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Makama M, Drukker CA, Rutgers EJT, Slaets L, Cardoso F, Rookus MA, Tryfonidis K, Van't Veer LJ, Schmidt MK. Corrigendum to "An association study of established breast cancer reproductive and lifestyle risk factors with tumour subtype defined by the prognostic 70-gene expression signature (MammaPrint ®)" [Eur J Cancer 75 (April 2017) 5-13]. Eur J Cancer 2018; 96:131-132. [PMID: 29656866 DOI: 10.1016/j.ejca.2018.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Makama
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Division of Molecular Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - C A Drukker
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Albert Schweitzer Hospital, Department of Surgery, Dordrecht, The Netherlands
| | - E J Th Rutgers
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - L Slaets
- Department of Statistics, European Organization for Research and Treatment of Cancer, Brussels, Belgium
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
| | - M A Rookus
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - K Tryfonidis
- Medical Department, European Organization for Research and Treatment of Cancer, Brussels, Belgium
| | - L J Van't Veer
- Division of Molecular Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - M K Schmidt
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Division of Molecular Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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Phillips KA, Milne RL, Bassett JK, Hopper JL, Buys SS, Daly MB, Hooning MJ, Mooij TM, Andrieu N, Antoniou AC, Rookus MA, Easton DF, Mary-Beth T. Abstract P3-10-01: Tamoxifen and contralateral breast cancer (CBC) risk for BRCA1 and BRCA2 mutation carriers: An updated analysis of data from the Kathleen Cuningham Foundation consortium for research into familial breast cancer, the International BRCA1 and BRCA2 Carrier cohort study and the breast cancer family registry. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-10-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Findings from an analysis published in 2013, using combined retrospective and prospective data pooled from 3 cohort studies, were consistent with tamoxifen use after 1st breast cancer (BC) being associated with reduced CBC risk for both BRCA1 and BRCA2 mutation carriers, although the analysis of prospective data alone (based on 100 incident CBCs) gave inconclusive results. The association did not differ by estrogen receptor (ER) status of the 1st BC, suggesting that tamoxifen may be a useful secondary BC prevention agent for mutation carriers regardless of the ER status of their 1st BC. The aim of this updated analysis was to assess these associations after incorporating data from an additional 1,279 mutation carriers and with further follow-up providing 153 additional prospective CBC events. Methods: Eligible women were BRCA1 and BRCA2 mutation carriers diagnosed with unilateral BC since 1970 and with no other invasive cancer or tamoxifen use before their 1st BC. They were followed up from their 1st BC (or, for the prospective analysis, from the later of recruitment and 1st BC diagnosis) to the development of CBC or censoring (at contralateral mastectomy, death or loss to follow-up). Hazard ratios (HRs) for CBC associated with tamoxifen use were estimated using Cox regression, adjusting for year and age of diagnosis, country and bilateral oophorectomy; analyses were also stratified by ER status of the 1st BC. Results: This 2017 analysis includes 3,743 mutation carriers (BRCA1 2,343; BRCA2 1,400) with 21,436 person years of follow-up. Compared with the 2013 analysis, the strengths of the inverse associations were attenuated after including the additional data.
2017 2013 TotalCBCHR (95% CI) p-valueTotalCBCHR (95% CI) p-value NN NN BRCA1 Combined* Tam 1st BC No17615141.0012003381.00Yes5821290.77 (0.63-0.95) 0.01383350.38 (0.27-0.55) <0.001Prospective Tam 1st BC No9841321.00481541.00Yes369400.82 (0.57-1.20) 0.31176120.58 (0.29-1.13) 0.1BRCA2 Combined* Tam1st BC No6361661.004271151.00Yes764990.58 (0.44-0.76) <0.001454320.33 (0.22-0.50) <0.001Prospective Tam 1st BC No389461.00191211.00Yes497350.68 (0.40-1.15) 0.15235130.48 (0.22-1.05) 0.07*Combined = retrospective and prospective, N=number, BRCA1 & BRCA2=mutation carriers, Tam 1st BC= Tamoxifen for 1st Breast Cancer
In this updated prospective analysis, the inverse association between tamoxifen use for 1st BC and CBC risk was most apparent for women with ER positive 1st BC, especially for BRCA2 mutation carriers: BRCA1 ER positive HR=0.45 (95% CI 0.17-1.22, p=0.12), BRCA1 ER negative HR= 0.87 (95% CI 0.45-1.67, p=0.67), BRCA2 ER positive HR=0.33 (95% CI 0.15-0.74, p<0.007), BRCA2 ER negative HR=1.12 (95% CI 0.27-4.70, p=0.88).
Conclusions: Tamoxifen use for 1st BC might reduce CBC risk for mutation carriers, but predominantly for those with an ER positive 1st BC. These data do not support use of tamoxifen to prevent CBC for mutation carriers with ER negative BC.
Citation Format: Phillips K-A, Milne RL, Bassett JK, Hopper JL, Buys SS, Daly MB, Hooning MJ, Mooij TM, Andrieu N, Antoniou AC, Rookus MA, Easton DF, Mary-Beth T. Tamoxifen and contralateral breast cancer (CBC) risk for BRCA1 and BRCA2 mutation carriers: An updated analysis of data from the Kathleen Cuningham Foundation consortium for research into familial breast cancer, the International BRCA1 and BRCA2 Carrier cohort study and the breast cancer family registry [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-10-01.
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Affiliation(s)
- K-A Phillips
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - RL Milne
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - JK Bassett
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - JL Hopper
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - SS Buys
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - MB Daly
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - MJ Hooning
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - TM Mooij
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - N Andrieu
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - AC Antoniou
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - MA Rookus
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - DF Easton
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
| | - T Mary-Beth
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Cancer Council Victoria, Melbourne, Australia; The University of Melbourne, Melbourne, Australia; Huntsman Cancer Institute at the University of Utah, Utah, U.S.; Fox Chase Cancer Center, Philadelphia, PA; Erasmus Medical Center, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Institut Curie, Paris, France; University of Cambridge, Cambridge, United Kingdom; Columbia University, New York
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Schrijver LH, Olsson H, Antoniou AC, Milne RL, Phillips KA, Andrieu N, Easton DF, Goldgar D, Engel C, Kast K, Roos-Blom MJ, Mooij TM, Hopper JL, van Leeuwen FE, Terry MB, Rookus MA. Abstract P5-08-09: Use of oral contraceptives and risk of breast cancer in BRCA1 and BRCA2 mutation carriers: An international prospective cohort study; for the studies of EMBRACE, GENEPSO, HEBON, kConFab and BCFR. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-08-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- LH Schrijver
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - H Olsson
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - AC Antoniou
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - RL Milne
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - K-A Phillips
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - N Andrieu
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - DF Easton
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - D Goldgar
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - C Engel
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - K Kast
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - M-J Roos-Blom
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - TM Mooij
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - JL Hopper
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - FE van Leeuwen
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - M-B Terry
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
| | - MA Rookus
- Netherlands Cancer Institute, Amsterdam, Netherlands; Lund University, Lund, Sweden; University of Cambridge, Cambridge, United Kingdom; University of Melbourne, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Institute Curie, PSL Research University, INSERM, U900, Paris, France; University of Utah, Salt Lake City, UT; University of Leipzig, Leipzig, Germany; University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Colombia University, New York, NY
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Verloop J, van Leeuwen FE, Helmerhorst TJM, de Kok IMCM, van Erp EJM, van Boven HH, Rookus MA. Risk of cervical intra-epithelial neoplasia and invasive cancer of the cervix in DES daughters. Gynecol Oncol 2016; 144:305-311. [PMID: 27939984 DOI: 10.1016/j.ygyno.2016.11.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/23/2016] [Accepted: 11/29/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Women exposed to diethylstilbestrol in utero (DES) have an increased risk of clear cell adenocarcinoma (CCA) of the vagina and cervix, while their risk of non-CCA invasive cervical cancer is still unclear. METHODS We studied the risk of pre-cancerous (CIN) lesions and non-CCA invasive cervical cancer in a prospective cohort of 12,182 women with self-reported DES exposure followed from 2000 till 2008. We took screening behavior carefully into account. Incidence was obtained through linkage with the Netherlands Nationwide Pathology database (PALGA). General population data were also derived from PALGA. RESULTS The incidence of CIN1 was increased (Standardized Incidence Ratio (SIR)=2.8, 95% Confidence Interval (CI)=2.3 to 3.4), but no increased risk was observed for CIN2+ (CIN2, CIN3 or invasive cancer) compared to the screened general population (SIR=1.1, 95% CI=0.95 to1.4). Women with DES-related malformations had increased risks of both CIN1 and CIN2+ (SIR=4.1, 95%CI=3.0 to 5.3 and SIR=1.5, 95%CI=1.1 to 2.0, respectively). For CIN2+, this risk increase was largely restricted to women with malformations who were more intensively screened. CONCLUSIONS An increased risk of CIN1 among DES daughters was observed, especially in women with DES-related malformations, probably mainly due to screening. The risk of CIN2+ (including cancer) was not increased. However, among DES daughters with DES-related malformations a true small risk increase for non-CCA cervical cancer cannot be excluded.
