Highlights
- •Whether a history of breastfeeding is associated with the risk of ovarian cancer among BRCA mutation carriers is not known.
- •In this matched analysis, ever-breastfeeding was associated with a significant 23% reduction in risk of ovarian cancer.
- •We observed an additive effect of both oral contraceptive use and breastfeeding which was strongly protective.
- •Delineating the underlying mechanism(s) conferring the protective effect of breastfeeding is necessary.
Abstract
Objective
BRCA mutation carriers face a high lifetime risk of developing ovarian cancer. The strong
inverse association between breastfeeding and the risk of ovarian cancer is established
in the general population but is less well studied among women with a germline BRCA1 or BRCA2 mutation.
Method
Thus, we conducted a matched case-control analysis to evaluate the association between
breastfeeding history and the risk of developing ovarian cancer. After matching for
year of birth, country of residence, BRCA gene and personal history of breast cancer, a total of 1650 cases and 2702 controls
were included in the analysis. Conditional logistic regression was used to estimate
the odds ratio (OR) and 95% confidence intervals (CI) associated with various breastfeeding
exposures.
Results
A history of ever-breastfeeding was associated with a 23% reduction in risk (OR = 0.77;
95%CI 0.66–0.90; P = 0.001). The protective effect increased with breastfeeding from one month to seven
months after which the association was relatively stable. Compared to women who never
breastfed, breastfeeding for seven or more months was associated with a 32% reduction
in risk (OR = 0.68; 95%CI 0.57–0.81; P < 0.0001) and did not vary by BRCA gene or age at diagnosis. The combination of breastfeeding and oral contraceptive
use was strongly protective (0.47; 95%CI 0.37–0.58; P < 0.0001).
Conclusions
These findings support a protective effect of breastfeeding for at least seven months
among women with a BRCA1 or BRCA2 mutation, that is independent of oral contraceptive use.
Keywords
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Article info
Publication history
Published online: September 30, 2020
Accepted:
September 21,
2020
Received:
August 17,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
