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

Author

Schrijver, Lieske H., Olsson, Hakan, 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, Val Erie, 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., Garcia, Encarna B. Gomez, Mourits, Marian J. E., Roos-Blom, Marie-Jose, Friedlander, Michael L., McLachlan, Sue-Anne, Singer, Christian F., Foretova, Lenka, Gerdes, Anne-Marie, Caldes, Trinidad, Olah, Edith, Jakubowska, Anna, Nogues, Catherine, Andrieu, Nadine, Easton, Douglas F., van Leeuwen, Flora E., Hopper, John L., Milne, Roger L., Antoniou, Antonis C., Rookus, Matti A., Rookus, M. A., Hogervorst, F. B. L., van Leeuwen, F. E., Adank, M. A., Schmidt, M. K., Russell, N. S., de Lange, J. L., Wijnands, R., Jenner, D. J., Collee, J. M., van den Ouweland, A. M. W., Hooning, M. J., Seynaeve, C., van Deurzen, C. H. M., Obdeijn, I. M., van Asperen, C. J., Wijnen, J. T., Tollenaar, R. A. E. M., Devilee, P., van Cronenburg, T. C. T. E. F., Kets, C. M., Mensenkamp, A. R., Ausems, M. G. E. M., van der Luijt, R. B., van der Pol, C. C., Aalfs, C. M., Meijers-Heijboer, H. E. J., van Os, T. A. M., van Engelen, K., Gille, J. J. P., Waisfisz, Q., Gomez-Garcia, E. B., Blok, M. J., Oosterwijk, J. C., van der Hout, A. H., Mourits, M. J., de Bock, G. H., Siesling, S., Verloop, J., Overbeek, L. I. H., Schrijver, Lieske H., Olsson, Hakan, 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, Val Erie, 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., Garcia, Encarna B. Gomez, Mourits, Marian J. E., Roos-Blom, Marie-Jose, Friedlander, Michael L., McLachlan, Sue-Anne, Singer, Christian F., Foretova, Lenka, Gerdes, Anne-Marie, Caldes, Trinidad, Olah, Edith, Jakubowska, Anna, Nogues, Catherine, Andrieu, Nadine, Easton, Douglas F., van Leeuwen, Flora E., Hopper, John L., Milne, Roger L., Antoniou, Antonis C., Rookus, Matti A., Rookus, M. A., Hogervorst, F. B. L., van Leeuwen, F. E., Adank, M. A., Schmidt, M. K., Russell, N. S., de Lange, J. L., Wijnands, R., Jenner, D. J., Collee, J. M., van den Ouweland, A. M. W., Hooning, M. J., Seynaeve, C., van Deurzen, C. H. M., Obdeijn, I. M., van Asperen, C. J., Wijnen, J. T., Tollenaar, R. A. E. M., Devilee, P., van Cronenburg, T. C. T. E. F., Kets, C. M., Mensenkamp, A. R., Ausems, M. G. E. M., van der Luijt, R. B., van der Pol, C. C., Aalfs, C. M., Meijers-Heijboer, H. E. J., van Os, T. A. M., van Engelen, K., Gille, J. J. P., Waisfisz, Q., Gomez-Garcia, E. B., Blok, M. J., Oosterwijk, J. C., van der Hout, A. H., Mourits, M. J., de Bock, G. H., Siesling, S., Verloop, J., and Overbeek, L. I. H.

Abstract

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 non-hormonal contraceptive methods should be discussed.

