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Tytuł:
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Fertility treatments and breast cancer risk in Jewish Israeli BRCA mutation carriers.
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Autorzy:
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Perri T; Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel. Electronic address: .
Naor-Revel S; Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel.
Eliassi-Revivo P; Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel.
Lifshitz D; Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel.
Friedman E; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel; Susanne Levy-Gertner Oncogenetics Unit, Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel.
Korach J; Department of Gynecologic Oncology, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel.
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Źródło:
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Fertility and sterility [Fertil Steril] 2021 Aug; Vol. 116 (2), pp. 538-545. Date of Electronic Publication: 2021 Apr 03.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: New York. NY : Elsevier for the American Society for Reproductive Medicine
Original Publication: New York, Hoeber.
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MeSH Terms:
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Heterozygote*
Mutation*
BRCA1 Protein/*genetics
BRCA2 Protein/*genetics
Breast Neoplasms/*etiology
Infertility, Female/*therapy
Contraceptives, Oral/adverse effects ; Female ; Humans ; Jews ; Middle Aged ; Risk
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Contributed Indexing:
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Keywords: BRCA mutations; breast cancer; cancer risk; fertility treatment
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Substance Nomenclature:
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0 (BRCA1 Protein)
0 (BRCA1 protein, human)
0 (BRCA2 Protein)
0 (BRCA2 protein, human)
0 (Contraceptives, Oral)
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Entry Date(s):
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Date Created: 20210407 Date Completed: 20210823 Latest Revision: 20210823
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Update Code:
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20240104
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DOI:
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10.1016/j.fertnstert.2021.02.030
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PMID:
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33823990
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Objective: To determine whether fertility treatments impact the risk of breast cancer in Jewish Israeli BRCA1/2 mutation carriers.
Design: Historical cohort study.
Setting: University-affiliated tertiary medical center.
Patient(s): A total of 1,824 Jewish Israeli BRCA1/2 mutation carriers from a single center were stratified into 1,492 (81.8%) carriers who were not treated for infertility and 332 (18.2%) carriers who underwent fertility treatment with clomiphene citrate (n = 134), gonadotropin (n = 119), in vitro fertilization (n = 183), or a combination of treatments (n = 89).
Intervention(s): None.
Main Outcome Measure(s): Hazard ratios (HR) and 95% confidence intervals (CI) for the association of breast cancer with fertility treatment and other hormonal and reproductive variables.
Result(s): Breast cancer was diagnosed in 687 BRCA1/2 mutation carriers. Multivariate analysis, either of the whole group or stratified by each gene, showed no association between fertility treatment and breast cancer risk, regardless of the type of treatment (clomiphene citrate: HR 0.77, 95% CI 0.49-1.19; gonadotropin: HR 0.54, 95% CI 0.28-1.01; in vitro fertilization: HR 0.65, 95% CI 0.39-1.08; and combined treatments: HR 1.23, 95% CI 0.49-3.06). An increased breast cancer risk was associated with paternal origin of the mutation (HR 1.43, 95% CI 1.17-1.75) and use of oral contraceptives for >5 years (HR 1.62, 95% CI 1.27-2.06) in both BRCA1 and BRCA2 mutation carriers. Ovarian cancer risk was decreased with the use of any oral contraceptive (HR 0.61; 95% CI 0.46-0.82).
Conclusion(s): Fertility treatment for BRCA1/2 mutation carriers is not associated with a discernible increase in breast cancer risk.
(Copyright © 2021 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
Comment in: Fertil Steril. 2021 Aug;116(2):359-360. (PMID: 34247761)
