, M, Couch, F, Foulkes, WD, Warner, E, Kim-Sing, C, Olopade, O, Tung, N, Saal, HM, Weitzel, J, Merajver, S, Gauthier-Villars, M, Jernstrom, H, Sun, P & Brunet, JS 2002, 'Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers', Journal of the National Cancer Institute, vol. 94, no. 23, pp. 1773-1779.
Narod SA, Dubé MP, Klijn J, Lubinski J, Lynch HT, Ghadirian P et al. Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Journal of the National Cancer Institute. 2002 Dec 4;94(23):1773-1779.
Narod, Steven A. ; Dubé, Marie Pierre ; Klijn, Jan ; Lubinski, Jan ; Lynch, Henry T. ; Ghadirian, Parviz ; Provencher, Daine ; Heimdal, Ketil ; Moller, Pal ; Robson, Mark ; Offit, Kenneth ; Isaacs, Claudine ; Weber, Barbara ; Friedman, Eitan ; Gershoni-Baruch, Ruth ; Rennert, Gad ; Pasini, Barbara ; Wagner, Theresa ; Daly, Mary ; Garber, Judy E. ; Neuhausen, Susan L. ; Ainsworth, Peter ; Olsson, Hakan ; Evans, Gareth ; Osborne, Michael ; Couch, Fergus ; Foulkes, William D. ; Warner, Ellen ; Kim-Sing, Charmaine ; Olopade, Olufunmilayo ; Tung, Nadine ; Saal, Howard M. ; Weitzel, Jeffrey ; Merajver, Sofia ; Gauthier-Villars, Marion ; Jernstrom, Helena ; Sun, Ping ; Brunet, Jean Sebastien. / Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. In: Journal of the National Cancer Institute. 2002 ; Vol. 94, No. 23. pp. 1773-1779.
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title = "Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers",
abstract = "Background: Oral contraceptive use has been associated with an increase in the risk of breast cancer in young women. We examined whether this association is seen in women at high risk of breast cancer because they carry a mutation in one of two breast cancer susceptibility genes, BRCA1 and BRCA2. Methods: We performed a matched case-control study on 1311 pairs of women with known deleterious BRCA1 and/or BRCA2 mutations recruited from 52 centers in 11 countries. Women who had been diagnosed with breast cancer were matched to control subjects by year of birth, country of residence, mutation (BRCA1 or BRCA2), and history of ovarian cancer. All study subjects completed a questionnaire about oral contraceptive use. Odds ratios (ORs) and 95{\%} confidence intervals (CIs) were derived by conditional logistic regression. All statistical tests were two-sided. Results: Among BRCA2 mutation carriers, ever use of oral contraceptives was not associated with an increased risk of breast cancer (OR = 0.94, 95{\%} CI = 0.72 to 1.24). For BRCA1 mutation carriers, ever use of oral contraceptives was associated with a modestly increased risk of breast cancer (OR = 1.20, 95 {\%} CI = 1.02 to 1.40). However, compared with BRCA1 mutation carriers who never used oral contraceptives, those who used oral contraceptives for at least 5 years had an increased risk of breast cancer (OR = 1.33, 95{\%} CI = 1.11 to 1.60), as did those who used oral contraceptives before age 30 (OR = 1.29, 95{\%} CI = 1.09 to 1.52), those who were diagnosed with breast cancer before age 40 (OR = 1.38, 95{\%} CI = 1.11 to 1.72), and those who first used oral contraceptives before 1975 (OR = 1.42, 95 {\%} CI = 1. 17 to 1.75). Conclusions: Among BRCA1 mutation carriers, women who first used oral contraceptives before 1975, who used them before age 30, or who used them for 5 or more years may have an increased risk of early-onset breast cancer. Oral contraceptives do not appear to be associated with risk of breast cancer in BRCA2 carriers, but data for BRCA2 carriers are limited.",
author = "Narod, {Steven A.} and Dub{\'e}, {Marie Pierre} and Jan Klijn and Jan Lubinski and Lynch, {Henry T.} and Parviz Ghadirian and Daine Provencher and Ketil Heimdal and Pal Moller and Mark Robson and Kenneth Offit and Claudine Isaacs and Barbara Weber and Eitan Friedman and Ruth Gershoni-Baruch and Gad Rennert and Barbara Pasini and Theresa Wagner and Mary Daly and Garber, {Judy E.} and Neuhausen, {Susan L.} and Peter Ainsworth and Hakan Olsson and Gareth Evans and Michael Osborne and Fergus Couch and Foulkes, {William D.} and Ellen Warner and Charmaine Kim-Sing and Olufunmilayo Olopade and Nadine Tung and Saal, {Howard M.} and Jeffrey Weitzel and Sofia Merajver and Marion Gauthier-Villars and Helena Jernstrom and Ping Sun and Brunet, {Jean Sebastien}",
year = "2002",
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TY - JOUR

T1 - Oral contraceptives and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers

AU - Narod, Steven A.

AU - Dubé, Marie Pierre

AU - Klijn, Jan

AU - Lubinski, Jan

AU - Lynch, Henry T.