Published
2018

2. The Influence of Number and Timing of Pregnancies on Breast Cancer Risk for Women With BRCA1 or BRCA2 Mutations

Author

Terry, Mary Beth, Liao, Yuyan, Kast, Karin, Antoniou, Antonis C., McDonald, Jasmine A., Mooij, Thea M., Engel, Christoph, Nogues, Catherine, Buecher, Bruno, Mari, Veronique, Moretta-Serra, Jessica, Gladieff, Laurence, Luporsi, Elisabeth, Barrowdale, Daniel, Frost, Debra, Henderson, Alex, Brewer, Carole, Evans, D. Gareth, Eccles, Diana, Cook, Jackie, Ong, Kai-ren, Izatt, Louise, Ahmed, Munaza, Morrison, Patrick J., Dommering, Charlotte J., Oosterwijk, Jan C., Ausems, Margreet G. E. M., Kriege, Mieke, Buys, Saundra S., Andrulis, Irene L., John, Esther M., Daly, Mary, Friedlander, Michael, McLachlan, Sue Anne, Osorio, Ana, Caldes, Trinidad, Jakubowska, Anna, Simard, Jacques, Singer, Christian F., Tan, Yen, Olah, Edith, Navratilova, Marie, Foretova, Lenka, Gerdes, Anne-Marie, Roos-Blom, Marie-Jose, Arver, Brita, Olsson, Hakan, Schmutzler, Rita K., Hopper, John L., van Leeuwen, Flora E., Goldgar, David, Milne, Roger L., Easton, Douglas F., Rookus, Matti A., Andrieu, Nadine, Evans, Gareth, Adlard, Julian, Eeles, Ros, Davidson, Rosemarie, Tischkowitz, Marc, Snape, Katie, Walker, Lisa, Porteous, Mary, Donaldson, Alan, Morrison, Patrick, Eason, Jacqueline, Rogers, Mark, Miller, Claire, Brady, Angela, Kennedy, M. John, Barwell, Julian, Gregory, Helen, Pottinger, Caroline, Murray, Alex, Angelakos, Maggie, Dite, Gillian, Tsimiklis, Helen, Breysse, Emmanuel, Pontois, Pauline, Laborde, Lilian, Stoppa-Lyonnet, Dominique, Gauthier-Villars, Marion, Caron, Olivier, Fourme-Mouret, Emmanuelle, Fricker, Jean-Pierre, Lasset, Christine, Bonadona, Valerie, Fert-Ferrer, Sandra, Berthet, Pascaline, Venat-Bouvet, Laurence, Gilbert-Dussardier, Brigitte, Faivre, Laurence, Gesta, Paul, Sobol, Hagay, Eisinger, Francois, Longy, Michel, Dugast, Catherine, Coupier, Isabelle, Colas, Chrystelle, Soubrier, Florent, Pujol, Pascal, Corsini, Carole, Lortholary, Alain, Vennin, Philippe, Adenis, Claude, Penet, Clotilde, Delnatte, Capucine, Tinat, Julie, Tennevet, Isabelle, Limacher, Jean-Marc, Maugard, Christine, Demange, Liliane, Dreyfus, Helene, Cohen-Haguenauer, Odile, Leroux, Dominique, Zattara-Cannoni, Helene, Bera, Odile, Hogervorst, F. B. L., Adank, M. A., Schmidt, M. K., Russell, N. S., Jenner, D. J., Collee, J. M., van den Ouweland, A. M. W., Hooning, M. J., Seynaeve, C. M., van Deurzen, C. H. M., Obdeijn, I. M., van Asperen, C. J., Devilee, P., Kets, C. M., Mensenkamp, A. R., Koudijs, M. J., Aalfs, C. M., van Engelen, K., Gille, J. J. P., Gomez-Garcia, E. B., Blok, M. J., van der Hout, A. H., Mourits, M. J., de Bock, G. H., Siesling, S., Verloop, J., van den Belt-Dusebout, A. W., Terry, Mary Beth, Liao, Yuyan, Kast, Karin, Antoniou, Antonis C., McDonald, Jasmine A., Mooij, Thea M., Engel, Christoph, Nogues, Catherine, Buecher, Bruno, Mari, Veronique, Moretta-Serra, Jessica, Gladieff, Laurence, Luporsi, Elisabeth, Barrowdale, Daniel, Frost, Debra, Henderson, Alex, Brewer, Carole, Evans, D. Gareth, Eccles, Diana, Cook, Jackie, Ong, Kai-ren, Izatt, Louise, Ahmed, Munaza, Morrison, Patrick J., Dommering, Charlotte J., Oosterwijk, Jan C., Ausems, Margreet G. E. M., Kriege, Mieke, Buys, Saundra S., Andrulis, Irene L., John, Esther M., Daly, Mary, Friedlander, Michael, McLachlan, Sue Anne, Osorio, Ana, Caldes, Trinidad, Jakubowska, Anna, Simard, Jacques, Singer, Christian F., Tan, Yen, Olah, Edith, Navratilova, Marie, Foretova, Lenka, Gerdes, Anne-Marie, Roos-Blom, Marie-Jose, Arver, Brita, Olsson, Hakan, Schmutzler, Rita K., Hopper, John L., van Leeuwen, Flora E., Goldgar, David, Milne, Roger L., Easton, Douglas F., Rookus, Matti A., Andrieu, Nadine, Evans, Gareth, Adlard, Julian, Eeles, Ros, Davidson, Rosemarie, Tischkowitz, Marc, Snape, Katie, Walker, Lisa, Porteous, Mary, Donaldson, Alan, Morrison, Patrick, Eason, Jacqueline, Rogers, Mark, Miller, Claire, Brady, Angela, Kennedy, M. John, Barwell, Julian, Gregory, Helen, Pottinger, Caroline, Murray, Alex, Angelakos, Maggie, Dite, Gillian, Tsimiklis, Helen, Breysse, Emmanuel, Pontois, Pauline, Laborde, Lilian, Stoppa-Lyonnet, Dominique, Gauthier-Villars, Marion, Caron, Olivier, Fourme-Mouret, Emmanuelle, Fricker, Jean-Pierre, Lasset, Christine, Bonadona, Valerie, Fert-Ferrer, Sandra, Berthet, Pascaline, Venat-Bouvet, Laurence, Gilbert-Dussardier, Brigitte, Faivre, Laurence, Gesta, Paul, Sobol, Hagay, Eisinger, Francois, Longy, Michel, Dugast, Catherine, Coupier, Isabelle, Colas, Chrystelle, Soubrier, Florent, Pujol, Pascal, Corsini, Carole, Lortholary, Alain, Vennin, Philippe, Adenis, Claude, Penet, Clotilde, Delnatte, Capucine, Tinat, Julie, Tennevet, Isabelle, Limacher, Jean-Marc, Maugard, Christine, Demange, Liliane, Dreyfus, Helene, Cohen-Haguenauer, Odile, Leroux, Dominique, Zattara-Cannoni, Helene, Bera, Odile, Hogervorst, F. B. L., Adank, M. A., Schmidt, M. K., Russell, N. S., Jenner, D. J., Collee, J. M., van den Ouweland, A. M. W., Hooning, M. J., Seynaeve, C. M., van Deurzen, C. H. M., Obdeijn, I. M., van Asperen, C. J., Devilee, P., Kets, C. M., Mensenkamp, A. R., Koudijs, M. J., Aalfs, C. M., van Engelen, K., Gille, J. J. P., Gomez-Garcia, E. B., Blok, M. J., van der Hout, A. H., Mourits, M. J., de Bock, G. H., Siesling, S., Verloop, J., and van den Belt-Dusebout, A. W.

