Are some breast cancers sexually transmitted?

Abstract

Sir,High-risk human papilloma viruses (HPVs) have been consistently identified in 13 -86% of breast tumours in the 10 studies published since 1999 (Lawson et al, 2006). High-risk HPVs of the same type have been identified in both cervical and breast cancer that had occurred in the same women (Hennig et al, 1999;Widschwendter et al, 2004). This observation has lead to the hypothesis that HPVs may be transmitted to the breast during sexual activities (Kan et al, 2005). If this hypothesis is correct, it is likely that HPV-positive breast cancers would occur in women younger than those with HPV-negative breast cancer. This is because HPV genital infections are much more common in young women who have had multiple sexual partners (IARC, 1995).There are only two studies in which the age of women with HPV-positive and -negative breast cancer has been published. There were no differences in the average of age of women with either HPV-positive and -negative breast cancer in a study of Brazilian women (Damin et al, 2004). This is in contrast to a recent study of Greek women in which those with HPV-positive breast cancer were of average age 38 years as compared to average age 53 years for women with HPV-negative breast cancer (P-values for difference ¼ 0.001) (Kroupis et al, 2006).We have reviewed the ages of Australian women with HPVpositive and -negative breast cancer in our study published in this Journal (Kan et al, 2005). These data are shown in Table 1. The average age of women with HPV-positive breast cancer was 55.6 years as compared to 63.8 years for women with HPV-negative breast cancer (P-values for difference ¼ 0.049). These data are compatible with the hypothesis that HPV-positive breast cancers occur in younger women than those with HPV-negative breast cancers, and that high-risk HPVs may have been transmitted by sexual activity with HPV-positive sexual partners. HPV ¼ human papilloma virus. P-value for difference in average ages ¼ 0.049, which is significant at the 95% level. REFERENCES

Human papillomavirus detected in female breast carcinomas in Japan

“…Similar results were described in studies of Norwegian and Brazilian women (Hennig et al, 1999;Damin et al, 2004). In contrast, Kroupis et al (2006) and Lawson et al (2006) demonstrated that the average age of women with HPV-positive breast cancer is significantly younger than women with HPV-negative breast cancer, suggesting that sexual activity is one of the risk factors of HPV-positive breast cancer.…”

Cervical screening in the 21st century: the case for human papillomavirus testing of self-collected specimens

“…Interestingly, HPV DNA can be found in plasma from cervical cancer patients (52). In addition, HPV has been located, and may contribute to cancer, in breast tissue, suggesting acquisition from sexual activity (53,54) or carriage in the bloodstream from an infected cervix (55,56). A role for HPV in breast cancer remains controversial, however.…”

Reply: Breast cancer, human papilloma virus and sexual activities

“…Three of these studies report that the age of women with HPV-positive breast cancer is significantly younger than the women with HPV-negative breast cancer. On an average, Greek women with HPV-positive breast cancer were 15 years, Australian women 8 years, and Canadian and Syrian women were 11 years younger than those with HPV-negative breast cancer (Kroupis et al, 2006;Lawson et al, 2006;Akil et al, 2007). Two studies report no difference in the age of women with HPV-positive or -negative breast cancer (Hennig et al, 1999;Damin et al, 2004).…”

“…The presence of high-risk HPV DNA in breast tumours has been shown, mainly by PCR analyses, in 11 out of 13 studies conducted in a various countries (reviewed by Lawson et al, 2006; plus a recent positive study by Yasmeen et al, 2007; a negative study by Lindel et al, 2007). Tumours of the breast nipple appear to have histological characteristics similar to HPV-positive cervical cancer (de Villiers et al, 2005).…”

“…Based on the younger age of some women with HPV-positive breast cancer, and the higher incidence of HPV-positive cervical cancer among younger women with multiple sexual partners, we have hypothesised that high-risk HPVs may be transmitted to the breast during sexual activities (Lawson et al, 2006).…”