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Affiliation(s)
- J Verloop
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F E van Leeuwen
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Th J M Helmerhorst
- Department of Obstetrics and Gynaecology, Erasmus MC, University Hospital Rotterdam, The Netherlands
| | - I M C M de Kok
- Department of Public Health, Erasmus MC, The Netherlands
| | | | - H H van Boven
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M A Rookus
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Wevers MR, Schmidt MK, Engelhardt EG, Verhoef S, Hooning MJ, Kriege M, Seynaeve C, Collée M, van Asperen CJ, Tollenaar RAEM, Koppert LB, Witkamp AJ, Rutgers EJT, Aaronson NK, Rookus MA, Ausems MGEM. Timing of risk reducing mastectomy in breast cancer patients carrying a BRCA1/2 mutation: retrospective data from the Dutch HEBON study. Fam Cancer 2016; 14:355-63. [PMID: 25700605 PMCID: PMC4559099 DOI: 10.1007/s10689-015-9788-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
It is expected that rapid genetic counseling and testing (RGCT) will lead to increasing numbers of breast cancer (BC) patients knowing their BRCA1/2 carrier status before primary surgery. Considering the potential impact of knowing one’s status on uptake and timing of risk-reducing contralateral mastectomy (RRCM), we aimed to evaluate trends over time in RRCM, and differences between carriers identified either before (predictively) or after (diagnostically) diagnosis. We collected data from female BRCA1/2 mutation carriers diagnosed with BC between 1995 and 2009 from four Dutch university hospitals. We compared the timing of genetic testing and RRCM in relation to diagnosis in 1995–2000 versus 2001–2009 for all patients, and predictively and diagnostically tested patients separately. Of 287 patients, 219 (76 %) had a diagnostic BRCA1/2 test. In this cohort, the median time from diagnosis to DNA testing decreased from 28 months for those diagnosed between 1995 and 2000 to 14 months for those diagnosed between 2001 and 2009 (p < 0.001). Similarly, over time women in this cohort underwent RRCM sooner after diagnosis (median of 77 vs. 27 months, p = 0.05). Predictively tested women who subsequently developed BC underwent an immediate RRCM significantly more often than women who had a diagnostic test (21/61, 34 %, vs. 13/170, 7.6 %, p < 0.001). Knowledge of carrying a BRCA1/2 mutation when diagnosed with BC influenced decisions concerning primary surgery. Additionally, in more recent years, women who had not undergone predictive testing were more likely to undergo diagnostic DNA testing and RRCM sooner after diagnosis. This suggests the need for RGCT to guide treatment decisions.
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Affiliation(s)
- M R Wevers
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, PO Box 90203, 1006 BE, Amsterdam, The Netherlands,
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Affiliation(s)
- B A M Heemskerk-Gerritsen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands (BAMHG, MJH); Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands (MAR)
| | - M J Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands (BAMHG, MJH); Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands (MAR)
| | - M A Rookus
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands (BAMHG, MJH); Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands (MAR)
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Heemskerk-Gerritsen BAM, Seynaeve C, van Asperen CJ, Ausems MGEM, Collée JM, van Doorn HC, Gomez Garcia EB, Kets CM, van Leeuwen FE, Meijers-Heijboer HEJ, Mourits MJE, van Os TAM, Vasen HFA, Verhoef S, Rookus MA, Hooning MJ. Breast cancer risk after salpingo-oophorectomy in healthy BRCA1/2 mutation carriers: revisiting the evidence for risk reduction. J Natl Cancer Inst 2015; 107:djv033. [PMID: 25788320 DOI: 10.1093/jnci/djv033] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Previous studies have reported a breast cancer (BC) risk reduction of approximately 50% after risk-reducing salpingo-oophorectomy (RRSO) in BRCA1/2 mutation carriers, but may have been subject to several types of bias. The purpose of this nationwide cohort study was to assess potential bias in the estimated BC risk reduction after RRSO. METHODS We selected BRCA1/2 mutation carriers from an ongoing nationwide cohort study on Hereditary Breast and Ovarian Cancer in the Netherlands (HEBON). First, we replicated the analytical methods as previously applied in four major studies on BC risk after RRSO. Cox proportional hazards models were used to calculate hazard ratios and conditional logistic regression to calculate odds ratios. Secondly, we analyzed the data in a revised design in order to further minimize bias using an extended Cox model with RRSO as a time-dependent variable to calculate the hazard ratio. The most important differences between our approach and those of previous studies were the requirement of no history of cancer at the date of DNA diagnosis and the inclusion of person-time preceding RRSO. RESULTS Applying the four previously described analytical methods and the data of 551 to 934 BRCA1/2 mutation carriers with a median follow-up of 2.7 to 4.6 years, the odds ratio was 0.61 (95% confidence interval [CI] = 0.35 to 1.08), and the hazard ratios were 0.36 (95% CI = 0.25 to 0.53), 0.62 (95% CI = 0.39 to 0.99), and 0.49 (95% CI = 0.33 to 0.71), being similar to earlier findings. For the revised analysis, we included 822 BRCA1/2 mutation carriers. After a median follow-up period of 3.2 years, we obtained a hazard ratio of 1.09 (95% CI = 0.67 to 1.77). CONCLUSION In previous studies, BC risk reduction after RRSO in BRCA1/2 mutation carriers may have been overestimated because of bias. Using a design that maximally eliminated bias, we found no evidence for a protective effect.