Abstract

Background: Full-term pregnancy (FTP) is associated with a reduced breast cancer (BC) risk over time, but women are at increased BC risk in the immediate years following an FTP. No large prospective studies, however, have examined whether the number and timing of pregnancies are associated with BC risk for BRCA1 and BRCA2 mutation carriers. Methods: Using weighted and time-varying Cox proportional hazards models, we investigated whether reproductive events are associated with BC risk for mutation carriers using a retrospective cohort (5707 BRCA1 and 3525 BRCA2 mutation carriers) and a prospective cohort (2276 BRCA1 and 1610 BRCA2 mutation carriers), separately for each cohort and the combined prospective and retrospective cohort. Results: For BRCA1 mutation carriers, there was no overall association with parity compared with nulliparity (combined hazard ratio [HRc] = 0.99, 95% confidence interval [CI] = 0.83 to 1.18). Relative to being uniparous, an increased number of FTPs was associated with decreased BC risk (HRc = 0.79, 95% CI = 0.69 to 0.91; HRc =0.70, 95% CI = 0.59 to 0.82; HRc = 0.50, 95% CI = 0.40 to 0.63, for 2, 3, and >= 4 FTPs, respectively, P-trend < .0001) and increasing duration of breastfeeding was associated with decreased BC risk (combined cohort P-trend = .0003). Relative to being nulliparous, uniparous BRCA1 mutation carriers were at increased BC risk in the prospective analysis (prospective hazard ration [HRp] =1.69, 95% CI =1.09 to 2.62). For BRCA2 mutation carriers, being parous was associated with a 30% increase in BC risk (HRc =1.33, 95% CI =1.05 to 1.69), and there was no apparent decrease in risk associated with multiparity except for having at least 4 FTPs vs. 1 FTP (HRc =0.72, 95% CI = 0.54 to 0.98). Conclusions: These findings suggest differential associations with parity between BRCA1 and BRCA2 mutation carriers with higher risk for uniparous BRCA1 carriers and parous BRCA2 carriers.

