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01.12.2008 | Original Paper

Infertility, treatment of infertility, and the risk of breast cancer among women with BRCA1 and BRCA2 mutations: a case–control study

verfasst von: Joanne Kotsopoulos, Clifford L. Librach, Jan Lubinski, Jacek Gronwald, Charmaine Kim-Sing, Parviz Ghadirian, Henry T. Lynch, Pal Moller, William D. Foulkes, Susan Randall, Siranoush Manoukian, Barbara Pasini, Nadine Tung, Peter J. Ainsworth, Shelly Cummings, Ping Sun, Steven A. Narod, Hereditary Breast Cancer Clinical Study Group

Erschienen in: Cancer Causes & Control | Ausgabe 10/2008

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Abstract

Background

Women with a breast cancer susceptibility gene 1 (BRCA1) or breast cancer susceptibility gene 2 (BRCA2) mutation are at increased risk for developing breast and ovarian cancer. Various reproductive and hormonal factors have been shown to modify the risk of breast cancer. These studies suggest that estrogen exposure and deprivation are important in the etiology of hereditary cancer. Many patients are interested in the possibility of an adverse effect of fertility treatment on breast cancer risk. It is important to evaluate whether or not infertility per se or exposure to fertility medications increase the risk of breast cancer in genetically predisposed women.

Methods

We conducted a matched case–control study of 1,380 pairs of women with a BRCA1 or BRCA2 mutation to determine if a history of infertility, the use of fertility medications, or undergoing in vitro fertilization (IVF) were associated with and increased the risk of breast cancer.

Results

Sixteen percent of the study subjects reported having experienced a fertility problem and 4% had used a fertility medication. Women who had used a fertility medication were not at significantly increased risk of breast cancer (odds ratio [OR] = 1.21; 95% confidence interval [CI] = 0.81–1.82) compared to non-users. Furthermore, there was no risk associated with a history of use of a fertility medication when the subjects were stratified by parity: (OR = 1.29; 95% CI = 0.83–2.01 for nulliparous women and OR = 0.81; 95% CI = 0.30–2.22 for parous women).

Conclusions

The results of this study suggest that the use of fertility medications does not adversely affect the risk of breast cancer among BRCA mutation carriers. Given the small sizes of the exposed subgroups, these findings should be interpreted with caution and confirmatory studies are required.

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Titel: Infertility, treatment of infertility, and the risk of breast cancer among women with BRCA1 and BRCA2 mutations: a case–control study
verfasst von: Joanne Kotsopoulos
Clifford L. Librach
Jan Lubinski
Jacek Gronwald
Charmaine Kim-Sing
Parviz Ghadirian
Henry T. Lynch
Pal Moller
William D. Foulkes
Susan Randall
Siranoush Manoukian
Barbara Pasini
Nadine Tung
Peter J. Ainsworth
Shelly Cummings
Ping Sun
Steven A. Narod
Hereditary Breast Cancer Clinical Study Group
Publikationsdatum: 01.12.2008
Verlag: Springer Netherlands
Erschienen in: Cancer Causes & Control / Ausgabe 10/2008
Print ISSN: 0957-5243
Elektronische ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-008-9175-0

Springer Medizin

Infertility, treatment of infertility, and the risk of breast cancer among women with BRCA1 and BRCA2 mutations: a case–control study