Oral, injected and implanted contraceptives and breast cancer risk among U.S. Hispanic and non‐Hispanic white women

Sweeney, Carol; Giuliano, Anna R.; Baumgartner, Kathy B.; Byers, Tim; Herrick, Jennifer S.; Edwards, Sandra L.; Slattery, Martha L.

doi:10.1002/ijc.22970

Cited by 40 publications

(43 citation statements)

References 46 publications

(48 reference statements)

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“…While one prior study observed a stronger association between recent OC use and risk of ER+/PR+ than ER−/PR− cancer (13), others found the opposite where OC use was more strongly related to ER− compared to ER+ cancer (11, 12), and another study found no association between recent use and luminal A or triple-negative breast cancer risk (14). Two studies including both pre- and postmenopausal women observed greater risks of ER− than ER+ cancer associated with recent use, though the differences were not statistically significant (15, 16). Differences in results may be due to varying age distributions or to having insufficient power to detect modest differences.…”

Section: Discussionmentioning

confidence: 94%

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Recent Oral Contraceptive Use by Formulation and Breast Cancer Risk among Women 20 to 49 Years of Age

et al. 2014

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Previous studies of oral contraceptives (OC) and breast cancer indicate that recent use slightly increases risk, but most studies relied on self-reported use and did not examine contemporary OC formulations. This nested case-control study was among female enrollees in a large US integrated health care delivery system. Cases were 1,102 women ages 20–49 diagnosed with invasive breast cancer from 1990–2009. Controls were randomly sampled from enrollment records (n=21,952) and matched to cases on age, year, enrollment length, and medical chart availability. Detailed OC use information was ascertained from electronic pharmacy records and analyzed using conditional logistic regression, odds ratios (OR), and 95% confidence intervals (CI). Recent OC use (within the prior year) was associated with an increased breast cancer risk (OR=1.5, 95% CI=1.3–1.9) relative to never or former OC use. The association was stronger for ER+ (OR=1.7, 95% CI=1.3–2.1) than ER− disease (OR=1.2, 95% CI=0.8–1.8), though not statistically significantly different (p=0.15). Recent use of OCs involving high dose estrogen (OR=2.7, 95% CI=1.1–6.2), ethynodiol diacetate (OR=2.6, 95% CI=1.4–4.7), or triphasic dosing with an average of 0.75 milligrams of norethindrone (OR=3.1, 95% CI=1.9–5.1, p for heterogeneity compared to using other OCs=0.004) was associated with particularly elevated risks, while other types including low dose estrogen OCs were not (OR=1.0, 95% CI=0.6–1.7). Our results suggest that recent use of contemporary OCs is associated with an increased breast cancer risk, which may vary by formulation. If confirmed, consideration of the breast cancer risk associated with different OC types could impact discussions weighing recognized health benefits and potential risks.

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Section: Discussionmentioning

confidence: 94%

“…Yet these studies and most other studies lack formulation data and/or are susceptible to exposure misclassification due to their reliance solely on participant recall. Additionally, comparatively few studies assessing recent OC use have stratified breast cancer risk by estrogen receptor status and existing results are mixed (11–16). …”

Section: Introductionmentioning

confidence: 99%

Recent Oral Contraceptive Use by Formulation and Breast Cancer Risk among Women 20 to 49 Years of Age

et al. 2014

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“…Three more recently published studies including pre-and postmenopausal women and evaluating risk by ER and/or PR status may include more relevant OC exposures, but they report differing findings. One study among African-American women and another study in the southwestern US found that recent OC use and long durations of use were more strongly related to ER− or ER−/PR− cancer than ER+ or ER+/PR+ cancer (38, 39). Furthermore, risk of ER−/PR− cancer increased among recent users with increasing duration of use (38).…”

Section: Discussionmentioning

confidence: 99%

Oral Contraceptives and Breast Cancer Risk Overall and by Molecular Subtype Among Young Women