Published
2018

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

Author

Schrijver, LH, Olsson, H, Phillips, K-A, Terry, MB, Goldgar, DE, Kast, K, Engel, C, Mooij, TM, Adlard, J, Barrowdale, D, Davidson, R, Eeles, R, Ellis, S, Evans, DG, Frost, D, Izatt, L, Porteous, ME, Side, LE, Walker, L, Berthet, P, Bonadona, V, Leroux, D, Mouret-Fourme, E, Venat-Bouvet, L, Buys, SS, Southey, MC, John, EM, Chung, WK, Daly, MB, Bane, A, van Asperen, CJ, Garcia, EBG, Mourits, MJE, van Os, TAM, Roos-Blom, M-J, Friedlander, ML, McLachlan, S-A, Singer, CF, Tan, YY, Foretova, L, Navratilova, M, Schmutzler, RK, Ellberg, C, Gerdes, A-M, Caldes, T, Simard, J, Olah, E, Jakubowska, A, Arver, B, Osorio, A, Nogues, C, Andrieu, N, Easton, DF, van Leeuwen, FE, Hopper, JL, Milne, RL, Antoniou, AC, Rookus, MA, Hogervorst, FBL, Adank, MA, Schmidt, MK, Russell, NS, de Lange, JL, Wijnands, R, Jenner, DJ, Collee, JM, van den Ouweland, AMW, Hooning, MJ, Seynaeve, C, van Deurzen, CHM, Obdeijn, IM, Wijnen, JT, Tollenaar, RAEM, Devilee, P, van Cronenburg, TCTEF, Kets, CM, Mensenkamp, AR, Ausems, MGEM, van der Luijt, RB, van der Pol, CC, Aalfs, CM, Meijers-Heijboer, HEJ, van Engelen, K, Gille, JJP, Waisfisz, Q, Gomez-Garcia, EB, Blok, MJ, Oosterwijk, JC, van der Hout, AH, Mourits, MJ, de Bock, GH, Siesling, S, Verloop, J, Overbeek, LIH, Schrijver, LH, Olsson, H, Phillips, K-A, Terry, MB, Goldgar, DE, Kast, K, Engel, C, Mooij, TM, Adlard, J, Barrowdale, D, Davidson, R, Eeles, R, Ellis, S, Evans, DG, Frost, D, Izatt, L, Porteous, ME, Side, LE, Walker, L, Berthet, P, Bonadona, V, Leroux, D, Mouret-Fourme, E, Venat-Bouvet, L, Buys, SS, Southey, MC, John, EM, Chung, WK, Daly, MB, Bane, A, van Asperen, CJ, Garcia, EBG, Mourits, MJE, van Os, TAM, Roos-Blom, M-J, Friedlander, ML, McLachlan, S-A, Singer, CF, Tan, YY, Foretova, L, Navratilova, M, Schmutzler, RK, Ellberg, C, Gerdes, A-M, Caldes, T, Simard, J, Olah, E, Jakubowska, A, Arver, B, Osorio, A, Nogues, C, Andrieu, N, Easton, DF, van Leeuwen, FE, Hopper, JL, Milne, RL, Antoniou, AC, Rookus, MA, Hogervorst, FBL, Adank, MA, Schmidt, MK, Russell, NS, de Lange, JL, Wijnands, R, Jenner, DJ, Collee, JM, van den Ouweland, AMW, Hooning, MJ, Seynaeve, C, van Deurzen, CHM, Obdeijn, IM, Wijnen, JT, Tollenaar, RAEM, Devilee, P, van Cronenburg, TCTEF, Kets, CM, Mensenkamp, AR, Ausems, MGEM, van der Luijt, RB, van der Pol, CC, Aalfs, CM, Meijers-Heijboer, HEJ, van Engelen, K, Gille, JJP, Waisfisz, Q, Gomez-Garcia, EB, Blok, MJ, Oosterwijk, JC, van der Hout, AH, Mourits, MJ, de Bock, GH, Siesling, S, Verloop, J, and Overbeek, LIH

Abstract

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.