AU - Ghadirian, Parviz

AU - Provencher, Daine

AU - Heimdal, Ketil

AU - Moller, Pal

AU - Robson, Mark

AU - Offit, Kenneth

AU - Isaacs, Claudine

AU - Weber, Barbara

AU - Friedman, Eitan

AU - Gershoni-Baruch, Ruth

AU - Rennert, Gad

AU - Pasini, Barbara

AU - Wagner, Theresa

AU - Daly, Mary

AU - Garber, Judy E.

AU - Neuhausen, Susan L.

AU - Ainsworth, Peter

AU - Olsson, Hakan

AU - Evans, Gareth

AU - Osborne, Michael

AU - Couch, Fergus

AU - Foulkes, William D.

AU - Warner, Ellen

AU - Kim-Sing, Charmaine

AU - Olopade, Olufunmilayo

AU - Tung, Nadine

AU - Saal, Howard M.

AU - Weitzel, Jeffrey

AU - Merajver, Sofia

AU - Gauthier-Villars, Marion

AU - Jernstrom, Helena

AU - Sun, Ping

AU - Brunet, Jean Sebastien

PY - 2002/12/4

Y1 - 2002/12/4

N2 - Background: Oral contraceptive use has been associated with an increase in the risk of breast cancer in young women. We examined whether this association is seen in women at high risk of breast cancer because they carry a mutation in one of two breast cancer susceptibility genes, BRCA1 and BRCA2. Methods: We performed a matched case-control study on 1311 pairs of women with known deleterious BRCA1 and/or BRCA2 mutations recruited from 52 centers in 11 countries. Women who had been diagnosed with breast cancer were matched to control subjects by year of birth, country of residence, mutation (BRCA1 or BRCA2), and history of ovarian cancer. All study subjects completed a questionnaire about oral contraceptive use. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived by conditional logistic regression. All statistical tests were two-sided. Results: Among BRCA2 mutation carriers, ever use of oral contraceptives was not associated with an increased risk of breast cancer (OR = 0.94, 95% CI = 0.72 to 1.24). For BRCA1 mutation carriers, ever use of oral contraceptives was associated with a modestly increased risk of breast cancer (OR = 1.20, 95 % CI = 1.02 to 1.40). However, compared with BRCA1 mutation carriers who never used oral contraceptives, those who used oral contraceptives for at least 5 years had an increased risk of breast cancer (OR = 1.33, 95% CI = 1.11 to 1.60), as did those who used oral contraceptives before age 30 (OR = 1.29, 95% CI = 1.09 to 1.52), those who were diagnosed with breast cancer before age 40 (OR = 1.38, 95% CI = 1.11 to 1.72), and those who first used oral contraceptives before 1975 (OR = 1.42, 95 % CI = 1. 17 to 1.75). Conclusions: Among BRCA1 mutation carriers, women who first used oral contraceptives before 1975, who used them before age 30, or who used them for 5 or more years may have an increased risk of early-onset breast cancer. Oral contraceptives do not appear to be associated with risk of breast cancer in BRCA2 carriers, but data for BRCA2 carriers are limited.

AB - Background: Oral contraceptive use has been associated with an increase in the risk of breast cancer in young women. We examined whether this association is seen in women at high risk of breast cancer because they carry a mutation in one of two breast cancer susceptibility genes, BRCA1 and BRCA2. Methods: We performed a matched case-control study on 1311 pairs of women with known deleterious BRCA1 and/or BRCA2 mutations recruited from 52 centers in 11 countries. Women who had been diagnosed with breast cancer were matched to control subjects by year of birth, country of residence, mutation (BRCA1 or BRCA2), and history of ovarian cancer. All study subjects completed a questionnaire about oral contraceptive use. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived by conditional logistic regression. All statistical tests were two-sided. Results: Among BRCA2 mutation carriers, ever use of oral contraceptives was not associated with an increased risk of breast cancer (OR = 0.94, 95% CI = 0.72 to 1.24). For BRCA1 mutation carriers, ever use of oral contraceptives was associated with a modestly increased risk of breast cancer (OR = 1.20, 95 % CI = 1.02 to 1.40). However, compared with BRCA1 mutation carriers who never used oral contraceptives, those who used oral contraceptives for at least 5 years had an increased risk of breast cancer (OR = 1.33, 95% CI = 1.11 to 1.60), as did those who used oral contraceptives before age 30 (OR = 1.29, 95% CI = 1.09 to 1.52), those who were diagnosed with breast cancer before age 40 (OR = 1.38, 95% CI = 1.11 to 1.72), and those who first used oral contraceptives before 1975 (OR = 1.42, 95 % CI = 1. 17 to 1.75). Conclusions: Among BRCA1 mutation carriers, women who first used oral contraceptives before 1975, who used them before age 30, or who used them for 5 or more years may have an increased risk of early-onset breast cancer. Oral contraceptives do not appear to be associated with risk of breast cancer in BRCA2 carriers, but data for BRCA2 carriers are limited.

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