Summary
The effect of regularity and length of the menstrual cycle on breast cancer risk was studied prospectively in 78 cases and 383 age-matched controls who participated in a breast cancer screening programme, the DOM-project, in Utrecht, the Netherlands. Before entering the screening programme when they were aged 41–46, the women kept a menstrual calendar during at least three consecutive cycles. Cycles were considered to be irregular if any of three cycles was shorter than 21 days or longer than 35 days and/or if variation between cycle lengths was more than five days. Women with irregular cycles had a significantly reduced risk of breast cancer (odds ratio = 0.44; 95% confidence interval 0.22–0.86) after adjustment for age at menarche, age at first birth, parity, Quetelet's index and family history of breast cancer. Among regularly menstruating women, long cycles (28 days or more) were not significantly associated with increased risk of breast cancer (odds ratio 1.17; 95% confidence interval 0.66–2.09).
To the extent that irregular menstrual cycles reflect anovulatory cycles, our findings support the hypothesis that the cumulative number of regular ovulatory cycles increases breast cancer risk.
References
Henderson BE, Ross RK, Judd H, Krailo MD, Pike MC: Do regular ovulatory cycles increase breast cancer risk? Cancer 56: 1206–1208, 1985
Baanders EA, de Waard F: Menstrual cycles shortly after menarche in European and Bantu girls. Hum Biol 40: 314–322, 1968
MacMahon B, Trichopoulos D, Brown J, Anderson AP, Aoki K, Cole P, de Waard F, Kauraniemi T, Morgan RW, Purde M, Ravnihar B, Stormby N, Westlund K, Woo NC: Age at menarche, probability of ovulation and breast cancer risk. Int J Cancer 29: 13–16, 1982
Apter D, Vihko R: Early menarche, a risk factor for breast cancer, indicates early onset of ovulatory cycles. J Clin Endocrinol Metab 57: 82–86, 1983
Henderson BE, Pike MC, Casagrande JT: Breast cancer and the estrogen window hypothesis. Lancet 2: 363–364, 1981
Ferguson DJP, Anderson TJ: Morphological evaluation of cell turnover in relation to the menstrual cycle in the ‘resting’ human breast. Br J Cancer 44: 177–181, 1981
Venturoli S, Porcu E, Fabbri R, Paradisi R, Ruggeri S, Bolelli G, Orsini LF, Gabbi D, Flamigni C: Menstrual irregularities in adolescents: hormonal pattern and ovarian morphology. Hormone Res 24: 269–279, 1986
Henderson BE, Ross R, Bernstein L: Estrogens as a cause of human cancer: The Richard and Hinda Rosenthal Foundation award lecture. Cancer Res 48: 246–253, 1988
Sherman BM, Korenman SG: Hormonal characteristics of the human menstrual cycle throughout reproductive life. J Clin Invest 55: 699–706, 1975
Metcalf MG, Mackenzie JA: Menstrual cycle and exposure to oestrogens unopposed by progesterone: relevance to studies on breast cancer incidence. J Endocr 104: 137–141, 1985
Wynder EL, Bross IJ, Hirayama TA: A study of the epidemiology of cancer of the breast. Cancer 13: 559–601, 1960
MacMahon B, Feinlein M: Breast cancer in relation to nursing and menopausal history. J Natl Cancer Inst 24: 733–753, 1960
Soini I: Risk factors of breast cancer in Finland. Int J Epidemiol 6: 365–373, 1977
Choi NW, Howe GR, Miller AB, Matthews V, Morgan RW, Munan L, Burch JD, Feather J, Jain M, Kelly A: An epidemiologic study of breast cancer. Am J Epidemiol 107: 510–521, 1978
Sherman BM, Wallace RB, Bean JA: Cyclic ovarian function and breast cancer. Cancer Res (suppl.) 42: 3286s-3288s, 1982
La Vecchia C, Decarli A, di Pietro S, Franceschi S, Negri E, Parazzini F: Menstrual cycle patterns and the risk of breast disease. Eur J Cancer Clin Oncol 21: 417–422, 1985
Kvle G, Heuch I: Menstrual factors and breast cancer risk. Cancer 62: 1625–1631, 1988
Yuan JM, Yu MC, Ross RK, Gao YT, Henderson BE: Risk factors for breast cancer in Chinese women in Shanghai. Cancer Research 48: 1949–1953, 1988
Adami HO, 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 62: 122–126, 1990
Whelan A, Sandler DP, Root J, Smith KR, Voda AM: Menstrual cycle patterns and risk of breast cancer (Abstract). Am J Epidemiol 136: 965, 1992
Moseson M, Koenig KL, Shore RE, Pasternack BS: The influence of medical conditions associated with hormones on the risk of breast cancer. Int J Epidemiol 22: 1000–1009, 1993
Parazzini F, La Vecchia C, Negri E, Franceschi S, Tozzi L: Lifelong menstrual pattern and risk of breast cancer. Oncology 50: 222–225, 1993
Treloar AE, Boynton RE, Behn BG, Brown BW: Variation of the human menstrual cycle through reproductive life. Int J Fertility 12: 77–126, 1967
Olsson H, Landin-Olsson M, Gullberg B: Retrospective assessment of menstrual cycle length in patients with breast cancer, in patients with benign breast disease, and in women without breast disease. JNCI 70: 17–20, 1983
Sherman BM, Korenman SG: Inadequate corpus luteum function: a pathophysiological interpretation of human breast cancer epidemiology. Cancer 33: 1306–1312, 1974
den Tonkelaar I, Blankenstein MA, Collette HJA, de Waard F, Thijssen JHH: A prospective study on corpus luteum function and breast cancer risk. Gynecol Endocrinol 3: 11–19, 1989
Brinton LA, Melton LJ, Malkasian GD, Bond A, Hoover R: Cancer risk after evaluation for infertility. Am J Epidemiol 129: 712–722, 1989
Gammon MD, Thompson WD: Infertility and breast cancer: a population-based case-control study. Am J Epidemiol 132: 708–716, 1990
Bernstein L, Yuan JM, Ross RK, Pike MC, Hanisch R, Lobo R, Stanczyk F, Gao YT, Henderson BE: Serum hormone levels in pre-menopausal Chinese women in Shanghai and white women in Los Angeles: results from two breast casecontrol studies. Cancer Causes and Control 1: 51–58, 1990
Statistics and Epidemiology, Research Corporation, Seattle, 1990
Trichopoulos D, MacMahon B, Cole P: Menopause and breast cancer risk. J Natl Cancer Inst 48: 605–613, 1972
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den Tonkelaar, I., de Waard, F. Regularity and length of menstrual cycles in women aged 41–46 in relation to breast cancer risk: Results from the DOM-project. Breast Cancer Res Tr 38, 253–258 (1996). https://doi.org/10.1007/BF01806143
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DOI: https://doi.org/10.1007/BF01806143