Abstract
Epidemiological evidence suggests that breastfeeding protects against breast cancer. Whether an effect of age at first breastfeeding is independent of an effect of age at first birth is unclear. We hypothesized that nausea and vomiting in pregnancy, which are associated with elevated serum oestradiol levels during pregnancy, may increase risk. Cases were 452 parous, premenopausal women, 40 years or younger, diagnosed with breast cancer in Los Angeles County from July 1983 to December 1988. Control subjects were matched to cases on age, race, parity and neighbourhood. Pregnancy and breastfeeding histories were obtained from in-person interviews. Odds of breast cancer among women who breastfed for at least 16 months relative to those among women who did not breastfeed was 0.66 [95% confidence interval (CI) 0.41-1.05]. Number of children breastfed was not associated with risk. Risk was lower in women who first breastfed at older ages. Having ever been treated for nausea or vomiting during pregnancy was associated with an increased risk, especially in women experiencing recent pregnancies (OR = 2.03, 95% CI 1.05-3.92). These results support a protective role of breastfeeding and an adverse role of nausea or vomiting during pregnancy in the development of premenopausal breast cancer, especially in the years immediately following pregnancy.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adami H. O., Bergström R., Lund E., Meirik O. Absence of association between reproductive variables and the risk of breast cancer in young women in Sweden and Norway. Br J Cancer. 1990 Jul;62(1):122–126. doi: 10.1038/bjc.1990.242. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Albrektsen G., Heuch I., Kvåle G. The short-term and long-term effect of a pregnancy on breast cancer risk: a prospective study of 802,457 parous Norwegian women. Br J Cancer. 1995 Aug;72(2):480–484. doi: 10.1038/bjc.1995.359. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bernstein L., Henderson B. E., Hanisch R., Sullivan-Halley J., Ross R. K. Physical exercise and reduced risk of breast cancer in young women. J Natl Cancer Inst. 1994 Sep 21;86(18):1403–1408. doi: 10.1093/jnci/86.18.1403. [DOI] [PubMed] [Google Scholar]
- Brinton L. A., Potischman N. A., Swanson C. A., Schoenberg J. B., Coates R. J., Gammon M. D., Malone K. E., Stanford J. L., Daling J. R. Breastfeeding and breast cancer risk. Cancer Causes Control. 1995 May;6(3):199–208. doi: 10.1007/BF00051791. [DOI] [PubMed] [Google Scholar]
- Bruzzi P., Negri E., La Vecchia C., Decarli A., Palli D., Parazzini F., Del Turco M. R. Short term increase in risk of breast cancer after full term pregnancy. BMJ. 1988 Oct 29;297(6656):1096–1098. doi: 10.1136/bmj.297.6656.1096. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Byers T., Graham S., Rzepka T., Marshall J. Lactation and breast cancer. Evidence for a negative association in premenopausal women. Am J Epidemiol. 1985 May;121(5):664–674. doi: 10.1093/aje/121.5.664. [DOI] [PubMed] [Google Scholar]
- Cummings P., Stanford J. L., Daling J. R., Weiss N. S., McKnight B. Risk of breast cancer in relation to the interval since last full term pregnancy. BMJ. 1994 Jun 25;308(6945):1672–1674. doi: 10.1136/bmj.308.6945.1672. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Depue R. H., Bernstein L., Ross R. K., Judd H. L., Henderson B. E. Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiologic study. Am J Obstet Gynecol. 1987 May;156(5):1137–1141. doi: 10.1016/0002-9378(87)90126-8. [DOI] [PubMed] [Google Scholar]
- Gray R. H., Campbell O. M., Apelo R., Eslami S. S., Zacur H., Ramos R. M., Gehret J. C., Labbok M. H. Risk of ovulation during lactation. Lancet. 1990 Jan 6;335(8680):25–29. doi: 10.1016/0140-6736(90)90147-w. [DOI] [PubMed] [Google Scholar]
- Henderson B. E., Ross R. K., Judd H. L., Krailo M. D., Pike M. C. Do regular ovulatory cycles increase breast cancer risk? Cancer. 1985 Sep 1;56(5):1206–1208. doi: 10.1002/1097-0142(19850901)56:5<1206::aid-cncr2820560541>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
- Hsieh C., Pavia M., Lambe M., Lan S. J., Colditz G. A., Ekbom A., Adami H. O., Trichopoulos D., Willett W. C. Dual effect of parity on breast cancer risk. Eur J Cancer. 1994;30A(7):969–973. doi: 10.1016/0959-8049(94)90125-2. [DOI] [PubMed] [Google Scholar]
- Katsouyanni K., Trichopoulos D., Boyle P., Xirouchaki E., Trichopoulou A., Lisseos B., Vasilaros S., MacMahon B. Diet and breast cancer: a case-control study in Greece. Int J Cancer. 1986 Dec 15;38(6):815–820. doi: 10.1002/ijc.2910380606. [DOI] [PubMed] [Google Scholar]
- Lambe M., Hsieh C., Trichopoulos D., Ekbom A., Pavia M., Adami H. O. Transient increase in the risk of breast cancer after giving birth. N Engl J Med. 1994 Jul 7;331(1):5–9. doi: 10.1056/NEJM199407073310102. [DOI] [PubMed] [Google Scholar]