Published
2018

4. The Influence of Number and Timing of Pregnancies on Breast Cancer Risk for Women With BRCA1 or BRCA2 Mutations

Author

Terry, MB, Liao, Y, Kast, K, Antoniou, AC, McDonald, JA, Mooij, TM, Engel, C, Nogues, C, Buecher, B, Mari, V, Moretta-Serra, J, Gladieff, L, Luporsi, E, Barrowdale, D, Frost, D, Henderson, A, Brewer, C, Evans, DG, Eccles, D, Cook, J, Ong, K-R, Izatt, L, Ahmed, M, Morrison, PJ, Dommering, CJ, Oosterwijk, JC, Ausems, MGEM, Kriege, M, Buys, SS, Andrulis, IL, John, EM, Daly, M, Friedlander, M, McLachlan, SA, Osorio, A, Caldes, T, Jakubowska, A, Simard, J, Singer, CF, Tan, Y, Olah, E, Navratilova, M, Foretova, L, Gerdes, A-M, Roos-Blom, M-J, Arver, B, Olsson, H, Schmutzler, RK, Hopper, JL, van Leeuwen, FE, Goldgar, D, Milne, RL, Easton, DF, Rookus, MA, Andrieu, N, Evans, G, Adlard, J, Eeles, R, Davidson, R, Tischkowitz, M, Snape, K, Walker, L, Porteous, M, Donaldson, A, Morrison, P, Eason, J, Rogers, M, Miller, C, Brady, A, Kennedy, MJ, Barwell, J, Gregory, H, Pottinger, C, Murray, A, Angelakos, M, Dite, G, Tsimiklis, H, Breysse, E, Pontois, P, Laborde, L, Stoppa-Lyonnet, D, Gauthier-Villars, M, Caron, O, Fourme-Mouret, E, Fricker, J-P, Lasset, C, Bonadona, V, Fert-Ferrer, S, Berthet, P, Venat-Bouvet, L, Gilbert-Dussardier, B, Faivre, L, Gesta, P, Sobol, H, Eisinger, F, Longy, M, Dugast, C, Coupier, I, Colas, C, Soubrier, F, Pujol, P, Corsini, C, Lortholary, A, Vennin, P, Adenis, C, Tan, DN, Penet, C, Delnatte, C, Tinat, J, Tennevet, I, Limacher, J-M, Maugard, C, Demange, L, Dreyfus, H, Cohen-Haguenauer, O, Leroux, D, Zattara-Cannoni, H, Bera, O, Hogervorst, FBL, Adank, MA, Schmidt, MK, Russell, NS, Jenner, DJ, Collee, JM, van den Ouweland, AMW, Hooning, MJ, Seynaeve, CM, van Deurzen, CHM, Obdeijn, IM, van Asperen, CJ, Devilee, P, Kets, CM, Mensenkamp, AR, Koudijs, MJ, Aalfs, CM, van Engelen, K, Gille, JJP, Gomez-Garcia, EB, Blok, MJ, van der Hout, AH, Mourits, MJ, de Bock, GH, Siesling, S, Verloop, J, van den Belt-Dusebout, AW, Terry, MB, Liao, Y, Kast, K, Antoniou, AC, McDonald, JA, Mooij, TM, Engel, C, Nogues, C, Buecher, B, Mari, V, Moretta-Serra, J, Gladieff, L, Luporsi, E, Barrowdale, D, Frost, D, Henderson, A, Brewer, C, Evans, DG, Eccles, D, Cook, J, Ong, K-R, Izatt, L, Ahmed, M, Morrison, PJ, Dommering, CJ, Oosterwijk, JC, Ausems, MGEM, Kriege, M, Buys, SS, Andrulis, IL, John, EM, Daly, M, Friedlander, M, McLachlan, SA, Osorio, A, Caldes, T, Jakubowska, A, Simard, J, Singer, CF, Tan, Y, Olah, E, Navratilova, M, Foretova, L, Gerdes, A-M, Roos-Blom, M-J, Arver, B, Olsson, H, Schmutzler, RK, Hopper, JL, van Leeuwen, FE, Goldgar, D, Milne, RL, Easton, DF, Rookus, MA, Andrieu, N, Evans, G, Adlard, J, Eeles, R, Davidson, R, Tischkowitz, M, Snape, K, Walker, L, Porteous, M, Donaldson, A, Morrison, P, Eason, J, Rogers, M, Miller, C, Brady, A, Kennedy, MJ, Barwell, J, Gregory, H, Pottinger, C, Murray, A, Angelakos, M, Dite, G, Tsimiklis, H, Breysse, E, Pontois, P, Laborde, L, Stoppa-Lyonnet, D, Gauthier-Villars, M, Caron, O, Fourme-Mouret, E, Fricker, J-P, Lasset, C, Bonadona, V, Fert-Ferrer, S, Berthet, P, Venat-Bouvet, L, Gilbert-Dussardier, B, Faivre, L, Gesta, P, Sobol, H, Eisinger, F, Longy, M, Dugast, C, Coupier, I, Colas, C, Soubrier, F, Pujol, P, Corsini, C, Lortholary, A, Vennin, P, Adenis, C, Tan, DN, Penet, C, Delnatte, C, Tinat, J, Tennevet, I, Limacher, J-M, Maugard, C, Demange, L, Dreyfus, H, Cohen-Haguenauer, O, Leroux, D, Zattara-Cannoni, H, Bera, O, Hogervorst, FBL, Adank, MA, Schmidt, MK, Russell, NS, Jenner, DJ, Collee, JM, van den Ouweland, AMW, Hooning, MJ, Seynaeve, CM, van Deurzen, CHM, Obdeijn, IM, van Asperen, CJ, Devilee, P, Kets, CM, Mensenkamp, AR, Koudijs, MJ, Aalfs, CM, van Engelen, K, Gille, JJP, Gomez-Garcia, EB, Blok, MJ, van der Hout, AH, Mourits, MJ, de Bock, GH, Siesling, S, Verloop, J, and van den Belt-Dusebout, AW

