Hypertension, Pregnancy, and Risk of Breast Cancer

Thompson, W. Douglas; Jacobson, Herbert I.; Negrini, Bryan P.; Janerich, Dwight T.

doi:10.1093/jnci/81.20.1571

Cited by 60 publications

(41 citation statements)

References 18 publications

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“…Previous studies have also shown an inverse association related to pre-eclampsia (Polednak and Janerich, 1983;Thompson et al, 1989;Troisi et al, 1998;Cohn et al, 2001;Vatten et al, 2002a, b), but no previous study has assessed whether the offspring's gender could modify this association.…”

Section: Discussionmentioning

confidence: 98%

“…Women who are diagnosed with pre-eclampsia in pregnancy may have a lower risk for breast cancer later in life compared to other parous women (Polednak and Janerich, 1983;Thompson et al, 1989;Troisi et al, 1998;Cohn et al, 2001;Vatten et al, 2002a, b) although a higher risk has also been reported (Paltiel et al, 2004). Women who develop pre-eclampsia tend to have higher levels of androgens and lower oestrogen and progesterone levels than women in normotensive pregnancies (Innes and Byers, 1999).…”

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confidence: 96%

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The negative association between pre-eclampsia and breast cancer risk may depend on the offspring's gender

et al. 2007

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If the negative association between pre-eclampsia and subsequent breast cancer risk differs by gender, this would strengthen the hypothesis that factors intrinsic to the particular pregnancy may explain the association. The study included 701 006 parous Norwegian women with follow-up for breast cancer through the Cancer Registry of Norway. Breast cancer risk was lower in women with pre-eclampsia/hypertension in their first pregnancy, compared to other women (relative risk, 0.86, 95% CI, 0.78 -0.94), after adjustment for age at first birth, maternal birth year, length of gestation, marital status, and parity. The risk reduction was slightly greater if the woman delivered a son as opposed to a daughter (relative risks of 0.79 vs 0.94, P-value for interaction, 0.06), and if preeclampsia/hypertension was combined with pre-term delivery, these differences were more pronounced (relative risks, 0.62 vs 1.07, P-value for interaction 0.03). A subanalysis among 176 036 primiparous women showed a substantial risk reduction if the mother delivered a son (relative risk, 0.62, 95% CI, 0.47 -0.82), but essentially null if she delivered a daughter (relative risk, 0.92, 95% CI, 0.72 -1.18; P-value for interaction, 0.05). These results suggest that the effect of pre-eclampsia/hypertension may be attributed to factors associated with the particular pregnancy rather than an underlying biological trait of the mother. The stronger risk reduction related to having a son suggests a role for sex-dependent hormones in pregnancy.

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Section: Discussionmentioning

confidence: 98%

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confidence: 96%

The negative association between pre-eclampsia and breast cancer risk may depend on the offspring's gender

et al. 2007

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“…13 Several studies have observed an inverse association between pre-eclampsia and subsequent maternal risk of breast cancer. 14 Also, gender of offspring may influence the risk of developing breast cancer. A recent study observed that breast cancer risk at young age was significantly lower in women who gave birth to 2 or more boys, but no girls, compared with women who gave birth to 2 or more girls, but no boys.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer risk in women who have had children with different partners

et al. 2001

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The fetal antigen hypothesis suggests that the lowered risk of breast cancer in parous women may be afforded by the development of antibodies to fetal antigens that are structurally similar to mammary cancer antigens. It has previously been hypothesized that the likelihood of developing such antibodies may be higher among women who have had children with more than 1 partner. Utilizing information on parenthood and breast cancer available in nationwide Swedish registers, we undertook a case-control study nested within a nation-wide cohort to address this issue. Number of partners fathering a child was categorized as 1, 2 and 3 or more. All analyses were restricted to subjects with 2 or more births and encompassed a total of 20,881 women with breast cancer and 111,989 control women. In an unadjusted analysis, the risk of breast cancer was somewhat lower (odds ratio [ Key words: breast cancer; parity; childbearing; fetal antigens; SwedenThe inverse association between childbearing and the risk of breast cancer has been attributed to hormonal factors and pregnancy-induced structural changes of breast cells. The fetal antigen hypothesis suggests that there may also be an immunologic mechanism: protection is afforded by the development of antibodies to fetal antigens, structurally similar to mammary cancer antigens, that may participate in an immune response resulting in the elimination of cancer cells. 1 Indirect support of this theory comes from laboratory findings indicating that Tcells from biparous women, but not from nulliparous women or men, proliferate in response to core peptide sequences of MUC-1, a human breast cancer associated tumor antigen that is also present in fetal tissue. 2,3 Janerich proposed that the likelihood of developing antibodies to fetal antigens could be higher for women who have had children with more than one partner. 4 With inconclusive results, only 2 epidemiologic studies have tried to assess the risk of breast cancer in women who have had children with more than 1 partner. 5,6 To address this issue in a large population-based study, we took advantage of detailed information on parenthood and breast cancer available in nation-wide Swedish registers. MATERIAL AND METHODS

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“…The evidence of an effect on maternal risk is perhaps best for preeclampsia where breast cancer risk is lower in women who experienced preeclampsia or hypertension during pregnancy in most (64,(169)(170)(171)(172), but not all studies (173,174). Moreover, data from the Child Health and Development Studies show a marked reduction in breast cancer risk with elevated mean arterial pressure (175), and systolic blood pressure increases from mid-to late pregnancy below the diagnostic criterion for hypertension (58).…”

Section: Prenatal Risk Factors For Maternal Breast Cancermentioning

confidence: 99%

Exploring the Underlying Hormonal Mechanisms of Prenatal Risk Factors for Breast Cancer: A Review and Commentary

Troisi

Potischman

Hoover

2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Prenatal factors have been hypothesized to influence subsequent breast cancer development. Directly evaluating the associations of in utero exposures with risk, however, presents several methodologic and theoretical challenges, including the long induction period between exposure and disease and the lack of certainty regarding the critical timing of exposure. Indirect evaluation of these associations has been achieved by use of proxies such as gestational and neonatal characteristics. Evidence suggests that preeclampsia is associated with a reduced breast cancer risk, whereas high birth weight and dizygotic twinning seem associated with an increased risk. Asians born in Asia have substantially lower breast cancer risks than women born in the West. Although data thus far are few, what exists is not consistent with a unifying hypothesis for a particular biological exposure (such as estrogens or androgens) during pregnancy as mediating the observed associations between pregnancy factors and breast cancer risk. This suggests that additional studies of prenatal factors should seek to broaden the range of hormones, growth, and other endocrine factors that are evaluated in utero. Once candidate biomarkers are identified, assessing them with respect to breast cancer and with intermediate end points in carcinogenesis should be a priority. In addition, investigations should explore the possibility that in utero exposures may not act directly on the breast, but may alter other physiologic pathways such as hormone metabolism that have their effect on risk later in life. (Cancer Epidemiol Biomarkers Prev 2007;16(9):1700 -12)

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Hypertension, Pregnancy, and Risk of Breast Cancer

Cited by 60 publications

References 18 publications

The negative association between pre-eclampsia and breast cancer risk may depend on the offspring's gender

The negative association between pre-eclampsia and breast cancer risk may depend on the offspring's gender

Breast cancer risk in women who have had children with different partners

Exploring the Underlying Hormonal Mechanisms of Prenatal Risk Factors for Breast Cancer: A Review and Commentary

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