- Layde P. M., Webster L. A., Baughman A. L., Wingo P. A., Rubin G. L., Ory H. W. The independent associations of parity, age at first full term pregnancy, and duration of breastfeeding with the risk of breast cancer. Cancer and Steroid Hormone Study Group. J Clin Epidemiol. 1989;42(10):963–973. doi: 10.1016/0895-4356(89)90161-3. [DOI] [PubMed] [Google Scholar]
- Leon D. A., Carpenter L. M., Broeders M. J., Gunnarskog J., Murphy M. F. Breast cancer in Swedish women before age 50: evidence of a dual effect of completed pregnancy. Cancer Causes Control. 1995 Jul;6(4):283–291. doi: 10.1007/BF00051403. [DOI] [PubMed] [Google Scholar]
- McTiernan A., Thomas D. B. Evidence for a protective effect of lactation on risk of breast cancer in young women. Results from a case-control study. Am J Epidemiol. 1986 Sep;124(3):353–358. doi: 10.1093/oxfordjournals.aje.a114405. [DOI] [PubMed] [Google Scholar]
- Miller W. R. Hormonal factors and risk of breast cancer. Lancet. 1993 Jan 2;341(8836):25–26. doi: 10.1016/0140-6736(93)92489-g. [DOI] [PubMed] [Google Scholar]
- Newcomb P. A., Storer B. E., Longnecker M. P., Mittendorf R., Greenberg E. R., Clapp R. W., Burke K. P., Willett W. C., MacMahon B. Lactation and a reduced risk of premenopausal breast cancer. N Engl J Med. 1994 Jan 13;330(2):81–87. doi: 10.1056/NEJM199401133300201. [DOI] [PubMed] [Google Scholar]
- Romieu I., Hernández-Avila M., Lazcano E., Lopez L., Romero-Jaime R. Breast cancer and lactation history in Mexican women. Am J Epidemiol. 1996 Mar 15;143(6):543–552. doi: 10.1093/oxfordjournals.aje.a008784. [DOI] [PubMed] [Google Scholar]
- Rosero-Bixby L., Oberle M. W., Lee N. C. Reproductive history and breast cancer in a population of high fertility, Costa Rica, 1984-85. Int J Cancer. 1987 Dec 15;40(6):747–754. doi: 10.1002/ijc.2910400606. [DOI] [PubMed] [Google Scholar]
- Ross R. K., Yu M. C. Breast-feeding and breast cancer. N Engl J Med. 1994 Jun 9;330(23):1683–1684. [PubMed] [Google Scholar]
- Russo J., Tay L. K., Russo I. H. Differentiation of the mammary gland and susceptibility to carcinogenesis. Breast Cancer Res Treat. 1982;2(1):5–73. doi: 10.1007/BF01805718. [DOI] [PubMed] [Google Scholar]
- Stern J. M., Konner M., Herman T. N., Reichlin S. Nursing behaviour, prolactin and postpartum amenorrhoea during prolonged lactation in American and !Kung mothers. Clin Endocrinol (Oxf) 1986 Sep;25(3):247–258. doi: 10.1111/j.1365-2265.1986.tb01689.x. [DOI] [PubMed] [Google Scholar]
- Tao S. C., Yu M. C., Ross R. K., Xiu K. W. Risk factors for breast cancer in Chinese women of Beijing. Int J Cancer. 1988 Oct 15;42(4):495–498. doi: 10.1002/ijc.2910420404. [DOI] [PubMed] [Google Scholar]
- Vatten L. J., Kvinnsland S. Pregnancy-related factors and risk of breast cancer in a prospective study of 29,981 Norwegian women. Eur J Cancer. 1992;28A(6-7):1148–1153. doi: 10.1016/0959-8049(92)90476-i. [DOI] [PubMed] [Google Scholar]
- Vorherr H. Contraception after abortion and post partum. An evaluation of risks and benefits of oral contraceptives with emphasis on the relation of female sex hormones to thromboembolism and genital and breast cancer. Am J Obstet Gynecol. 1973 Dec 1;117(7):1002–1025. [PubMed] [Google Scholar]
- Wang Q. S., Ross R. K., Yu M. C., Ning J. P., Henderson B. E., Kimm H. T. A case-control study of breast cancer in Tianjin, China. Cancer Epidemiol Biomarkers Prev. 1992 Sep-Oct;1(6):435–439. [PubMed] [Google Scholar]
- Williams E. M., Jones L., Vessey M. P., McPherson K. Short term increase in risk of breast cancer associated with full term pregnancy. BMJ. 1990 Mar 3;300(6724):578–579. doi: 10.1136/bmj.300.6724.578. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Woods K. L., Smith S. R., Morrison J. M. Parity and breast cancer: evidence of a dual effect. Br Med J. 1980 Aug 9;281(6237):419–421. doi: 10.1136/bmj.281.6237.419. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yang C. P., Weiss N. S., Band P. R., Gallagher R. P., White E., Daling J. R. History of lactation and breast cancer risk. Am J Epidemiol. 1993 Dec 15;138(12):1050–1056. doi: 10.1093/oxfordjournals.aje.a116823. [DOI] [PubMed] [Google Scholar]
- Yoo K. Y., Tajima K., Kuroishi T., Hirose K., Yoshida M., Miura S., Murai H. Independent protective effect of lactation against breast cancer: a case-control study in Japan. Am J Epidemiol. 1992 Apr 1;135(7):726–733. doi: 10.1093/oxfordjournals.aje.a116359. [DOI] [PubMed] [Google Scholar]
- Yuan J. M., Yu M. C., Ross R. K., Gao Y. T., Henderson B. E. Risk factors for breast cancer in Chinese women in Shanghai. Cancer Res. 1988 Apr 1;48(7):1949–1953. [PubMed] [Google Scholar]