Reproductive factors associated with breast cancer risk in Li–Fraumeni syndrome. (July 2019)

• Record Type: Journal Article
• Authors: Khincha, Payal P.; Best, Ana F.; Fraumeni, Joseph F.; Loud, Jennifer T.; Savage, Sharon A.; Achatz, Maria Isabel
• Is Part Of: European journal of cancer. Volume 116(2019)
• Page Start: 199
• Page End: 206
• Publication Date: 2019-07
• Subjects: Li-Fraumeni syndrome -- TP53 -- Breast cancer -- Breastfeeding -- Reproductive; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2019.05.005
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Li–Fraumeni syndrome (LFS) is a rare autosomal dominant cancer predisposition syndrome with exceptionally high lifetime cancer risks, caused primarily by germline TP53 variants. Early-onset breast cancer is the most common cancer in women with LFS. Associations between female reproductive factors and breast cancer risk have been widely studied in the general population and BRCA1/2 mutation carriers but not in LFS. We evaluated whether reproductive factors are associated with breast cancer in LFS. Questionnaire data were collected for 152 women with confirmed germline TP53 variants enrolled in the National Cancer Institute's LFS study (NCT01443468); of which, 85 had breast cancer, confirmed by pathology/medical reports. Fisher's exact test and Cox proportional hazards were used to calculate the effect of reproductive factors on breast cancer risk. Lifetime breastfeeding for at least 7 months was associated with lower breast cancer risk (hazard ratio [HR] 0.57, p = 0.05). Parity did not independently change breast cancer risk (HR 1.08, p = 0.8) but suggested an increased risk with older age at first live birth (HR 2.14, p = 0.05). Age at menarche (HR 1.09, p = 0.24) and use of oral contraceptives (HR 0.88; p = 0.7) did not significantly affect breast cancer risk. In this first study of reproductive factors and breast cancer in women with LFS, breastfeeding was observed to be protective against breast cancer risk, especially with at least 7 months of lifetime breastfeeding. Older age at first live birth was suggested to slightly increase breast cancer risk. Larger prospective studies of reproductive factors are warranted in women with LFS before making definitive clinical recommendations. Highlights: Early-onset breast cancer is the most frequent cancer in Li–Fraumeni syndrome (LFS). Breastfeeding reduces breast cancer risk in women with LFS. Breast cancer risk reduced most significantly with at least 7 months of breastfeeding. Parity, age at menarche and oral contraceptive use do not affect breast cancer risk. Older age at first live birth may slightly increase breast cancer risk in LFS.