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Schrijver LH, Olsson H, Phillips KA, et al. Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study. JNCI Cancer Spectr. 2018;2(2):pky023doi: 10.1093/jncics/pky023.
Schrijver, L. H., Olsson, H., Phillips, K. A., Terry, M. B., Goldgar, D. E., Kast, K., Engel, C., Mooij, T. M., Adlard, J., Barrowdale, D., Davidson, R., Eeles, R., Ellis, S., Evans, D. G., Frost, D., Izatt, L., Porteous, M. E., Side, L. E., Walker, L., Berthet, P., Bonadona, V., Leroux, D., Mouret-Fourme, E., Venat-Bouvet, L., Buys, S. S., Southey, M. C., John, E. M., Chung, W. K., Daly, M. B., Bane, A., van Asperen, C. J., Gómez Garcia, E. B., Mourits, M. J. E., van Os, T. A. M., Roos-Blom, M. J., Friedlander, M. L., McLachlan, S. A., Singer, C. F., Tan, Y. Y., Foretova, L., Navratilova, M., Gerdes, A. M., Caldes, T., Simard, J., Olah, E., Jakubowska, A., Arver, B., Osorio, A., Noguès, C., Andrieu, N., Easton, D. F., van Leeuwen, F. E., Hopper, J. L., Milne, R. L., Antoniou, A. C., Rookus, M. A. (2018). Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study. JNCI cancer spectrum, 2(2), pky023. https://doi.org/10.1093/jncics/pky023
Schrijver, Lieske H, et al. "Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study." JNCI cancer spectrum vol. 2,2 (2018): pky023. doi: https://doi.org/10.1093/jncics/pky023
Schrijver LH, Olsson H, Phillips KA, 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, Gómez Garcia EB, Mourits MJE, van Os TAM, Roos-Blom MJ, Friedlander ML, McLachlan SA, Singer CF, Tan YY, Foretova L, Navratilova M, Gerdes AM, Caldes T, Simard J, Olah E, Jakubowska A, Arver B, Osorio A, Noguès C, Andrieu N, Easton DF, van Leeuwen FE, Hopper JL, Milne RL, Antoniou AC, Rookus MA. Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study. JNCI Cancer Spectr. 2018 Jun 28;2(2):pky023. doi: 10.1093/jncics/pky023. eCollection 2018 Apr. PMID: 31360853; PMCID: PMC6649757.
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JNCI Cancer Spectr. 2018 Jun 28;2(2):pky023. doi: 10.1093/jncics/pky023. eCollection 2018 Apr.

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

JNCI cancer spectrum

Lieske H Schrijver, Håkan Olsson, Kelly-Anne Phillips, Mary Beth Terry, David E Goldgar, Karin Kast, Christoph Engel, Thea M Mooij, Julian Adlard, Daniel Barrowdale, Rosemarie Davidson, Ros Eeles, Steve Ellis, D Gareth Evans, Debra Frost, Louise Izatt, Mary E Porteous, Lucy E Side, Lisa Walker, Pascaline Berthet, Valérie Bonadona, Dominique Leroux, Emmanuelle Mouret-Fourme, Laurence Venat-Bouvet, Saundra S Buys, Melissa C Southey, Esther M John, Wendy K Chung, Mary B Daly, Anita Bane, Christi J van Asperen, Encarna B Gómez Garcia, Marian J E Mourits, Theo A M van Os, Marie-José Roos-Blom, Michael L Friedlander, Sue-Anne McLachlan, Christian F Singer, Yen Y Tan, Lenka Foretova, Marie Navratilova, Anne-Marie Gerdes, Trinidad Caldes, Jacques Simard, Edith Olah, Anna Jakubowska, Brita Arver, Ana Osorio, Catherine Noguès, Nadine Andrieu, Douglas F Easton, Flora E van Leeuwen, John L Hopper, Roger L Milne, Antonis C Antoniou, Matti A Rookus,

Affiliations

  1. Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
  2. Department of Oncology, Lund University Hospital.
  3. Lund University, Lund, Sweden; Sir Peter MacCallum Department of Oncology.
  4. Division of Cancer Medicine.
  5. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
  6. Department of Epidemiology.
  7. Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT.
  8. Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
  9. Oncology and Pathology, Department of Clinical Sciences Lund.
  10. Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Germany.
  11. Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, UK.
  12. Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK.
  13. Department of Clinical Genetics, South Glasgow University Hospitals, Glasgow, UK.
  14. Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK.
  15. Genomic Medicine, Manchester Academic Health Sciences Centre, Institute of Human Development, Manchester University, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
  16. Clinical Genetics, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
  17. South East of Scotland Regional Genetics Service, Western General Hospital, Edinburgh, UK.
  18. North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Trust, London, UK.
  19. Oxford Regional Genetics Service, Churchill Hospital, Oxford, UK.
  20. Centre François Baclesse, Caen, France.
  21. Université Claude Bernard Lyon 1, Villeurbanne, France.
  22. CHU de Grenoble, Hôpital Couple-Enfant, Département de Génétique, Grenoble, France.
  23. Service de Génétique Oncologique, Hôpital René Huguenin/Institut Curie, Saint-Cloud, France.
  24. Hôpital Universitaire Dupuytren, Service d'Oncologie Médicale, Limoges, France.
  25. Department of Medicine, Huntsman Cancer Institute, Salt Lake City, UT.
  26. Genetic Epidemiology Laboratory, Department of Pathology.
  27. Precision Medicine, School of Clinical Science at Monash Health, Monash University, Victoria, Australia.
  28. Department of Epidemiology, Cancer Prevention Institute of California, Fremont, CA.
  29. Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA.
  30. Department of Pediatrics and Medicine, Columbia University, New York, NY.
  31. Division of Population Science, Fox Chase Cancer Center, Philadelphia, PA.
  32. Department of Pathology and Molecular Medicine, Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, Ontario, Canada.
  33. Department of Oncology-Pathology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
  34. Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands.
  35. Department of Clinical Genetics and GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands.
  36. Department of Gynaecologic Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  37. Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands.
  38. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
  39. Department of Medical Oncology, Prince of Wales Hospital, Randwick, Australia.
  40. Department of Medicine, St. Vincent's Hospital, University of Melbourne, Parkville, Victoria, Australia.
  41. Department of Medical Oncology, St Vincent's Hospital, Fitzroy, Australia.
  42. Department of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
  43. Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic, Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology.
  44. Medical Faculty, University of Cologne and University Hospital Cologne, Germany.
  45. Department of Clincial Genetics, Rigshospitalet, København, Denmark.
  46. Molecular Oncology Laboratory, Hospital Clinico San Carlos, IdISSC, CIBERONC, Martin Lagos s/n, Madrid, Spain.
  47. Genomics Center, Centre Hospitalier Universitaire de Québec Research Center and Laval University, Quebec City, Quebec, Canada.
  48. Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary.
  49. Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.
  50. Human Genetics Group, Spanish National Cancer Centre, Madrid, Spain.
  51. Oncogénétique Clinique, Institut Paoli-Calmettes and Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.
  52. INSERM U900, Paris, France.
  53. Institut Curie, Paris, France.
  54. Ecole des Mines de Paris, ParisTech, Fontainebleau, France.
  55. Cancer Epidemiology Centre, Cancer Council Victoria, Victoria, Australia.

PMID: 31360853 PMCID: PMC6649757 DOI: 10.1093/jncics/pky023

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,

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.

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