Abstract

BACKGROUND: Full-term pregnancy (FTP) is associated with a reduced breast cancer (BC) risk over time, but women are at increased BC risk in the immediate years following an FTP. No large prospective studies, however, have examined whether the number and timing of pregnancies are associated with BC risk for BRCA1 and BRCA2 mutation carriers. METHODS: Using weighted and time-varying Cox proportional hazards models, we investigated whether reproductive events are associated with BC risk for mutation carriers using a retrospective cohort (5707 BRCA1 and 3525 BRCA2 mutation carriers) and a prospective cohort (2276 BRCA1 and 1610 BRCA2 mutation carriers), separately for each cohort and the combined prospective and retrospective cohort. RESULTS: For BRCA1 mutation carriers, there was no overall association with parity compared with nulliparity (combined hazard ratio [HRc] = 0.99, 95% confidence interval [CI] = 0.83 to 1.18). Relative to being uniparous, an increased number of FTPs was associated with decreased BC risk (HRc = 0.79, 95% CI = 0.69 to 0.91; HRc = 0.70, 95% CI = 0.59 to 0.82; HRc = 0.50, 95% CI = 0.40 to 0.63, for 2, 3, and ≥4 FTPs, respectively, P trend < .0001) and increasing duration of breastfeeding was associated with decreased BC risk (combined cohort P trend = .0003). Relative to being nulliparous, uniparous BRCA1 mutation carriers were at increased BC risk in the prospective analysis (prospective hazard ration [HRp] = 1.69, 95% CI = 1.09 to 2.62). For BRCA2 mutation carriers, being parous was associated with a 30% increase in BC risk (HRc = 1.33, 95% CI = 1.05 to 1.69), and there was no apparent decrease in risk associated with multiparity except for having at least 4 FTPs vs. 1 FTP (HRc = 0.72, 95% CI = 0.54 to 0.98). CONCLUSIONS: These findings suggest differential associations with parity between BRCA1 and BRCA2 mutation carriers with higher risk for uniparous BRCA1 carriers and parous BRCA2 carriers.

Published
2018

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

Author

Schrijver, Lieske H., Olsson, Hakan, 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, Val Erie, 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., Garcia, Encarna B. Gomez, Mourits, Marian J. E., Roos-Blom, Marie-Jose, Friedlander, Michael L., McLachlan, Sue-Anne, Singer, Christian F., Foretova, Lenka, Gerdes, Anne-Marie, Caldes, Trinidad, Olah, Edith, Jakubowska, Anna, Nogues, Catherine, Andrieu, Nadine, Easton, Douglas F., van Leeuwen, Flora E., Hopper, John L., Milne, Roger L., Antoniou, Antonis C., Rookus, Matti A., Rookus, M. A., Hogervorst, F. B. L., van Leeuwen, F. E., Adank, M. A., Schmidt, M. K., Russell, N. S., de Lange, J. L., Wijnands, R., Jenner, D. J., Collee, J. M., van den Ouweland, A. M. W., Hooning, M. J., Seynaeve, C., van Deurzen, C. H. M., Obdeijn, I. M., van Asperen, C. J., Wijnen, J. T., Tollenaar, R. A. E. M., Devilee, P., van Cronenburg, T. C. T. E. F., Kets, C. M., Mensenkamp, A. R., Ausems, M. G. E. M., van der Luijt, R. B., van der Pol, C. C., Aalfs, C. M., Meijers-Heijboer, H. E. J., van Os, T. A. M., van Engelen, K., Gille, J. J. P., Waisfisz, Q., Gomez-Garcia, E. B., Blok, M. J., Oosterwijk, J. C., van der Hout, A. H., Mourits, M. J., de Bock, G. H., Siesling, S., Verloop, J., Overbeek, L. I. H., Schrijver, Lieske H., Olsson, Hakan, 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, Val Erie, 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., Garcia, Encarna B. Gomez, Mourits, Marian J. E., Roos-Blom, Marie-Jose, Friedlander, Michael L., McLachlan, Sue-Anne, Singer, Christian F., Foretova, Lenka, Gerdes, Anne-Marie, Caldes, Trinidad, Olah, Edith, Jakubowska, Anna, Nogues, Catherine, Andrieu, Nadine, Easton, Douglas F., van Leeuwen, Flora E., Hopper, John L., Milne, Roger L., Antoniou, Antonis C., Rookus, Matti A., Rookus, M. A., Hogervorst, F. B. L., van Leeuwen, F. E., Adank, M. A., Schmidt, M. K., Russell, N. S., de Lange, J. L., Wijnands, R., Jenner, D. J., Collee, J. M., van den Ouweland, A. M. W., Hooning, M. J., Seynaeve, C., van Deurzen, C. H. M., Obdeijn, I. M., van Asperen, C. J., Wijnen, J. T., Tollenaar, R. A. E. M., Devilee, P., van Cronenburg, T. C. T. E. F., Kets, C. M., Mensenkamp, A. R., Ausems, M. G. E. M., van der Luijt, R. B., van der Pol, C. C., Aalfs, C. M., Meijers-Heijboer, H. E. J., van Os, T. A. M., van Engelen, K., Gille, J. J. P., Waisfisz, Q., Gomez-Garcia, E. B., Blok, M. J., Oosterwijk, J. C., van der Hout, A. H., Mourits, M. J., de Bock, G. H., Siesling, S., Verloop, J., and Overbeek, L. I. H.

Abstract

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 non-hormonal contraceptive methods should be discussed.

