Hormonal Contraception and Breast Cancer Risk for Carriers of Germline Mutations in BRCA1 and BRCA2

作者：Kelly‐Anne Phillips, Joanne Kotsopoulos, Susan M. Domchek, Mary Beth Terry, James A. Chamberlain, Julie K. Bassett, Amber M. Aeilts, Irene Louise Andrulis, Saundra S. Buys, Wanda Cui, Mary B. Daly, Andrea F. Eisen, William David Foulkes, Michael Leonard Friedlander, Jacek Gronwald, John Llewelyn Hopper, Esther M. John, Beth Y. Karlan, Raymond H. Kim, Allison W. Kurian, Jan Lubiński, Kelly A. Metcalfe, Katherine L. Nathanson, Christian Fridolin Singer, Melissa C. Southey, Heather Symecko, Nadine Tung, Steven Alexander Narod, Roger Laughlin Milne, David J. Amor, Lesley Andrews, Yoland Catherine Antill, Rosemary L. Balleine, Jonathan Beesley, Ian Bennett, Michael R. Bogwitz, Simon Bodek, Leon P. Botes, Meagan Elizabeth Brennan, Melissa A. Brown, Michael F. Buckley, Jo Burke, Phyllis Nancy Butow, Liz Caldon, Ian Campbell, Michelle Cao, Anannya Chakrabarti, Deepa Chauhan, Manisha Chauhan, Georgia Chenevix‐Trench, Alice Christian, Paul Andrew Cohen, Alison Colley, Ashley Crook, James Cui, Eliza Courtney, Margaret C. Cummings, Sarah‐Jane Dawson, Anna DeFazio, Martin Bruce Delatycki, Rebecca Dickson, Joanne Dixon, Stacey L. Edwards, Gelareh Farshid, Andrew Fellows, Georgina L. Fenton, Michael H. Field, James M. Flanagan, Peter C.C. Fong, Laura Elenor Forrest, Stephen Fox, Juliet D. French, Michael Leonard Friedlander, Clara Gaff, Mike Gattas, Peter George, Sian Greening, Marion Harris, Stewart A. Hart, Philip A. Harraka, Nick Hayward, John Llewelyn Hopper, Cass Hoskins, Clare Elizabeth Hunt, Paul Andrew James, Mark A. Jenkins, Alexa Kidd, Judy Kirk, Jessica Koehler, James Kollias, Sunil R. Lakhani, Mitchell Lawrence, Jason S. Lee, Shuai Li, Geoffrey J. Lindeman, Jocelyn Lippey, Lara Rachel Lipton, Liz Lobb, Sherene Loi, Graham J. Mann, Deborah J. Marsh, Sue Anne McLachlan, Bettina Meiser, Roger Laughlin Milne, Sophie S. Nightingale, Shona O’Connell, Sarah O’Sullivan, David Gallego‐Ortega, Nick Pachter, Jia‐Min Pang, Gargi H. Pathak, Briony Patterson, Amy Pearn, Kelly Phillips, Ellen Pieper, Susan Ramus, Edwina Rickard, Abi Ragunathan, Bridget Anne Robinson, Mona Saleh, Anita Rohini Skandarajah, Elizabeth Salisbury, Christobel Mary Saunders, Jodi M. Saunus, Peter Savas, Rodney J. Scott, Clare L. Scott, Adrienne Sexton, Joanne Margaret Shaw, Andrew Neil Shelling, Shweta Srinivasa, Peter Simpson, Melissa C. Southey, Amanda Spurdle, Jessica Averitt Taylor, Renea A. Taylor, Heather Thorne, Alison Trainer, Kathy Tucker, Jane E. Visvader, Logan Walker, Rachael Williams, Ingrid Winship, Mary Ann Young, Milita Zaheed · 发表于：Journal of Clinical Oncology · 年份：2024 · DOI：10.1200/jco.24.00176 · 被引用次数：25 · 研究领域：BRCA gene mutations in cancer、Ovarian cancer diagnosis and treatment、Prenatal Screening and Diagnostics

PURPOSE It is uncertain whether, and to what extent, hormonal contraceptives increase breast cancer (BC) risk for germline BRCA1 or BRCA2 mutation carriers. METHODS Using pooled observational data from four prospective cohort studies, associations between hormonal contraceptive use and BC risk for unaffected female BRCA1 and BRCA2 mutation carriers were assessed using Cox regression. RESULTS Of 3,882 BRCA1 and 1,509 BRCA2 mutation carriers, 53% and 71%, respectively, had ever used hormonal contraceptives for at least 1 year (median cumulative duration of use, 4.8 and 5.7 years, respectively). Overall, 488 BRCA1 and 191 BRCA2 mutation carriers developed BC during median follow-up of 5.9 and 5.6 years, respectively. Although for BRCA1 mutation carriers, neither current nor past use of hormonal contraceptives for at least 1 year was statistically significantly associated with BC risk (hazard ratio [HR], 1.40 [95% CI, 0.94 to 2.08], P = .10 for current use; 1.16 [0.80 to 1.69], P = .4, 1.40 [0.99 to 1.97], P = .05, and 1.27 [0.98 to 1.63], P = .07 for past use 1-5, 6-10, and >10 years before, respectively), ever use was associated with increased risk (HR, 1.29 [95% CI, 1.04 to 1.60], P = .02). Furthermore, BC risk increased with longer cumulative duration of use, with an estimated proportional increase in risk of 3% (1%-5%, P = .002) for each additional year of use. For BRCA2 mutation carriers, there was no evidence that current or ever use was associated with increased BC risk (...