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Affiliation(s)
- B A M Heemskerk-Gerritsen
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - C Seynaeve
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - C J van Asperen
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - M G E M Ausems
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - J M Collée
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - H C van Doorn
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - E B Gomez Garcia
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - C M Kets
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - F E van Leeuwen
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - H E J Meijers-Heijboer
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - M J E Mourits
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - T A M van Os
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - H F A Vasen
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - S Verhoef
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - M A Rookus
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
| | - M J Hooning
- Department of Medical Oncology (BAMHG, CS, MJH), Department of Clinical Genetics (JMC), and Department of Gynecology (HCvD), Erasmus MC Cancer Institute, Rotterdam, the Netherlands; Department of Clinical Genetics, Leiden University MC, Leiden, the Netherlands (CJvA); Department of Clinical Genetics, University MC Utrecht, Utrecht, the Netherlands (MGEMA); Department of Clinical Genetics, Maastricht University MC, Maastricht, the Netherlands (EBGG); Department of Human Genetics, Radboud University Nijmegen MC, Nijmegen, the Netherlands (CMK); Department of Epidemiology (FEvL, MAR), and Department of Clinical Genetics (SV), Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Human Genetics, VU University MC, Amsterdam, the Netherlands (HEJMH); Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands (HEJMJ, TAMvO); Department of Gynecology, University MC Groningen, Groningen, the Netherlands (MJEM); Foundation for Detection of Hereditary Tumours, Leiden, the Netherlands (HFAV)
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Phillips KA, Milne RL, Rookus MA, Goldgar D, Friedlander M, McLachlan SA, Buys S, Antoniou AC, Birch K, Terry MB, Easton DF, Weideman P, Daly M, Andrieu N, John EM, Hooning MJ, Andrulis IL, Caldes T, Olsson H, Hopper JL. Association of tamoxifen use and reduced risk of contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. Hered Cancer Clin Pract 2012. [PMCID: PMC3395384 DOI: 10.1186/1897-4287-10-s2-a11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Phillips K, Milne RL, Rookus MA, Goldgar D, Friedlander M, McLachlan S, Buys SS, Antoniou AC, Birch KE, Terry MB, Easton D, Weideman P, Daly MB, Andrieu N, John EM, Hooning M, Andrulis IL, Caldes T, Olsson H, Hopper JL. Tamoxifen and risk of contralateral breast cancer for BRCA1 and BRCA2 mutation carriers: A combined analysis from the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab), the International BRCA1 and BRCA2Carrier Cohort Study (IBCCS), and the Breast Cancer Family Registry (BCFR). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hermsen BBJ, Olivier RI, Verheijen RHM, van Beurden M, de Hullu JA, Massuger LF, Burger CW, Brekelmans CT, Mourits MJ, de Bock GH, Gaarenstroom KN, van Boven HH, Mooij TM, Rookus MA. No efficacy of annual gynaecological screening in BRCA1/2 mutation carriers; an observational follow-up study. Br J Cancer 2007; 96:1335-42. [PMID: 17426707 PMCID: PMC2360170 DOI: 10.1038/sj.bjc.6603725] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BRCA1/2 mutation carriers are offered gynaecological screening with the intention to reduce mortality by detecting ovarian cancer at an early stage. We examined compliance and efficacy of gynaecological screening in BRCA1/2 mutation carriers. In this multicentre, observational, follow-up study we examined medical record data of a consecutive series of 888 BRCA1/2 mutation carriers who started annual screening with transvaginal ultrasonography and serum CA125 between 1993 and 2005. The women were annually screened for 75% of their total period of follow-up. Compliance decreased with longer follow-up. Five of the 10 incident cancers were interval tumours, diagnosed in women with a normal screening result within 3–10 months before diagnosis. No difference in stage distribution between incident screen-detected and interval tumours was found. Eight of the 10 incident cancers were stage III/IV (80%). Cancers diagnosed in unscreened family members had a similar stage distribution (77% in stage III/IV). The observed number of cases detected during screening was not significantly higher than expected (Standardized Incidence Ratio (SIR): 1.5, 95% confidence interval: 0.7–2.8). For the subgroup that was fully compliant to annual screening, a similar SIR was found (1.6, 95% confidence interval: 0.5–3.6). Despite annual gynaecological screening, a high proportion of ovarian cancers in BRCA1/2 carriers are interval cancers and the large majority of all cancers are diagnosed in advanced stages. Therefore, it is unlikely that annual screening will reduce mortality from ovarian cancer in BRCA1/2 mutation carriers.
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Affiliation(s)
- B B J Hermsen
- Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, The Netherlands
| | - R I Olivier
- Department of Gynaecology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - R H M Verheijen
- Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, The Netherlands
| | - M van Beurden
- Department of Gynaecology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J A de Hullu
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - L F Massuger
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - C W Burger
- Departments of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - C T Brekelmans
- Department of Medical Oncology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M J Mourits
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen, The Netherlands
| | - G H de Bock
- Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - K N Gaarenstroom
- Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands
| | - H H van Boven
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - T M Mooij
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M A Rookus
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- E-mail:
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van Asperen CJ, Brohet RM, Meijers-Heijboer EJ, Hoogerbrugge N, Verhoef S, Vasen HFA, Ausems MGEM, Menko FH, Gomez Garcia EB, Klijn JGM, Hogervorst FBL, van Houwelingen JC, van't Veer LJ, Rookus MA, van Leeuwen FE. Cancer risks in BRCA2 families: estimates for sites other than breast and ovary. J Med Genet 2006; 42:711-9. [PMID: 16141007 PMCID: PMC1736136 DOI: 10.1136/jmg.2004.028829] [Citation(s) in RCA: 296] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND In BRCA2 mutation carriers, increased risks have been reported for several cancer sites besides breast and ovary. As most of the families included in earlier reports were selected on the basis of multiple breast/ovarian cancer cases, it is possible that risk estimates may differ in mutation carriers with a less striking family history. METHODS In the Netherlands, 139 BRCA2 families with 66 different pathogenic mutations were included in a nationwide study. To avoid testing bias, we chose not to estimate risk in typed carriers, but rather in male and female family members with a 50% prior probability of being a carrier (n = 1811). The relative risk (RR) for each cancer site with the exception of breast and ovarian cancer was determined by comparing observed numbers with those expected, based on Dutch cancer incidence rates. RESULTS We observed an excess risk for four cancer sites: pancreas (RR 5.9; 95% confidence interval (CI) 3.2 to 10.0), prostate (2.5; 1.6 to 3.8), bone (14.4; 2.9 to 42.1) and pharynx (7.3; 2.0 to 18.6). A small increase was observed for cancer of the digestive tract (1.5; 1.1 to 1.9). Histological verification was available for 46% of the tumours. Nearly all increased risks reached statistical significance for men only. Cancer risks tended to be higher for people before the age of 65 years. Moreover, families with mutations outside the previously defined ovarian cancer cluster region tended to have a higher cancer risk. CONCLUSIONS We found that BRCA2 carriers are at increased risk for cancers of the prostate and pancreas, and possibly bone and pharynx. Larger databases with extended follow up are needed to provide insight into mutation specific risks of selected carriers in BRCA2 families.
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Verloop J, Legdeur MA, Mooij TM, Rookus MA, van Leeuwen FE. Risk of Cancer in Des-Daughters. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s161-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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van Sprundel TC, Schmidt MK, Rookus MA, Brohet R, van Asperen CJ, Rutgers EJT, van‘t Veer LJ, Tollenaar RAEM. Risk reduction of contralateral breast cancer and survival after contralateral prophylactic mastectomy in BRCA1 or BRCA2 mutation carriers. Br J Cancer 2005; 93:287-92. [PMID: 16052221 PMCID: PMC2361560 DOI: 10.1038/sj.bjc.6602703] [Citation(s) in RCA: 221] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The clinical outcome of contralateral prophylactic mastectomy (CPM) in women with a BRCA1 or BRCA2 mutation and a personal history of invasive breast cancer is unknown. We identified a cohort of 148 female BRCA1 or BRCA2 mutation carriers (115 and 33, respectively) who previously were treated for unilateral invasive breast cancer stages I–IIIa. In all, 79 women underwent a CPM, while the other women remained under intensive surveillance. The mean follow-up was 3.5 years and started at the time of CPM or at the date of mutation testing, whichever came last, that is, on average 5 years after diagnosis of the first breast cancer. One woman developed an invasive contralateral primary breast cancer after CPM, whereas six were observed in the surveillance group (P<0.001). Contralateral prophylactic mastectomy reduced the risk of contralateral breast cancer by 91%, independent of the effect of bilateral prophylactic oophorectomy (BPO). At 5 years follow-up, overall survival was 94% for the CPM group vs 77% for the surveillance group (P=0.03), but this was unexpectedly mostly due to higher mortality related with first breast cancer and ovarian cancer in the surveillance group. After adjustment for BPO in a multivariate Cox analysis, the CPM effect on overall survival was no longer significant. Our data show that CPM markedly reduces the risk of contralateral breast cancer among BRCA1 or BRCA2 mutation carriers with a history of breast cancer. Longer follow-up is needed to study the impact of CPM on contralateral breast cancer-specific survival. The choice for CPM is highly correlated with that for BPO, while only BPO leads to a significant improvement in overall survival so far.