Published
2018

6. The Influence of Number and Timing of Pregnancies on Breast Cancer Risk for Women With BRCA1 or BRCA2 Mutations

Author

Terry, Mary Beth, Liao, Yuyan, Kast, Karin, Antoniou, Antonis C., McDonald, Jasmine A., Mooij, Thea M., Engel, Christoph, Nogues, Catherine, Buecher, Bruno, Mari, Veronique, Moretta-Serra, Jessica, Gladieff, Laurence, Luporsi, Elisabeth, Barrowdale, Daniel, Frost, Debra, Henderson, Alex, Brewer, Carole, Evans, D. Gareth, Eccles, Diana, Cook, Jackie, Ong, Kai-ren, Izatt, Louise, Ahmed, Munaza, Morrison, Patrick J., Dommering, Charlotte J., Oosterwijk, Jan C., Ausems, Margreet G. E. M., Kriege, Mieke, Buys, Saundra S., Andrulis, Irene L., John, Esther M., Daly, Mary, Friedlander, Michael, McLachlan, Sue Anne, Osorio, Ana, Caldes, Trinidad, Jakubowska, Anna, Simard, Jacques, Singer, Christian F., Tan, Yen, Olah, Edith, Navratilova, Marie, Foretova, Lenka, Gerdes, Anne-Marie, Roos-Blom, Marie-Jose, Arver, Brita, Olsson, Hakan, Schmutzler, Rita K., Hopper, John L., van Leeuwen, Flora E., Goldgar, David, Milne, Roger L., Easton, Douglas F., Rookus, Matti A., Andrieu, Nadine, Evans, Gareth, Adlard, Julian, Eeles, Ros, Davidson, Rosemarie, Tischkowitz, Marc, Snape, Katie, Walker, Lisa, Porteous, Mary, Donaldson, Alan, Morrison, Patrick, Eason, Jacqueline, Rogers, Mark, Miller, Claire, Brady, Angela, Kennedy, M. John, Barwell, Julian, Gregory, Helen, Pottinger, Caroline, Murray, Alex, Angelakos, Maggie, Dite, Gillian, Tsimiklis, Helen, Breysse, Emmanuel, Pontois, Pauline, Laborde, Lilian, Stoppa-Lyonnet, Dominique, Gauthier-Villars, Marion, Caron, Olivier, Fourme-Mouret, Emmanuelle, Fricker, Jean-Pierre, Lasset, Christine, Bonadona, Valerie, Fert-Ferrer, Sandra, Berthet, Pascaline, Venat-Bouvet, Laurence, Gilbert-Dussardier, Brigitte, Faivre, Laurence, Gesta, Paul, Sobol, Hagay, Eisinger, Francois, Longy, Michel, Dugast, Catherine, Coupier, Isabelle, Colas, Chrystelle, Soubrier, Florent, Pujol, Pascal, Corsini, Carole, Lortholary, Alain, Vennin, Philippe, Adenis, Claude, Penet, Clotilde, Delnatte, Capucine, Tinat, Julie, Tennevet, Isabelle, Limacher, Jean-Marc, Maugard, Christine, Demange, Liliane, Dreyfus, Helene, Cohen-Haguenauer, Odile, Leroux, Dominique, Zattara-Cannoni, Helene, Bera, Odile, Hogervorst, F. B. L., Adank, M. A., Schmidt, M. K., Russell, N. S., Jenner, D. J., Collee, J. M., van den Ouweland, A. M. W., Hooning, M. J., Seynaeve, C. M., van Deurzen, C. H. M., Obdeijn, I. M., van Asperen, C. J., Devilee, P., Kets, C. M., Mensenkamp, A. R., Koudijs, M. J., Aalfs, C. M., van Engelen, K., Gille, J. J. P., Gomez-Garcia, E. B., Blok, M. J., van der Hout, A. H., Mourits, M. J., de Bock, G. H., Siesling, S., Verloop, J., van den Belt-Dusebout, A. W., Terry, Mary Beth, Liao, Yuyan, Kast, Karin, Antoniou, Antonis C., McDonald, Jasmine A., Mooij, Thea M., Engel, Christoph, Nogues, Catherine, Buecher, Bruno, Mari, Veronique, Moretta-Serra, Jessica, Gladieff, Laurence, Luporsi, Elisabeth, Barrowdale, Daniel, Frost, Debra, Henderson, Alex, Brewer, Carole, Evans, D. Gareth, Eccles, Diana, Cook, Jackie, Ong, Kai-ren, Izatt, Louise, Ahmed, Munaza, Morrison, Patrick J., Dommering, Charlotte J., Oosterwijk, Jan C., Ausems, Margreet G. E. M., Kriege, Mieke, Buys, Saundra S., Andrulis, Irene L., John, Esther M., Daly, Mary, Friedlander, Michael, McLachlan, Sue Anne, Osorio, Ana, Caldes, Trinidad, Jakubowska, Anna, Simard, Jacques, Singer, Christian F., Tan, Yen, Olah, Edith, Navratilova, Marie, Foretova, Lenka, Gerdes, Anne-Marie, Roos-Blom, Marie-Jose, Arver, Brita, Olsson, Hakan, Schmutzler, Rita K., Hopper, John L., van Leeuwen, Flora E., Goldgar, David, Milne, Roger L., Easton, Douglas F., Rookus, Matti A., Andrieu, Nadine, Evans, Gareth, Adlard, Julian, Eeles, Ros, Davidson, Rosemarie, Tischkowitz, Marc, Snape, Katie, Walker, Lisa, Porteous, Mary, Donaldson, Alan, Morrison, Patrick, Eason, Jacqueline, Rogers, Mark, Miller, Claire, Brady, Angela, Kennedy, M. John, Barwell, Julian, Gregory, Helen, Pottinger, Caroline, Murray, Alex, Angelakos, Maggie, Dite, Gillian, Tsimiklis, Helen, Breysse, Emmanuel, Pontois, Pauline, Laborde, Lilian, Stoppa-Lyonnet, Dominique, Gauthier-Villars, Marion, Caron, Olivier, Fourme-Mouret, Emmanuelle, Fricker, Jean-Pierre, Lasset, Christine, Bonadona, Valerie, Fert-Ferrer, Sandra, Berthet, Pascaline, Venat-Bouvet, Laurence, Gilbert-Dussardier, Brigitte, Faivre, Laurence, Gesta, Paul, Sobol, Hagay, Eisinger, Francois, Longy, Michel, Dugast, Catherine, Coupier, Isabelle, Colas, Chrystelle, Soubrier, Florent, Pujol, Pascal, Corsini, Carole, Lortholary, Alain, Vennin, Philippe, Adenis, Claude, Penet, Clotilde, Delnatte, Capucine, Tinat, Julie, Tennevet, Isabelle, Limacher, Jean-Marc, Maugard, Christine, Demange, Liliane, Dreyfus, Helene, Cohen-Haguenauer, Odile, Leroux, Dominique, Zattara-Cannoni, Helene, Bera, Odile, Hogervorst, F. B. L., Adank, M. A., Schmidt, M. K., Russell, N. S., Jenner, D. J., Collee, J. M., van den Ouweland, A. M. W., Hooning, M. J., Seynaeve, C. M., van Deurzen, C. H. M., Obdeijn, I. M., van Asperen, C. J., Devilee, P., Kets, C. M., Mensenkamp, A. R., Koudijs, M. J., Aalfs, C. M., van Engelen, K., Gille, J. J. P., Gomez-Garcia, E. B., Blok, M. J., van der Hout, A. H., Mourits, M. J., de Bock, G. H., Siesling, S., Verloop, J., and van den Belt-Dusebout, A. W.

