Factors influencing ovulation and the risk of ovarian cancer in BRCA1 and BRCA2 mutation carriers. Issue 5 (18th December 2014)

• Record Type: Journal Article
• Authors: Kotsopoulos, Joanne; Lubinski, Jan; Gronwald, Jacek; Cybulski, Cezary; Demsky, Rochelle; Neuhausen, Susan L.; Kim‐Sing, Charmaine; Tung, Nadine; Friedman, Susan; Senter, Leigha; Weitzel, Jeffrey; Karlan, Beth; Moller, Pal; Sun, Ping; Narod, Steven A.; the Hereditary Breast Cancer Clinical Study Group; Lynch, Henry T.; Singer, Christian; Eng, Charis; Mitchell, Gillian; Huzarski, Tomasz; McCuaig, Jeanna; Hughes, Kevin; Mills, Gordon; Ghadirian, Parviz; Eisen, Andrea; Gilchrist, Dawna; Blum, Joanne L.; Zakalik, Dana; Pal, Tuya; Daly, Mary; Weber, Barbara; Snyder, Carrie; Fallen, Taya; Chudley, Albert; Lunn, John; Donenberg, Talia; Kurz, Raluca N.; Saal, Howard; Garber, Judy; Rennert, Gad; Sweet, Kevin; Gershoni‐Baruch, Ruth; Rappaport, Christine; Lemire, Edmond; Stoppa‐Lyonnet, Dominique; Olopade, Olufunmilayo I.; Merajver, Sofia; Bordeleau, Louise; Cullinane, Carey A.; Friedman, Eitan; McKinnon, Wendy; Wood, Marie; Rayson, Daniel; Meschino, Wendy; McLennan, Jane; Costalas, Josephine Wagner; Reilly, Robert E.; Vadaparampil, Susan; Offit, Kenneth; Kauff, Noah; Klijn, Jan; Euhus, David; Kwong, Ava; Isaacs, Claudine; Couch, Fergus; Manoukian, Siranoush; Byrski, Tomasz; Elser, Christine; Panchal, Seema; Armel, Susan; Nanda, Sonia; Metcalfe, Kelly; Poll, Aletta; Rosen, Barry; Foulkes, William D.; Rebbeck, Timothy; Ainsworth, Peter; Robidoux, Andre; Warner, Ellen; Maehle, Lovise; Osborne, Michael; Evans, Gareth; Pasini, Barbara; Ginsburg, Ophira; Cohen, Stephanie; Bohdan, Gorski; Jakubowska, Anna; Little, Janice;
• Is Part Of: International journal of cancer. Volume 137:Issue 5(2015:Sep. 01)
• Page Start: 1136
• Page End: 1146
• Publication Date: 2014-12-18
• Subjects: Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.29386
• Languages: English
• ISSNs: 0020-7136

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>The role of the lifetime number of ovulatory cycles has not been evaluated in the context of <italic>BRCA</italic>‐associated ovarian cancer. Thus, we conducted a matched case–control study to evaluate the relationship between the cumulative number of ovulatory cycles (and contributing components) and risk of developing ovarian cancer in <italic>BRCA</italic> mutation carriers (1, 329 cases and 5, 267 controls). Information regarding reproductive and hormonal factors was collected from a routinely administered questionnaire. Conditional logistic regression was used to evaluate all associations. We observed a 45% reduction in the risk of developing ovarian cancer among women in the lowest <italic>vs</italic>. highest quartile of ovulatory cycles (OR = 0.55; 95% CI 0.41–0.75, <italic>p</italic> = 0.0001). Breastfeeding for more than 12 months was associated with a 38% (95% CI 0.48–0.79) and 50% (95% CI 0.29–0.84) reduction in risk among <italic>BRCA1</italic> and <italic>BRCA2</italic> mutation carriers, respectively. For oral contraceptive use, maximum benefit was seen with five or more years of use among <italic>BRCA1</italic> mutation carriers (OR = 0.50; 95% CI 0.40–0.63) and three or more years for <italic>BRCA2</italic> mutation carriers (OR = 0.42; 95% CI 0.22–0.83). Increasing parity was associated with a significant inverse trend among <italic>BRCA1</italic> (OR = 0.87; 95% CI 0.79–0.96; <italic>p</italic>‐trend = 0.005) but not <italic>BRCA2</italic> mutation carriers (OR 0.98; 95% CI 0.81–1.19; <italic>p</italic>‐trend = 0.85). A later age at menopause was associated with an increased risk in women with a <italic>BRCA1</italic> mutation (OR trend = 1.18; 95% CI 1.03–1.35; <italic>p</italic> = 0.02). These findings support an important role of breastfeeding and oral contraceptive use for the primary prevention of ovarian cancer among women carrying <italic>BRCA</italic> mutations.</p> </abstract>