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Affiliation(s)
- T C van Sprundel
- Department of Surgery, D6-44, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - M K Schmidt
- Department of Pathology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Epidemiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - M A Rookus
- Department of Epidemiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - R Brohet
- Department of Epidemiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - C J van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - E J Th Rutgers
- Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - L J van‘t Veer
- Department of Pathology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - R A E M Tollenaar
- Department of Surgery, D6-44, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
- Department of Surgery, D6-44, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail:
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Rookus MA, Brohet RM, Andrieu N, Antoniou AC, Chang-Claude J, Easton DF, Peock S, Noguès C, van Leeuwen FE, Goldgar DE. Oral contraceptives and breast cancer risk in the International BRCA1/2 Carrier Cohort Study (IBCCS). Breast Cancer Res 2005. [PMCID: PMC4233518 DOI: 10.1186/bcr1097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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15
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Van Leeuwen FE, Andrieu N, Easton DF, Chang-Claude J, Brohet R, Cardis E, Antoniou AC, Peock S, Nogues C, Rookus MA, Goldgar DE. Low-dose ionizing radiation significantly increases the risk of breast cancer among BRCA1/2 mutation carriers in the International BRCA1/2 Carrier Cohort Study (IBCCS). Breast Cancer Res 2005. [PMCID: PMC4233516 DOI: 10.1186/bcr1095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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16
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Olivier RI, van Beurden M, Lubsen MAC, Rookus MA, Mooij TM, van de Vijver MJ, van't Veer LJ. Clinical outcome of prophylactic oophorectomy in BRCA1/BRCA2 mutation carriers and events during follow-up. Br J Cancer 2004; 90:1492-7. [PMID: 15083174 PMCID: PMC2409718 DOI: 10.1038/sj.bjc.6601692] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A retrospective study was performed to assess the histopathologic findings in high-risk women undergoing bilateral prophylactic (salpingo)-oophorectomy. The medical files of BRCA1 or BRCA2 mutation carriers and members of a hereditary breast/ovarian cancer (HBOC) family, who had undergone prophylactic surgery, were reviewed. In all, 38 women underwent a bilateral oophorectomy (26 BRCA1, three BRCA2 and nine HBOC, respectively). A total of 90 women underwent bilateral salpingo-oophorectomy (58 BRCA1, six BRCA2, one BRCA1 and 2, 25 HBOC, respectively). At the time of salpingo-oophorectomy, five of 58 BRCA1 carriers (8.6%) were diagnosed with an occult carcinoma: two fallopian tube carcinomas, two ovarian carcinomas and one case was defined as a fallopian tube/ovarian carcinoma. No occult carcinomas were found in the other groups. Of the 38 patients, who underwent a bilateral oophorectomy (mean follow-up 45 months), three of 26 BRCA1 mutation carriers (3.4 in 100 women-years) developed peritoneal papillary serous carcinoma (PPSC) during follow-up. So far, no PPSC have occurred in the 90 women, who underwent a salpingo-oophorectomy (mean follow-up 12 months), including 58 BRCA1 carriers (0 in 60 in women-years). These results contribute to the thesis that BRCA1 germline mutation carriers are not only at risk for ovarian cancer, but also for fallopian tube carcinoma and peritoneal papillary serous carcinoma. Our data suggest that PPSC risk among BRCA2 carriers is lower than among BRCA1 carriers.
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Affiliation(s)
- R I Olivier
- Department of Gynaecology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - M van Beurden
- Department of Gynaecology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Gynaecology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Department of Gynaecology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. E-mail:
| | - M A C Lubsen
- Department of Gynaecology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Gynaecology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - M A Rookus
- Department of Epidemiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - T M Mooij
- Department of Epidemiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - M J van de Vijver
- Department of Pathology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - L J van't Veer
- Department of Pathology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Family Cancer Clinic, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
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17
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Rookus MA. RESPONSE: Re: Potential for Bias in Studies on Efficacy of Prophylactic Surgery for BRCA1 and BRCA2 Mutation Carriers. J Natl Cancer Inst 2003. [DOI: 10.1093/jnci/djg054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Hamajima N, Hirose K, Tajima K, Rohan T, Calle EE, Heath CW, Coates RJ, Liff JM, Talamini R, Chantarakul N, Koetsawang S, Rachawat D, Morabia A, Schuman L, Stewart W, Szklo M, Bain C, Schofield F, Siskind V, Band P, Coldman AJ, Gallagher RP, Hislop TG, Yang P, Kolonel LM, Nomura AMY, Hu J, Johnson KC, Mao Y, De Sanjosé S, Lee N, Marchbanks P, Ory HW, Peterson HB, Wilson HG, Wingo PA, Ebeling K, Kunde D, Nishan P, Hopper JL, Colditz G, Gajalanski V, Martin N, Pardthaisong T, Silpisornkosol S, Theetranont C, Boosiri B, Chutivongse S, Jimakorn P, Virutamasen P, Wongsrichanalai C, Ewertz M, Adami HO, Bergkvist L, Magnusson C, Persson I, Chang-Claude J, Paul C, Skegg DCG, Spears GFS, Boyle P, Evstifeeva T, Daling JR, Hutchinson WB, Malone K, Noonan EA, Stanford JL, Thomas DB, Weiss NS, White E, Andrieu N, Brêmond A, Clavel F, Gairard B, Lansac J, Piana L, Renaud R, Izquierdo A, Viladiu P, Cuevas HR, Ontiveros P, Palet A, Salazar SB, Aristizabel N, Cuadros A, Tryggvadottir L, Tulinius H, Bachelot A, Lê MG, Peto J, Franceschi S, Lubin F, Modan B, Ron E, Wax Y, Friedman GD, Hiatt RA, Levi F, Bishop T, Kosmelj K, Primic-Zakelj M, Ravnihar B, Stare J, Beeson WL, Fraser G, Bullbrook RD, Cuzick J, Duffy SW, Fentiman IS, Hayward JL, Wang DY, McMichael AJ, McPherson K, Hanson RL, Leske MC, Mahoney MC, Nasca PC, Varma AO, Weinstein AL, Moller TR, Olsson H, Ranstam J, Goldbohm RA, van den Brandt PA, Apelo RA, Baens J, de la Cruz JR, Javier B, Lacaya LB, Ngelangel CA, La Vecchia C, Negri E, Marubini E, Ferraroni M, Gerber M, Richardson S, Segala C, Gatei D, Kenya P, Kungu A, Mati JG, Brinton LA, Hoover R, Schairer C, Spirtas R, Lee HP, Rookus MA, van Leeuwen FE, Schoenberg JA, McCredie M, Gammon MD, Clarke EA, Jones L, Neil A, Vessey M, Yeates D, Appleby P, Banks E, Beral V, Bull D, Crossley B, Goodill A, Green J, Hermon C, Key T, Langston N, Lewis C, Reeves G, Collins R, Doll R, Peto R, Mabuchi K, Preston D, Hannaford P, Kay C, Rosero-Bixby L, Gao YT, Jin F, Yuan JM, Wei HY, Yun T, Zhiheng C, Berry G, Cooper Booth J, Jelihovsky T, MacLennan R, Shearman R, Wang QS, Baines CJ, Miller AB, Wall C, Lund E, Stalsberg H, Shu XO, Zheng W, Katsouyanni K, Trichopoulou A, Trichopoulos D, Dabancens A, Martinez L, Molina R, Salas O, Alexander FE, Anderson K, Folsom AR, Hulka BS, Bernstein L, Enger S, Haile RW, Paganini-Hill A, Pike MC, Ross RK, Ursin G, Yu MC, Longnecker MP, Newcomb P, Bergkvist L, Kalache A, Farley TMM, Holck S, Meirik O. Alcohol, tobacco and breast cancer--collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer 2002; 87:1234-45. [PMID: 12439712 PMCID: PMC2562507 DOI: 10.1038/sj.bjc.6600596] [Citation(s) in RCA: 675] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2002] [Revised: 08/08/2002] [Accepted: 08/23/2002] [Indexed: 12/11/2022] Open
Abstract