Abstract

Background: Full-term pregnancy (FTP) is associated with a reduced breast cancer (BC) risk over time, but women are at increased BC risk in the immediate years following an FTP. No large prospective studies, however, have examined whether the number and timing of pregnancies are associated with BC risk for BRCA1 and BRCA2 mutation carriers. Methods: Using weighted and time-varying Cox proportional hazards models, we investigated whether reproductive events are associated with BC risk for mutation carriers using a retrospective cohort (5707 BRCA1 and 3525 BRCA2 mutation carriers) and a prospective cohort (2276 BRCA1 and 1610 BRCA2 mutation carriers), separately for each cohort and the combined prospective and retrospective cohort. Results: For BRCA1 mutation carriers, there was no overall association with parity compared with nulliparity (combined hazard ratio [HRc] = 0.99, 95% confidence interval [CI] = 0.83 to 1.18). Relative to being uniparous, an increased number of FTPs was associated with decreased BC risk (HRc = 0.79, 95% CI = 0.69 to 0.91; HRc =0.70, 95% CI = 0.59 to 0.82; HRc = 0.50, 95% CI = 0.40 to 0.63, for 2, 3, and >= 4 FTPs, respectively, P-trend < .0001) and increasing duration of breastfeeding was associated with decreased BC risk (combined cohort P-trend = .0003). Relative to being nulliparous, uniparous BRCA1 mutation carriers were at increased BC risk in the prospective analysis (prospective hazard ration [HRp] =1.69, 95% CI =1.09 to 2.62). For BRCA2 mutation carriers, being parous was associated with a 30% increase in BC risk (HRc =1.33, 95% CI =1.05 to 1.69), and there was no apparent decrease in risk associated with multiparity except for having at least 4 FTPs vs. 1 FTP (HRc =0.72, 95% CI = 0.54 to 0.98). Conclusions: These findings suggest differential associations with parity between BRCA1 and BRCA2 mutation carriers with higher risk for uniparous BRCA1 carriers and parous BRCA2 carriers.

Published
2018

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