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The preventive effect of breastfeeding against ovarian cancer in BRCA1 and BRCA2 mutation carriers: A systematic review and meta-analysis

  • Author Footnotes
    1 These authors contributed equally to this work.
    Kyung Jin Eoh
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Obstetrics and Gynecology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Eun Young Park
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Biostatistics Collaboration Team, Research Core Center, National Cancer Center, Goyang, Republic of Korea

    Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea
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  • Yoon Jung Chang
    Affiliations
    Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea

    Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
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  • Hyeong In Ha
    Affiliations
    Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National school of medicine, Yangsan, Republic of Korea
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  • Juhye Hong
    Affiliations
    Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
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  • Dan Huang
    Affiliations
    Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
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  • Eun Ji Nam
    Affiliations
    Department of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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  • Myong Cheol Lim
    Correspondence
    Corresponding author at: Center for Gynecologic Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea.
    Affiliations
    Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea

    Division of Tumor Immunology and Center for Gynecologic Cancer, Research Institute and Hospital, Goyang, Republic of Korea
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  • Author Footnotes
    1 These authors contributed equally to this work.

      Highlights

      • Ovarian cancer (OC) risk in BRCA1/2 mutation carriers who breastfed was investigated.
      • Ever having breastfed was preventive against OC in BRCA1 mutation carriers.
      • Breastfeeding >1 year was required for reduced OC risk in BRCA2 mutation carriers.

      Abstract

      Objective

      A recent study showed that even a few months of breastfeeding is associated with a significant decrease in the risk of ovarian cancer in the general population. This study aimed to perform a systematic review and meta-analysis to determine the significance of the length of the breastfeeding period on ovarian cancer risk in BRCA1/2 mutation carriers.

      Methods

      PubMed, EMBASE, and Cochrane databases were searched up to June 1, 2021. We included case-control and cohort studies that contained information on breastfeeding and the risk of ovarian cancer in BRCA1/2 mutation carriers. Odds ratios (OR) were meta-analytically pooled using a fixed-effects model.dd

      Results

      Five studies, including one cohort study and four case-control studies, were included in this meta-analysis. Of the 14,601 BRCA1/2 mutation carriers, the overall pooled OR of ever having performed breastfeeding in patients who had ovarian cancer was 0.767 (95% confidence interval [CI], 0.688–0.856) and 0.817 (95% CI, 0.650–1.028) for patients with BRCA1 and BRCA2 mutation, respectively. Breastfeeding for >1 year acted as a protective factor in both BRCA1 [OR: 0.787 (95% CI, 0.682–0.907)] and BRCA2 [OR: 0.567 (95% CI, 0.400–0.802)] mutation carriers. No significant heterogeneity was present (I2 = 0%), and the funnel plot was also properly distributed, showing no publication bias.

      Conclusions

      Breastfeeding is a preventive, modifiable factor for ovarian cancer in BRCA1/2 mutation carriers. Ever having performed breastfeeding was significantly preventive for ovarian cancer in the BRCA1 mutation carriers, however a period of 1 year or more of breastfeeding is required for a reduced ovarian cancer risk in BRCA2 mutation carriers.

      Keywords

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