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

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 C...

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Detalles Bibliográficos
Autores principales: Schrijver, Lieske H, Olsson, Håkan, Phillips, Kelly-Anne, Terry, Mary Beth, Goldgar, David E, Kast, Karin, Engel, Christoph, Mooij, Thea M, Adlard, Julian, Barrowdale, Daniel, Davidson, Rosemarie, Eeles, Ros, Ellis, Steve, Evans, D Gareth, Frost, Debra, Izatt, Louise, Porteous, Mary E, Side, Lucy E, Walker, Lisa, Berthet, Pascaline, Bonadona, Valérie, Leroux, Dominique, Mouret-Fourme, Emmanuelle, Venat-Bouvet, Laurence, Buys, Saundra S, Southey, Melissa C, John, Esther M, Chung, Wendy K, Daly, Mary B, Bane, Anita, van Asperen, Christi J, Gómez Garcia, Encarna B, Mourits, Marian J E, van Os, Theo A M, Roos-Blom, Marie-José, Friedlander, Michael L, McLachlan, Sue-Anne, Singer, Christian F, Tan, Yen Y, Foretova, Lenka, Navratilova, Marie, Gerdes, Anne-Marie, Caldes, Trinidad, Simard, Jacques, Olah, Edith, Jakubowska, Anna, Arver, Brita, Osorio, Ana, Noguès, Catherine, Andrieu, Nadine, Easton, Douglas F, van Leeuwen, Flora E, Hopper, John L, Milne, Roger L, Antoniou, Antonis C, Rookus, Matti A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6649757/
https://www.ncbi.nlm.nih.gov/pubmed/31360853
http://dx.doi.org/10.1093/jncics/pky023
Descripción
Sumario: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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