Alcohol and tobacco consumption are closely correlated and published results on their association with breast cancer have not always allowed adequately for confounding between these exposures. Over 80% of the relevant information worldwide on alcohol and tobacco consumption and breast cancer were collated, checked and analysed centrally. Analyses included 58,515 women with invasive breast cancer and 95,067 controls from 53 studies. Relative risks of breast cancer were estimated, after stratifying by study, age, parity and, where appropriate, women's age when their first child was born and consumption of alcohol and tobacco. The average consumption of alcohol reported by controls from developed countries was 6.0 g per day, i.e. about half a unit/drink of alcohol per day, and was greater in ever-smokers than never-smokers, (8.4 g per day and 5.0 g per day, respectively). Compared with women who reported drinking no alcohol, the relative risk of breast cancer was 1.32 (1.19-1.45, P<0.00001) for an intake of 35-44 g per day alcohol, and 1.46 (1.33-1.61, P<0.00001) for >/=45 g per day alcohol. The relative risk of breast cancer increased by 7.1% (95% CI 5.5-8.7%; P<0.00001) for each additional 10 g per day intake of alcohol, i.e. for each extra unit or drink of alcohol consumed on a daily basis. This increase was the same in ever-smokers and never-smokers (7.1% per 10 g per day, P<0.00001, in each group). By contrast, the relationship between smoking and breast cancer was substantially confounded by the effect of alcohol. When analyses were restricted to 22 255 women with breast cancer and 40 832 controls who reported drinking no alcohol, smoking was not associated with breast cancer (compared to never-smokers, relative risk for ever-smokers=1.03, 95% CI 0.98-1.07, and for current smokers=0.99, 0.92-1.05). The results for alcohol and for tobacco did not vary substantially across studies, study designs, or according to 15 personal characteristics of the women; nor were the findings materially confounded by any of these factors. If the observed relationship for alcohol is causal, these results suggest that about 4% of the breast cancers in developed countries are attributable to alcohol. In developing countries, where alcohol consumption among controls averaged only 0.4 g per day, alcohol would have a negligible effect on the incidence of breast cancer. In conclusion, smoking has little or no independent effect on the risk of developing breast cancer; the effect of alcohol on breast cancer needs to be interpreted in the context of its beneficial effects, in moderation, on cardiovascular disease and its harmful effects on cirrhosis and cancers of the mouth, larynx, oesophagus and liver.
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Affiliation(s)
- N Hamajima
- Cancer Research UK Epidemiology Unit, Gibson Building, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, UK
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Affiliation(s)
- M A Rookus
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam
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21
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Abstract
BACKGROUND/METHODS Although several studies have suggested that physical activity is associated with a decreased risk of breast cancer, such a decrease has not been found consistently, perhaps because physical activity was assessed in different ways and for restricted periods. Few studies have assessed the risk of breast cancer in relation to lifetime physical activity. We used data from a population-based, case-control study, including 918 case subjects (aged 20-54 years) and 918 age-matched population control subjects, to examine associations between breast cancer risk and physical activity at ages 10-12 years and 13-15 years, lifetime recreational activity, and title of longest held job. RESULTS Women who were more active than their peers at ages 10-12 years had a lower risk of breast cancer (odds ratio [OR] = 0.68; 95% confidence interval [CI] = 0.49-0.94). Women who had ever engaged in recreational physical activity had a reduced risk of breast cancer compared with inactive women (OR = 0.70; 95% CI = 0.56-0.88). Neither very early recreational activity (before age 20 years) nor recent activity (last 5 years) was associated with a greater reduction in risk than recreational activity in the intermediate period. Furthermore, women who started recreational activities after age 20 years and women who started earlier and continued their activities throughout adult life experienced a similar reduction in risk. Lean women, i.e., women with a body mass index (weight in kg/[height in m](2)) less than 21. 8 kg/m(2), appeared to have a lower risk associated with recreational physical activity than women with a body mass index greater than 24.5 kg/m(2) (OR = 0.57 [95% CI = 0.40-0.82] and OR = 0. 92 [95% CI = 0.65-1.29], respectively). CONCLUSIONS Our findings support the hypothesis that recreational physical activity is associated with a decreased risk of breast cancer. Physical activity in early or recent life does not appear to be associated with additional beneficial effects.
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Affiliation(s)
- J Verloop
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam
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22
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Ligtenberg MJ, Hogervorst FB, Willems HW, Arts PJ, Brink G, Hageman S, Bosgoed EA, Van der Looij E, Rookus MA, Devilee P, Vos EM, Wigbout G, Struycken PM, Menko FH, Rutgers EJ, Hoefsloot EH, Mariman EC, Brunner HG, Van 't Veer LJ. Characteristics of small breast and/or ovarian cancer families with germline mutations in BRCA1 and BRCA2. Br J Cancer 1999; 79:1475-8. [PMID: 10188893 PMCID: PMC2362698 DOI: 10.1038/sj.bjc.6690235] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
For families with a small number of cases of breast and/or ovarian cancer, limited data are available to predict the likelihood of genetic predisposition due to mutations in BRCA1 or BRCA2. In 104 families with three or more affected individuals (average 3.8) seeking counselling at family cancer clinics, mutation analysis was performed in the open reading frame of BRCA1 and BRCA2 by the protein truncation test and mutation-specific assays. In 31 of the 104 families tested, mutations were detected (30%). The majority of these mutations (25) occurred in BRCA1. Mutations were detected in 15 out of 25 families (60%) with both breast and ovarian cancer and in 16 out of 79 families (20%) with exclusively cases of breast cancer. Thus, an ovarian cancer case strongly predicted finding a mutation (P < 0.001). Within the group of small breast-cancer-only families, a bilateral breast cancer case or a unilateral breast cancer case diagnosed before age 40 independently predicted finding a BRCA1 or BRCA2 mutation (P = 0.005 and P = 0.02, respectively). Therefore, even small breast/ovarian cancer families with at least one case of ovarian cancer, bilateral breast cancer, or a case of breast cancer diagnosed before age 40, should be referred for mutation screening.
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Affiliation(s)
- M J Ligtenberg
- Department of Human Genetics, University Hospital Nijmegen, The Netherlands
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Kooy KVD, Rookus MA, Peterse HL, Leeuwen FE. THE AUTHORS REPLY. Am J Epidemiol 1998. [DOI: 10.1093/oxfordjournals.aje.a009480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rookus MA, van Leeuwen FE, Hamerlynck JV. [Last word on hormone replacement and breast cancer?]. Ned Tijdschr Geneeskd 1998; 142:111-3. [PMID: 9557006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A very large meta-analysis of the Collaborative Group on Hormonal Factors in Breast Cancer has revealed an increasing risk of breast cancer with longer durations of use of hormonal replacement therapy (HRT). This risk increase is restricted to current users of HRT or women who ceased use recently. A 35% increase of the relative risk of breast cancer was found after 5 years of HRT use or longer. After cessation of HRT use the excess breast cancer risk disappeared in 5 years, even after long durations of use. The risk increase was greater for women of normal or lean body weight than for more obese women. Tumours found in women who ever used HRT were diagnosed at a lower clinical stage, which suggests that enhanced screening might be involved. However, the increased breast cancer mortality in HRT users, as found in other studies, rather suggests a biologic mechanism Long-term use of HRT is not yet common in the Netherlands, but an increasing trend is present. Thus, the benefits of long-term use of HRT must be carefully weighted against the risks.
