TY - JOUR
T1 - Ovarian stimulation for IVF and risk of primary breast cancer in BRCA1/2 mutation carriers
AU - Derks-Smeets, Inge A. P.
AU - Schrijver, Lieske H.
AU - de Die-Smulders, Christine E. M.
AU - Tjan-Heijnen, Vivianne C. G.
AU - van Golde, Ron J. T.
AU - Smits, Luc J.
AU - Caanen, Beppy
AU - van Asperen, Christi J.
AU - Ausems, Margreet
AU - Collee, Margriet
AU - van Engelen, Klaartje
AU - Kets, C. Marleen
AU - van der Kolk, Lizet
AU - Oosterwijk, Jan C.
AU - van Os, Theo A. M.
AU - Rookus, Matti A.
AU - van Leeuwen, Flora E.
AU - Garcia, Encarna B.
AU - HEBON
PY - 2018/8/1
Y1 - 2018/8/1
N2 - BACKGROUND: The effect of in vitro fertilisation (IVF) on breast cancer risk for BRCA1/2 mutation carriers is rarely examined. As carriers may increasingly undergo IVF as part of preimplantation genetic diagnosis (PGD), we examined the impact of ovarian stimulation for IVF on breast cancer risk in BRCA1/2 mutation carriers. METHODS: The study population consisted of 1550 BRCA1 and 964 BRCA2 mutation carriers, derived from the nationwide HEBON study and the nationwide PGD registry. Questionnaires, clinical records and linkages with the Netherlands Cancer Registry were used to collect data on IVF exposure, risk-reducing surgeries and cancer diagnosis, respectively. Time-dependent Cox regression analyses were conducted, stratified for birth cohort and adjusted for subfertility. RESULTS: Of the 2514 BRCA1/2 mutation carriers, 3% (n = 76) were exposed to ovarian stimulation for IVF. In total, 938 BRCA1/2 mutation carriers (37.3%) were diagnosed with breast cancer. IVF exposure was not associated with risk of breast cancer (HR: 0.79, 95% CI: 0.46-1.36). Similar results were found for the subgroups of subfertile women (n = 232; HR: 0.73, 95% CI: 0.39-1.37) and BRCA1 mutation carriers (HR: 1.12, 95% CI: 0.60-2.09). In addition, age at and recency of first IVF treatment were not associated with breast cancer risk. CONCLUSION: No evidence was found for an association between ovarian stimulation for IVF and breast cancer risk in BRCA1/2 mutation carriers.
AB - BACKGROUND: The effect of in vitro fertilisation (IVF) on breast cancer risk for BRCA1/2 mutation carriers is rarely examined. As carriers may increasingly undergo IVF as part of preimplantation genetic diagnosis (PGD), we examined the impact of ovarian stimulation for IVF on breast cancer risk in BRCA1/2 mutation carriers. METHODS: The study population consisted of 1550 BRCA1 and 964 BRCA2 mutation carriers, derived from the nationwide HEBON study and the nationwide PGD registry. Questionnaires, clinical records and linkages with the Netherlands Cancer Registry were used to collect data on IVF exposure, risk-reducing surgeries and cancer diagnosis, respectively. Time-dependent Cox regression analyses were conducted, stratified for birth cohort and adjusted for subfertility. RESULTS: Of the 2514 BRCA1/2 mutation carriers, 3% (n = 76) were exposed to ovarian stimulation for IVF. In total, 938 BRCA1/2 mutation carriers (37.3%) were diagnosed with breast cancer. IVF exposure was not associated with risk of breast cancer (HR: 0.79, 95% CI: 0.46-1.36). Similar results were found for the subgroups of subfertile women (n = 232; HR: 0.73, 95% CI: 0.39-1.37) and BRCA1 mutation carriers (HR: 1.12, 95% CI: 0.60-2.09). In addition, age at and recency of first IVF treatment were not associated with breast cancer risk. CONCLUSION: No evidence was found for an association between ovarian stimulation for IVF and breast cancer risk in BRCA1/2 mutation carriers.
KW - PREIMPLANTATION GENETIC DIAGNOSIS
KW - HEREDITARY BREAST
KW - METAANALYSIS
KW - DISEASE
KW - WOMEN
U2 - 10.1038/s41416-018-0139-1
DO - 10.1038/s41416-018-0139-1
M3 - Article
C2 - 29937543
SN - 0007-0920
VL - 119
SP - 357
EP - 363
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 3
ER -