Highlights
- •Breastfeeding for as few as 3 months – the duration of a maternity leave – is associated with reduced ovarian cancer risk.
- •This association decreases over time but persists for more than 30 years.
- •Longer duration, greater number of offspring nursed, and earlier age at first breastfeeding associate with reduced risk.
- •This association is similar in magnitude and duration to that observed for oral contraceptive use and bearing children.
Abstract
Objective
Previous studies suggest that breastfeeding reduces epithelial ovarian cancer (EOC)
risk. However, the effects of age, timing and episode details on the EOC-breastfeeding
relationship have not been examined. The objective of this study was to examine the
association between breastfeeding factors and epithelial ovarian cancer.
Methods
We examined breastfeeding factors among parous women in a population-based, case-control
study conducted in Pennsylvania, Ohio, and New York from 2003 to 2008. We compared
689 incident EOC cases to 1572 community controls. Multivariable unconditional logistic
regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs)
associated with breastfeeding patterns adjusting for potential confounders.
Results
Compared to never breastfeeding, breastfeeding any offspring was associated with a
30% reduction in EOC risk (OR = 0.70; 95%CI = 0.58–0.85). That association lasted
more than 30 years (OR = 0.69, 95%CI = 0.53–0.88). An average breastfeeding episode
of 3 months was also associated with reduced risk (OR = 0.73, 95%CI = 0.58–0.80).
A greater number of breastfeeding episodes was associated with greater risk reduction
(OR = 0.78, 95%CI = 0.64–0.96 and OR = 0.49, 95%CI = 0.36–0.68 1–2 and 3+ episodes,
respectively, compared to never breastfed, trend p = 0.01). Longer breastfeeding duration
was also associated with reduced risk (OR = 0.75 and 0.62 for less than and greater
than 1-year total duration, respectively, compared to never breastfed). An earlier
age at first breastfeeding was further associated with increased protection (OR = 0.50–0.80,
for first episode at age <25, 25–29, and 30+, respectively, trend p = 0.001).
Conclusions
Breastfeeding for as few as 3 months is associated with reduced EOC risk. Although
this association decreases over time, it persists for more than 30 years. Longer cumulative
duration, increasing number of breastfeeding episodes, and earlier age at first breastfeeding
episode are each associated with increased benefit.
Keywords
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Article info
Publication history
Published online: January 25, 2019
Accepted:
January 20,
2019
Received in revised form:
January 17,
2019
Received:
December 11,
2018
Footnotes
☆An early version of this work was presented at the AACR Special Conference: Addressing Critical Questions in Ovarian Cancer Research and Treatment, Pittsburgh, PA. October 2017.
Identification
Copyright
© 2019 Published by Elsevier Inc.