Beaber

Malone

Tang

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Evidence suggests that recent oral contraceptive (OC) use is associated with a small increased breast cancer risk; yet risks associated with contemporary OC preparations and by molecular subtype are not well characterized. Methods We conducted a population-based case-control study of invasive breast cancer among women ages 20-44 residing in the Seattle-Puget Sound area from 2004-2010 (985 cases and 882 controls). We collected information on contraceptive use and participant characteristics via an in-person interview. Multivariable-adjusted logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results Lifetime duration of OC use for ≥15 years was associated with an increased breast cancer risk (OR=1.5, 95% CI=1.1-2.2). Current OC use (within 1 year of reference date) for ≥5 years was associated with an increased risk (OR=1.6, 95% CI=1.1-2.5) and there were no statistically significant differences in risk by OC preparation. Risk magnitudes were generally greater among women ages 20-39, and for estrogen receptor negative (ER−) and triple-negative breast cancer (current use for ≥5 years among ages 20-39: ER− OR=3.5, 95% CI=1.3-9.0; triple-negative OR=3.7, 95% CI=1.2-11.8), though differences between groups were not statistically significant. Conclusions Long-term use of contemporary OCs and current use for ≥5 years was associated with an increased breast cancer risk among women ages 20-44. Risk may be greater among younger women and for ER− and triple-negative breast cancer, but these findings require confirmation. Impact Continued surveillance and pooled analyses of OC use and breast cancer risk by molecular subtype are needed as OC preparations evolve.

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“…And although their use is lowest in Latinas, especially those with high NA ancestry, they have also been associated with higher BC risk in recent users and for ER negative tumors in Hispanics [27,30].…”

Section: Socioeconomic and Cultural Factorsmentioning

confidence: 99%

Genetics, Tumor Features and Treatment Response of Breast Cancer in Latinas

Castañeda

Castillo

Villarreal‐Garza

et al. 2018

Breast Cancer Manag.

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Practice pointsr Latinas with breast cancer have been associated with lower prevalence and higher mortality rates. r The access to healthcare system for Latinas has been described as lower than for white women. r Rates of grade III and triple-negative phenotype breast cancer are higher for Latinas than for white women. r BRCA mutation prevalence appears to be higher in Latinas than white women in the American population. r Distribution of BRCA mutation differs by country in Central, Latin America or Caribbean and recurrent mutations have been described in Mexico. r Finally, evaluated information about treatment efficacy and toxicity in Latinas with breast cancer indicate similar effects than in the white race.Breast cancer is a heterogeneous and genetic disease that has variability according to ethnicity and race with respect to incidence, clinical characteristics and prognosis. The incidence of breast cancer is lower but mortality is higher in Latinas than Caucasians in the US series. Risk factors appear to have different prevalence and impact in Latinas. Breast cancer in Latinas has particular clinic-pathological features including younger age, higher rates of triple-negative subtype and advanced stages. Molecular studies find that Latinas from every region have a specific BRCA incidence and a recurrent mutation, as well as differences in activity of molecular pathways. Treatment response rates and toxicity have also been compared, and no difference was found between Latinas and other ethnic groups.

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Oral, injected and implanted contraceptives and breast cancer risk among U.S. Hispanic and non‐Hispanic white women

Abstract: Associations between oral contraceptive (OC) use and breast cancer have been reported, but few studies have considered associations in racial and ethnic minorities. Data regarding injected or implanted hormonal contraceptives are limited. In a case-control study of Hispanic (796

Cited by 40 publications

References 46 publications

Recent Oral Contraceptive Use by Formulation and Breast Cancer Risk among Women 20 to 49 Years of Age

Recent Oral Contraceptive Use by Formulation and Breast Cancer Risk among Women 20 to 49 Years of Age

Oral Contraceptives and Breast Cancer Risk Overall and by Molecular Subtype Among Young Women

Genetics, Tumor Features and Treatment Response of Breast Cancer in Latinas

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