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Affiliation(s)
- M A Rookus
- Antoni van Leeuwenhoek Ziekenhuis-Het Nederlands Kanker Instituut, afd. Epidemiologie, Amsterdam
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25
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Abstract
BACKGROUND In general, no association has been found between spontaneous abortion (naturally occurring termination of a pregnancy) and the risk for breast cancer. With respect to induced abortion (termination of a pregnancy by artificial means), the results have been more inconclusive. A positive association was found in five studies, no association was found in six studies, and a negative association was found in the only cohort study. It is thought that part of the inconsistency of the reported results may be attributable to reporting (recall) bias, since all but two studies on induced abortion used the case-control design and were based only on information obtained from study subjects. In comparison with breast cancer case patients, healthy control subjects may be more reluctant to report on a controversial, emotionally charged subject such as induced abortion. Thus, differential underreporting may be a cause of spurious associations in case-control studies. PURPOSE Our goal was threefold: 1) to evaluate the relationship between a history of induced or spontaneous abortion and the risk for breast cancer in a Dutch population-based, case-control study; 2) to examine reporting bias by comparing risks between two geographic areas (i.e., western regions and southeastern regions in The Netherlands that differ in prevalence of and attitudes toward induced abortion); and 3) to compare reporting bias in data on induced abortion with reporting bias in data on oral contraceptive use. METHODS Data analyzed in this study were obtained from 918 women (20-54 years of age at diagnosis) who were diagnosed with invasive breast cancer during the period from 1986 through 1989 and had been initially enrolled in a population-based, case-control study investigating oral contraceptive use and breast cancer risk. The women resided in one of four geographic areas that were covered by Regional Cancer Registries: two western regions (Amsterdam and West) and two southeastern regions (East and Eindhoven). Each case patient was pair-matched, on the basis of age (within 1 year) and region, with a control subject who was randomly selected from municipal registries that fully covered the Dutch population. Both the case patients and the control subjects were interviewed at home by the same trained interviewer, who used a structured questionnaire. Reporting bias was examined indirectly by comparing risks between the western and the southeastern regions of the country, which differ in the prevalence of and attitude toward induced abortion. Multivariate conditional logistic regression methods for individually matched case-control studies were used to estimate relative risks (RRs). Reported P values are two-sided. RESULTS AND CONCLUSION Among parous women, a history of induced abortion was associated with a 90% increased risk for breast cancer (adjusted RR = 1.9; 95% confidence interval [CI] = 1.1-3.2). Among nulliparous women, no association between induced abortion and breast cancer was found. Neither among parous women nor among nulliparous women was a history of spontaneous abortion related to the risk for breast cancer. The association between induced abortion and breast cancer was stronger in the southeastern regions of the country, which have a predominantly Roman Catholic population, than in the western regions (adjusted RR = 14.6 [95% CI = 1.8-120.0] versus adjusted RR = 1.3 [95% CI = 0.7-2.6], respectively; test of difference between regions, P = .017), suggesting reporting bias. Support for reporting bias as an explanation for the regional differences was also found in data supplied by both study subjects and their physicians on the use of oral contraceptives. In comparison with physicians, control subjects in the southeastern regions underreported the duration of their oral contraceptive use by 6.3 months more than control subjects in the western regions (P = .007)...
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Affiliation(s)
- M A Rookus
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Abstract
To investigate whether breast tumors developing through a pathway with p53 protein overexpression (p53+) show different risk factor associations compared with breast tumors without p53 overexpression (p53-), the authors determined p53 overexpression in tissue sections of 528 patients with invasive breast cancer by using immunohistochemistry. These patients and 918 healthy controls aged 20-54 years participated in a Netherlands population-based case-control study on oral contraceptives in 1986-1989. A total of 142 tumors (27%) demonstrated clear p53 overexpression (p53+). Most risk factors did not show different associations with p53+ and p53- tumors. However use of oral contraceptives for 9 or more years was associated with a 2.5-fold increase in the risk of p53+ tumors (95% confidence interval 1.4-4.4; test for trend with months of use, p = 0.01), whereas such use increase the risk of p53- tumors only 1.4-fold (95% confidence interval 0.9-2.1; test for trend p = 0.06). Prolonged lactation > or = 25 weeks) was associated with a 40% reduction in risk of p53+ tumors (odds ratio = 0.6; 95%, confidence interval 0.3-1.0; test for trend with weeks of lactation, p = 0.09), whereas the risk of p53- tumors was not associated with lactation. The authors conclude that p53+ and p53- breast tumors are not associated with very distinct risk profiles but that the stronger associations of p53+ tumors with oral contraceptive use and lactation suggest differences in risks that deserve further investigation. If these findings can be confirmed and possible molecular mechanisms explored, this may help to elucidate the associations between these risk factors and breast cancer in general.
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Affiliation(s)
- K van der Kooy
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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27
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Calle EE, Heath CW, Miracle-McMahill HL, Coates RJ, Liff JM, Franceschi S, Talamini R, Chantarakul N, Koetsawang S, Rachawat D, Morabia A, Schuman L, Stewart W, Szklo M, Bain C, Schofield F, Siskind V, Band P, Coldman AJ, Gallagher RP, Hislop TG, Yang P, Duffy SW, Kolonel LM, Nomura AMY, Oberle MW, Ory HW, Peterson HB, Wilson HG, Wingo PA, Ebeling K, Kunde D, Nishan P, Colditz G, Martin N, Pardthaisong T, Silpisornkosol S, Theetranont C, Boosiri B, Chutivongse S, Jimakorn P, Virutamasen P, Wongsrichanalai C, McMichael AJ, Rohan T, Ewertz M, Paul C, Skegg DCG, Spears GFS, Boyle P, Evstifeeva T, Daling JR, Malone K, Noonan EA, Stanford JL, Thomas DB, Weiss NS, White E, Andrieu N, Brêmond A, Clavel F, Gairard B, Lansac J, Piana L, Renaud R, Fine SRP, Cuevas HR, Ontiveros P, Palet A, Salazar SB, Aristizabel N, Cuadros A, Bachelot A, Leê MG, Deacon J, Peto J, Taylor CN, Alfandary E, Modan B, Ron E, Friedman GD, Hiatt RA, Bishop T, Kosmelj K, Primic-Zakelj M, Ravnihar B, Stare J, Beeson WL, Fraser G, Allen DS, Bulbrook RD, Cuzick J, Fentiman IS, Hayward JL, Wang DY, Hanson RL, Leske MC, Mahoney MC, Nasca PC, Varma AO, Weinstein AL, Moller TR, Olsson H, Ranstam J, Goldbohm RA, van den Brandt PA, Apelo RA, Baens J, de la Cruz JR, Javier B, Lacaya LB, Ngelangel CA, La Vecchia C, Negri E, Marbuni E, Ferraroni M, Gerber M, Richardson S, Segala C, Gatei D, Kenya P, Kungu A, Mati JG, Brinton LA, Hoover R, Schairer C, Spirtas R, Lee HP, Rookus MA, van Leeuwen FE, Schoenberg JA, Gammon MD, Clarke EA, Jones L, McPherson K, Neil A, Vessey M, Yeates D, Beral V, Bull D, Crossley B, Hermon C, Jones S, Key T, Reeves CG, Smith P, Collins R, Doll R, Peto R, Hannaford P, Kay C, Rosero-Bixby L, Yuan JM, Wei HY, Yun T, Zhiheng C, Berry G, Booth JC, Jelihovsky T, Maclennan R, Shearman R, Wang QS, Baines CJ, Miller AB, Wall C, Lund E, Stalsberg H, Dabancens A, Martinez L, Molina R, Salas O, Alexander FE, Hulka BS, Chilvers CED, Bernstein L, Haile RW, Paganini-Hill A, Pike MC, Ross RK, Ursin G, Yu MC, Adami HO, Bergstrom R, Longnecker MP, Farley TMN, Holck S, Meirik O. Breast cancer and hormonal contraceptives: further results. Collaborative Group on Hormonal Factors in Breast Cancer. Contraception 1996; 54:1S-106S. [PMID: 8899264 DOI: 10.1016/s0010-7824(15)30002-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The Collaborative Group on Hormonal Factors in Breast Cancer has brought together and reanalysed the worldwide epidemiological evidence on breast cancer risk and use of hormonal contraceptives. Original data from 54 studies, representing about 90% of the information available on the topic, were collected, checked and analysed centrally. The 54 studies were performed in 26 countries and include a total of 53,297 women with breast cancer and 100,239 women without breast cancer. The studies were varied in their design, setting and timing. Most information came from case-control studies with controls chosen from the general population; most women resided in Europe or North America and most cancers were diagnosed during the 1980s. Overall 41% of the women with breast cancer and 40% of the women without breast cancer had used oral contraceptives at some time; the median age at first use was 26 years, the median duration of use was 3 years, the median year of first use was 1968, the median time since first use was 16 years, and the median time since last use was 9 years. The main findings, summarised elsewhere, are that there is a small increase in the risk of having breast cancer diagnosed in current users of combined