The impact of reproductive life on breast cancer risk in women with family history or BRCA mutation

Autor: Elisabetta De Matteis, Luigi Marcheselli, Elisabetta Razzaboni, Silvia Pavesi, Laura Cortesi, Chiara Tomasello, Angela Toss, Giovanni Grandi, Angelo Cagnacci, Stefano Cascinu
Přispěvatelé: Toss, A., Grandi, G., Cagnacci, A., Marcheselli, L., Pavesi, S., De Matteis, E., Razzaboni, E., Tomasello, C., Cascinu, S., Cortesi, L.
Rok vydání: 2016
Předmět:
0301 basic medicine
Oncology
Heredity
Time Factors
BRCA
Breast cancer
Combined hormonal contraceptive
Family history
Reproductive factors
0302 clinical medicine
Pregnancy
Risk Factors
combined hormonal contraceptive
family history
education.field_of_study
BRCA1 Protein
Middle Aged
Pedigree
Parity
Breast Feeding
Phenotype
Reproductive Health
Italy
Risk factors for breast cancer
030220 oncology & carcinogenesis
Female
reproductive factors
Menopause
Contraceptives
Oral
Sequential
Research Paper
Adult
medicine.medical_specialty
Population
Breast Neoplasms
03 medical and health sciences
breast cancer
Internal medicine
Biomarkers
Tumor
medicine
Humans
Genetic Predisposition to Disease
education
Aged
Proportional Hazards Models
BRCA2 Protein
Menarche
Gynecology
Chi-Square Distribution
business.industry
BRCA mutation
Cancer
medicine.disease
Fertility
030104 developmental biology
Mutation
business
Breast feeding
Zdroj: Oncotarget
ISSN: 1949-2553
DOI: 10.18632/oncotarget.13423
Popis: Reproductive history and exogenous hormonal exposures are acknowledged risk factors for breast cancer in the general population. In women at increased breast cancer risk for genetic predisposition or positive family history, data regarding these risk factors are limited or conflicting, and recommendations for these categories are unclear. We evaluated the characteristics of reproductive life in 2522 women at increased genetic or familial breast cancer risk attending our Family Cancer Center. Breast cancers in BRCA mutation carriers were more likely to be hormone receptor negative, diagnosed at 35 years or before and multiple during the lifetime than tumors in women at increased familial risk, while the distribution of invasive cancers and HER2 positive tumors was similar in the different risk groups. At least one full-term pregnancy (HR 0.27; 95% CI 0.12-0.58; p = 0.001), breastfeeding either less (HR 0.24; 95% CI 0.09-0.66; p = 0.005) or more (HR 0.25; 95% IC 0.08-0.82; p = 0.022) than one year and late age at menopause (HR 0.10; 95% CI 0.01-0.82; p = 0.033) showed to be protective factors in BRCA mutation carriers, while in women at increased familial risk early age at first full-term pregnancy (HR 0.62; 95% IC 0.38-0.99; p = 0.048) and late menarche (HR 0.61; 95% CI 0.42-0.85; p = 0.004) showed to be the main protective factors. Finally, for the entire population, combined hormonal contraceptives demonstrated to do not increase breast cancer risk. The results of our study suggest that women at high familial risk and mutation carries develop tumors with different clinical-pathological characteristics and, consequently, are influenced by different protective and risk factors.
Databáze: OpenAIRE
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