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Breast Cancer and Pregnancy

Stand / Letzte Aktualisierung durch Elisabeth Rieping 23.07.2005

To Analyse the Influence of Pregnancies on Breast Cancer Development

Answers to Question 5: back

a) one should compare the number of of pregnancies in women with breast cancer and women without breast cancer.
That is a problem, because it is not clear whether the women who never get breast
cancer, are distinct are so distict from the population of women who ever get breast
cancer, that it is not informative to compare them.

If one looks at mice one would not compare the influence of pregnancy on mammary
tumor development on a mixed population of MMTV and non MMTV infected mice.

But in women that is done, becaues the infection background in women is not known.

If one for example looks on the influence of pregnancies on women who carry the
BRCA1 or 2 mutation it is favorable for the early development of breast cancer
(Jernstrom H, Lerman C, Ghadirian P, Lynch HT, Weber B, Garber J, Daly M, Olopade
OI, Foulkes WD, Warner E, Brunet JS, Narod SA ,1999).
b) one should compare only women with breast cancer and analyse the influence of birth number on the time of breast cancer diagnosis.
In this way one could escape the above mentioned problem.
c) one should analyse the influence of pregnancies on breast cancer appearance in BRCA 1 and BRCA 2 mutation carriers.
That was done in the work cited in answer a).
d) one could look at cats with cancer of the udder and compare the age at diagnosis with the number of pregnancies.
Cats very often develop cancer similar to that of women. They get bone metastases and
can develop an inflammatory type of breast cancer. In this way they differ from mouse
models where this until now has not been achieved.

This similarity between human and cat breast cancer is not unlikely in connection with
theory of a bovine milk transmitted origin of breast cancer as this animal as a pet often
gets fed with cow's milk.

e) one should analyse the appearence of mammary neoplasms in mice, without knowledge on their infection with MMTV.
This is the way in which most studies of human breast bancer are done and it is possible
that most risk factors for breast cancer like early menarche, late pregnancy, long
education would look different, if one would change the type of studies, look at women
who ever get breast cancer and analyse which influence the known risk factors have on
the age of developing the disease.

Jernstrom H, Lerman C, Ghadirian P, Lynch HT, Weber B, Garber J, Daly M, Olopade OI, Foulkes WD, Warner E, Brunet JS,
Narod SA.

Pregnancy and risk of early breast cancer in carriers of BRCA1 and BRCA2.
Lancet. 1999 Nov 27;354(9193):1846-50.
Centre for Research on Women's Health, Women's College Hospital, University of Toronto, Ontario, Canada.

BACKGROUND: Early age at first full-term pregnancy and increasing parity are associated with a reduced risk of breast cancer. However,
whether pregnancy decreases the risk of early-onset hereditary breast cancer is unknown. There is concern that pregnancy may increase
breast-cancer risk in carriers of BRCA1 and BRCA2 germline mutations. We aimed to establish whether pregnancy is a risk factor for
hereditary breast cancer. METHODS: We did a matched case-control study of breast cancer in women who carry deleterious BRCA1 or
BRCA2 mutations. Cases were carriers who developed breast cancer by age 40 years, and controls were carriers of the same age without
breast cancer, or who were diagnosed with breast cancer after age 40 years. Women who had undergone preventive mastectomy,
hysterectomy, or oophorectomy, or who were diagnosed with ovarian cancer before the age at which breast cancer was diagnosed in the
matched case were excluded. Information about pregnancies and pregnancy outcome was derived from a questionnaire completed by women
in the course of genetic counselling. FINDINGS: A higher proportion of cases than controls had had a full term pregnancy (173/236 vs
146/236; odds ratio 1.71 [95% CI 1.13-2.62], p=0.01). The mean number of births was also greater for cases than for controls (1.62 vs 1.38,
p=0.04). The risk increased with the number of births and did not diminish with time since last pregnancy. There were no significant
differences in age at first birth or age at last birth between cases and controls. INTERPRETATION: Carriers of the BRCA1 and BRCA2
mutations who have children are significantly more likely to develop breast cancer by age 40 than carriers who are nulliparous. Each
pregnancy is associated with an increased cancer risk. An early first pregnancy does not confer protection for carriers of BRCA1 or BRCA2
mutations.

Comment in:

• Lancet. 2000 Mar 18;355(9208):1017.

Permalink Library of Congress: http://web.archive.org/web/*/http://www.erieping.de/answer5.htm (not available?)

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