oral contraceptives and in women who had stopped use in the past 10 years but that there is no evidence of an increase in the risk more than 10 years after stopping use. In addition, the cancers diagnosed in women who had used oral contraceptives tended to be less advanced clinically than the cancers diagnosed in women who had not used them. Despite the large number of possibilities investigated, few factors appeared to modify the main findings either in recent or in past users. For recent users who began use before age 20 the relative risks are higher than for recent users who began at older ages. For women whose use of oral contraceptives ceased more than 10 years before there was some suggestion of a reduction in breast cancer risk in certain subgroups, with a deficit of tumors that had spread beyond the breast, especially among women who had used preparations containing the highest doses of oestrogen and progestogen. These findings are unexpected and need to be confirmed. Although these data represent most of the epidemiological evidence on the topic to date, there is still insufficient information to comment reliably about the effects of specific types of oestrogen or of progestogen. What evidence there is suggests, however, no major differences in the effects for specific types of oestrogen or of progestogen and that the pattern of risk associated with use of hormonal contraceptives containing progestogens alone may be similar to that observed for preparations containing both oestrogens and progestogens. On the basis of these results, there is little difference between women who have and have not used combined oral contraceptives in terms of the estimated cumulative number of breast cancers diagnosed during the period from starting use up to 20 years after stopping. The cancers diagnosed in women who have used oral contraceptives are, however, less advanced clinically than the cancers diagnosed in never users. Further research is needed to establish whether the associations described here are due to earlier diagnosis of breast cancer in women who have used oral contraceptives, to the biological effects of the hormonal contraceptives or to a combination of both. Little information is as yet available about the effects on breast cancer risk of oral contraceptive use that ceased more than 20 years before and as such data accumulate it will be necessary to re-examine the worldwide evidence.
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Oosterwijk JC, Sijmons RH, Menko FH, Chorus AM, Rookus MA. [The chance of breast carcinoma and related carcinomas in a positive family anamnesis. Landelijke Werkgroep Erfelijk Mammacarcinoom van de Stichting Opsporing Erfelijke Tumoren]. Ned Tijdschr Geneeskd 1995; 139:423-8. [PMID: 7891763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Abstract
Although the use of oral contraceptives (OCs) is not generally associated with increased risk of breast cancer, higher risks have been reported for some subgroups of users. We have carried out a population-based case-control study in the Netherlands to assess the effect of timing and duration of OC use on the risk of breast cancer developing at various ages. 918 women with breast cancer (20-54 years at diagnosis) were pair-matched by age with controls randomly selected from municipal registries. Information on OC use obtained from women and their prescribers was combined according to standard decision rules. Overall, long-term use of OCs (> or = 12 years) had an associated relative risk (RR) of 1.3 (95% CI 0.9-1.9; test for trend in risk with months of use p = 0.03). This positive trend was found in both the youngest (< 36 years; p = 0.08) and the oldest (46-54 years, p = 0.004) age groups, but not in women aged 36-45 years. The RR of developing breast cancer before age 36 was 2.1 (1.0-4.5) for 4 or more years of OC use compared with shorter use. In women younger than 36, risk increased for longer OC use before age 20 (1.44 per year, p = 0.04). Recent use (previous 3 years) was associated with increased risk in women of 46-54 (RR 1.9 [0.9-4.1], p = 0.02). We conclude that 4 or more years of OC use, especially if partly before age 20, is associated with an increased risk of breast cancer developing at an early age. There is limited evidence that the excess risk disappears as the cohort of young OC users ages, but this issue needs confirmation.
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Affiliation(s)
- M A Rookus
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam
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van Leeuwen FE, van Duijn CM, Camps MH, Kempers BA, Mentjens MF, Mulder HB, Schouten EG, Zwijsen RM, Rookus MA. Agreement between oral contraceptive users and prescribers: implications for case-control studies. Contraception 1992; 45:399-408. [PMID: 1623713 DOI: 10.1016/0010-7824(92)90154-l] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Case-control studies examining the effects of oral contraceptives (OC) are prone to misclassification bias due to errors in assessment of OC use. Concern about inaccurate exposure histories has increased since current studies require women to recall OC use over prolonged periods of time. In preparation for a case-control study of breast cancer and OC use, an investigation was carried out to assess agreement between women's lifetime histories of OC use (covering a period of up to 20 years) and prescribers' records. OC histories were obtained during personal interview with 218 women who had used OC at some point in their lives (127 breast cancer patients, 91 controls). Recall was aided by an album with color photographs of all OC marketed in the Netherlands from 1962 onwards (n = 65), and a calendar that covered the women's life span from date of birth to menopause. The participants were asked for the names of all physicians who prescribed OC for them. The rate of response from the prescribers was high (94%), but only half of the forms provided useful information. Patient-prescriber agreement on brand names (including dosage) was 70%. About half of the women agreed with their prescribers on starting dates to within less than a year's difference. Approximately the same percentage of agreement was found for stopping dates. Multiple linear regression indicated that agreement on brand names and dates of usage was lower for women of low socioeconomic status, for healthy women (as compared to breast cancer patients) and for periods of pill use that had to be recalled from the more distant past. Agreement on total duration of use was high enough to permit testing of a moderately strong duration-response relationship in a case-control study.
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Affiliation(s)
- F E van Leeuwen
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam
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Treurniet HF, Rookus MA, Peterse HL, Hart AA, van Leeuwen FE. Differences in breast cancer risk factors to neu (c-erbB-2) protein overexpression of the breast tumor. Cancer Res 1992; 52:2344-5. [PMID: 1348449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
To investigate whether overexpression of the neu protein in breast tumors differentiates risk factor patterns for breast cancer, neu protein overexpression was determined in 296 breast carcinomas of patients participating in an ongoing population-based case-control study. Risk factor information on these patients and 737 controls was obtained during home interviews. Most breast cancer risk factors showed similar associations with neu-positive and neu-negative tumors, but remarkable differences were found for breast-feeding and age at first full-term pregnancy. In contrast to the slightly protective effect of breast-feeding in the neu-negative group, the risk of neu-positive breast cancer was 4.2-fold increased in women who ever breast-fed. Increasing age at first full-term pregnancy was positively associated with both neu-positive and neu-negative breast cancer, but the association was about 2 times stronger for neu-positive tumors. We conclude that neu oncogene overexpression of the breast tumor seems to be associated with a distinct risk factor pattern.
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Affiliation(s)
- H F Treurniet
- Department of Epidemiology, The Netherlands Cancer Institute, Plesmanlaan, Amsterdam
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Haring MH, Rookus MA, van Leeuwen FE. [Does breast feeding protect against breast cancer? An epidemiological study]. Ned Tijdschr Geneeskd 1992; 136:743-7. [PMID: 1560867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The association between breastfeeding and the risk of breast cancer was studied as part of a Dutch population-based epidemiological study of the aetiology of female breast cancer. A total of 484 breast cancer patients and 484 controls (matched for age; age range: 20-54 years) were compared with regard to their breastfeeding habits. There was no clear association between breastfeeding and breast cancer risk. After adjustment for confounders women who had ever breastfed had no lower risk of breast cancer than women who never had given breastfeeding. Women who had breastfed for prolonged periods (total lifetime nursing of 44 weeks or more) had, after adjustment for confounders, a 29% lower risk of breast cancer compared to women who had never breastfed, but this risk reduction was not statistically significant. These results do not support the hypothesis that (short) periods of breastfeeding reduce the risk of breast cancer in young women. A possible protective effect of longer periods of breastfeeding, which is suggested more strongly in the literature, could not be investigated in this study because the women breastfed their children for relatively short periods.
