Comparison of age at natural menopause in BRCA1/2 mutation carriers with a non–clinic‐based sample of women in northern California. Issue 9 (29th January 2013)

• Record Type: Journal Article
• Authors: Lin, Wayne T.; Beattie, Mary; Chen, Lee‐may; Oktay, Kutluk; Crawford, Sybil L.; Gold, Ellen B.; Cedars, Marcelle; Rosen, Mitchell
• Is Part Of: Cancer. Volume 119:Issue 9(2013)
• Page Start: 1652
• Page End: 1659
• Publication Date: 2013-01-29
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.27952
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>BACKGROUND:</title> <p>Germline mutations in <italic>BRCA1</italic> and <italic>BRCA2</italic> (<italic>BRCA1/2</italic>) are related to an increased lifetime risk of developing breast and ovarian cancer. Although risk‐reducing salpingo‐oophorectomy reduces the risk of both cancers, loss of fertility is a major concern. A recent study suggested an association between <italic>BRCA1</italic> mutation and occult primary ovarian insufficiency. The objective of the current study was to determine whether <italic>BRCA1/2</italic> mutation carriers have an earlier onset of natural menopause compared with unaffected women.</p> </sec> <sec id="abs1-2" sec-type="section"> <title>METHODS:</title> <p>White carriers of the <italic>BRCA1/2</italic> gene (n = 382) were identified within the Breast Cancer Risk Program Registry at the University of California at San Francisco and compared with non–clinic‐based white women in northern California (n = 765). The 2 groups were compared with regard to median age at the time of natural menopause before and after adjustment for known risk factors, and the role of smoking within each group was examined using the Kaplan‐Meier approach for unadjusted analyses and Cox proportional hazards regression analyses for adjusted analyses.</p> </sec> <sec id="abs1-3" sec-type="section"> <title>RESULTS:</title> <p>The median age at the time of natural menopause in the <italic>BRCA1/2</italic> carriers was significantly younger than among the unaffected sample (50 years vs 53 years; <italic>P</italic> < .001). The unadjusted hazard ratio for natural menopause when comparing <italic>BRCA1/2</italic> carriers with unaffected women was 4.06 (95% confidence interval, 3.03‐5.45) and was 3.98 (95% confidence interval, 2.87‐5.53) after adjusting for smoking, parity, and oral contraceptive use. For <italic>BRCA1/2</italic> carriers who were current heavy smokers (smoking ≥ 20 cigarettes/day), the median age at natural menopause was 46 years versus 49 years for nonsmokers (<italic>P</italic> = .027).</p> </sec> <sec id="abs1-4" sec-type="section"> <title>CONCLUSIONS:</title> <p>The <italic>BRCA1</italic>/<italic>2</italic> mutation was associated with a significantly earlier age at natural menopause, and heavy smoking compounded this risk. Because the relationship between menopause and the end of natural fertility is considered to be fixed, these findings suggest the risk of earlier infertility among <italic>BRCA1</italic>/<italic>2</italic> carriers. Cancer 2013. © 2012 American Cancer Society.</p> </sec> </abstract>