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Affiliation(s)
- M H Haring
- Het Nederlands Kanker Instituut/Antoni van Leeuwenhoek Huis, afd. Epidemiologie, Amsterdam
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Abstract
This review focuses on the effects of oral contraceptives (OC) and estrogen replacement therapy (ERT) on the risk of breast, ovarian and endometrial cancer. The relationship between OC and cancer risk is first placed in a historical perspective. Since 1960, when OC were introduced, the hormonal composition of OC as well as the characteristics of the OC user have changed considerably. Studies conducted in the 1970s were generally reassuring, but it was not until the 1980s that studies could evaluate the effect of prolonged OC use after an extended follow-up period. Although the relationship between breast cancer and OC has been investigated in about 40 studies, the issue still remains essentially unresolved. Most studies report no association between ever use of OC and breast cancer risk. Several studies find increased risk for prolonged use and other studies report elevated risks for women who used OC very early in their reproductive years. The inconsistent results of recent studies are attributed to bias or to geographical variation in latency period elapsed, types of OC preparations, or prevalence of other risk factors. In contrast, the use of combined OC has consistently been shown to reduce the risk of ovarian and endometrial cancer. The risk further decreases with increasing duration of use and the protective effect seems to persist in ex-users for at least 5 years. Some evidence indicates that higher parity reduces the protective effect. Though studies relating ERT to breast cancer are far from consistent, overall, there is evidence for a moderately increased risk with high dose and/or long duration. The effect seems to be modified by mode of administration (injections vs. pills) and by type of ERT, but this needs confirmation. The number of adequate studies on the relationship between ERT and ovarian cancer is too small to draw firm conclusions. The positive relationship between ERT and endometrial cancer is now well established. The ERT effect is dose- and duration-dependent and is characterized by a short latency period. The cyclic addition of progesterone (greater than 10 days/cycle) may reduce the risk increase.
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Affiliation(s)
- F E van Leeuwen
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam
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Rookus MA, Burema J, Frijters JE. Changes in body mass index in young adults in relation to number of life events experienced. Int J Obes (Lond) 1988; 12:29-39. [PMID: 3360562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
As part of an extensive longitudinal study, the effect of experiencing few or many life events on the development of the body mass index (BMI = weight/height2) over periods of 1 year and 2 years was examined in 350 men and 395 women, 20-35 years of age. Body weight was measured and a life event questionnaire referring to the preceding 6 months was completed every 6 months from spring 1981 through spring 1984. The change in BMI of subjects who experienced few or many life events was compared with the change in BMI of subjects who experienced an intermediate number of life events (the intermediate group). During the first year of follow-up, several subgroups of men and women who experienced many life events showed a gain in body mass. In several subgroups of men who experienced few life events a comparable effect occurred. After another year of follow-up this gain in body mass had disappeared in almost all subgroups. In the subgroup of men that tried to reduce their body weight by dieting during the follow-up period, the gain in body mass following few or many life events seemed to be permanent. In conclusion, the gain in body mass that may occur following the experience of many life events in women, seems to be effectively counterbalanced by regulatory mechanisms. In men, however, the experience of few or many life events may play a part in the aetiology of overweight.
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Affiliation(s)
- M A Rookus
- Department of Human Nutrition, Agricultural University, Wageningen, the Netherlands
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Rookus MA, Burema J, van 't Hof MA, Deurenberg P, Hautvast JG. The development of the body mass index in young adults, II: Interrelationships of level, change and fluctuation, a four-year longitudinal study. Hum Biol 1987; 59:617-30. [PMID: 3623508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Rookus MA, Burema J, van 't Hof MA, Deurenberg P, van der Wiel-Wetzels WA, Hautvast JG. The development of the body mass index in young adults, I: Age-reference curves based on a four-year mixed-longitudinal study. Hum Biol 1987; 59:599-615. [PMID: 3623507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Rookus MA, Burema J. Frame categories in weight-height tables. Am J Public Health 1987; 77:94. [PMID: 3789246 PMCID: PMC1646800 DOI: 10.2105/ajph.77.1.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Rookus MA, Rokebrand P, Burema J, Deurenberg P. The effect of pregnancy on the body mass index 9 months postpartum in 49 women. Int J Obes (Lond) 1987; 11:609-18. [PMID: 3440682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The effect of pregnancy on the body mass index (weight/height2) was studied. The change in the body mass index from pregestation through 9 months postpartum of 49 pregnant women was compared with the change in the body mass index during the same period of follow-up in 400 non-pregnant women. All women participated in a follow-up study in which body weight was measured every 6 months. In addition the body weight of the pregnant women was measured at 6 and 12 months postpartum. Nine months postpartum the total group of pregnant women had gained as much body mass as was to be expected from ageing. The same was true for the subgroup of women who did not breast-feed their child or who breast-fed for a period shorter than 2 months. Unexpectedly, women who breast-fed their child for more than 2 months gained +0.6 kg/m2 (90 per cent CI: +0.1, +1.0) more body mass than the non-pregnant women. Compared to the latter group, women who used bromocriptine to stop lactation lost body mass (-0.5 kg/m2, 90 per cent CI: -1.1, +0.0). These observations suggest that, postpartum, the total group of pregnant women has not gained more body mass than expected from ageing. 'Maternal obesity' may be associated with breast-feeding for long periods.
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Affiliation(s)
- M A Rookus
- Department of Human Nutrition, Agricultural University, Wageningen, The Netherlands
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Van Strien T, Rookus MA, Bergers GP, Frijters JE, Defares PB. Life events, emotional eating and change in body mass index. Int J Obes (Lond) 1986; 10:29-35. [PMID: 3710686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The results are reported of a longitudinal study on effects of negative life events on change in body mass index (BMI; weight/height2 (kg/m2)) in men and women classified as either low or high emotional eaters. It was predicted that emotional eating and negative life events would have an interaction effect on change in BMI. Low emotional eaters would gain less weight and high emotional eaters would gain more weight after experiencing negative life events, than those who had not experienced such events. For men, emotional eating and negative life events were found to have a significant interaction effect on change in BMI 6 months after the assessment of life events on the first, but not on the second assessment date in the same study. Data on the long-term effects of negative life events indicate that the significant interaction effect found was not an artefact. For women, no such interaction effects were found. Thus, it is concluded that the hypothesis was confirmed to some extent in the men, but not in the women.
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Rookus MA, Burema J, Deurenberg P, Van der Wiel-Wetzels WA. The impact of adjustment of a weight-height index (W/H2) for frame size on the prediction of body fatness. Br J Nutr 1985; 54:335-42. [PMID: 4063321 DOI: 10.1079/bjn19850118] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The impact of frame-size categories in weight-height tables was studied by comparing the efficiency of the body-mass index (weight/height2 (W/H2] and weight adjusted for body-height and a body-diameter, W/(H2Dp), in predicting body fatness. Body-weight, body-height, six body-diameters and four skinfold thicknesses were measured in ninety-five men and seventy women, aged between 23 and 35 years. Percentage of body fat was calculated from skinfold thicknesses using regression equations according to Durnin & Womersley (1974). The inclusion of a body-diameter increased the explained variation of body fatness from 57% to 62% (knee) and 63% (shoulder) in men and from 63% to 69% (knee) in women. It can be concluded that in the present population the efficiency of the prediction of percentage of body fat was not improved markedly by the inclusion of a body-diameter in the body-mass index, thus giving no support for the inclusion of frame-size categories in weight-height tables.
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