Abstract
Purpose
Previous studies have suggested that migraineurs are at decreased risk for developing breast cancer. Further prospective studies are warranted to confirm these results. In addition, studies evaluating migraine characteristics (e.g., migraine subtypes and frequency) are lacking.
Methods
We conducted a prospective cohort study among 39,696 participants in the Women’s Health Study who were 45 years and older at study entry. Information on migraine was self-reported with good validation rates. Incident breast cancer cases were confirmed by medical record review. We distinguished the following major endpoints: any breast cancer, a combined endpoint of invasive and in situ cases, in situ breast cancer only, and invasive breast cancer only. Cox proportional hazards models were used to calculate age- and multivariable-adjusted hazard ratios (HRs) and 95 % confidence intervals (95 % CI).
Results
A total of 7,318 (18.4 %) women reported any migraine. During a mean follow-up time of 13.6 years, 432 in situ and 1,846 invasive breast cancer cases occurred. Migraine was not associated with breast cancer risk. The multivariable-adjusted HRs (95 % CI) were 1.10 (0.99–1.22) for any breast cancer, 1.06 (0.83–1.35) for in situ breast cancer, and 1.11 (0.99–1.25) for invasive breast cancer. The risk for developing breast cancer differed according to hormone receptor status with a suggestion of increased risks for hormone receptor negative tumors (HR ER−/PR− : 1.28, 95 % CI: 0.96–1.71). We did not observe meaningful differences with regard to histologic subtype or according to migraine aura status or migraine attack frequency.
Conclusions
Results of our study do not support the hypothesis that migraineurs have a decreased risk for breast cancer.
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References
Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society (1988). Cephalalgia 8 Suppl 7:1–96
Lipton RB, Bigal ME (2005) The epidemiology of migraine. Am J Med 118(Suppl 1):3S–10S
Bigal ME, Liberman JN, Lipton RB (2006) Age-dependent prevalence and clinical features of migraine. Neurology 67(2):246–251
Brandes JL (2006) The influence of estrogen on migraine: a systematic review. JAMA 295(15):1824–1830
Sances G, Granella F, Nappi RE, Fignon A, Ghiotto N, Polatti F, Nappi G (2003) Course of migraine during pregnancy and postpartum: a prospective study. Cephalalgia 23(3):197–205
Scharff L, Marcus DA, Turk DC (1997) Headache during pregnancy and in the postpartum: a prospective study. Headache 37(4):203–210
Martin VT, Lipton RB (2008) Epidemiology and biology of menstrual migraine. Headache 48(Suppl 3):S124–S130
Porter PL (2009) Global trends in breast cancer incidence and mortality. Salud Publica Mex 51(Suppl 2):s141–s146
Li CI, Malone KE, Porter PL, Weiss NS, Tang MT, Cushing-Haugen KL, Daling JR (2003) Relationship between long durations and different regimens of hormone therapy and risk of breast cancer. JAMA 289(24):3254–3263
Tamimi RM, Byrne C, Colditz GA, Hankinson SE (2007) Endogenous hormone levels, mammographic density, and subsequent risk of breast cancer in postmenopausal women. J Natl Cancer Inst 99(15):1178–1187
Althuis MD, Fergenbaum JH, Garcia-Closas M, Brinton LA, Madigan MP, Sherman ME (2004) Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomarkers Prev 13(10):1558–1568
Li CI, Mathes RW, Bluhm EC, Caan B, Cavanagh MF, Chlebowski RT, Michael Y, O’Sullivan MJ, Stefanick ML, Prentice R (2010) Migraine history and breast cancer risk among postmenopausal women. J Clin Oncol 28(6):1005–1010
Li CI, Mathes RW, Malone KE, Daling JR, Bernstein L, Marchbanks PA, Strom BL, Simon MS, Press MF, Deapen D, Burkman RT, Folger SG, McDonald JA, Spirtas R (2009) Relationship between migraine history and breast cancer risk among premenopausal and postmenopausal women. Cancer Epidemiol Biomarkers Prev 18(7):2030–2034
Mathes RW, Malone KE, Daling JR, Davis S, Lucas SM, Porter PL, Li CI (2008) Migraine in postmenopausal women and the risk of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 17(11):3116–3122
Rexrode KM, Lee IM, Cook NR, Hennekens CH, Buring JE (2000) Baseline characteristics of participants in the Women’s Health Study. J Womens Health Gend Based Med 9(1):19–27
Ridker PM, Cook NR, Lee IM, Gordon D, Gaziano JM, Manson JE, Hennekens CH, Buring JE (2005) A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 352(13):1293–1304
Kurth T, Gaziano JM, Cook NR, Logroscino G, Diener HC, Buring JE (2006) Migraine and risk of cardiovascular disease in women. JAMA 296(3):283–291
Rist PM, Buring JE, Kase CS, Schurks M, Kurth T (2010) Migraine and functional outcome from ischemic cerebral events in women. Circulation 122(24):2551–2557
Bensenor IM, Cook NR, Lee IM, Chown MJ, Hennekens CH, Buring JE (2001) Low-dose aspirin for migraine prophylaxis in women. Cephalalgia 21(3):175–183
The international classification of headache disorders: 2nd edition (2004) Cephalalgia 24(Suppl 1):9–160
Schurks M, Buring JE, Kurth T (2009) Agreement of self-reported migraine with ICHD-II criteria in the Women’s Health Study. Cephalalgia 29(10):1086–1090
Colditz GA, Rosner BA, Chen WY, Holmes MD, Hankinson SE (2004) Risk factors for breast cancer according to estrogen and progesterone receptor status. J Natl Cancer Inst 96(3):218–228
Manzoni GC, Torelli P (2008) Migraine with and without aura: a single entity? Neurol Sci 29(Suppl 1):S40–S43
Schurks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T (2009) Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ 339:b3914
Acknowledgments
We are indebted to the participants in the Women’s Health Study for their outstanding commitment and cooperation, to the entire Women’s Health Study staff for their expert and unfailing assistance. This study was supported in part by a research fellowship of the German Research Foundation (DFG) to Dr. Winter. The Women’s Health Study is supported by grants from the National Heart, Lung, and Blood Institute (HL-043851 and HL-080467) and the National Cancer Institute (CA-47988). The sponsors of the study played no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Conflict of interest
We report a full disclosure for the last 2 years for each author: Dr. Winter has received an international postdoctoral research fellowship of the American Association of University Women and a research fellowship of the German Research Foundation (DFG). Dr. Rexrode has received investigator-initiated research funding from the National Institutes of Health. She has also received honoria from Pfizer pharmaceuticals for contributing to a scientific advisory panel. Dr. Lee has received investigator-initiated research funding and support from the National Institutes of Health. She has served as a consultant to, and on the Scientific Advisory Board of, Virgin HealthMiles. Dr. Buring has received investigator-initiated research funding and support from the National Institutes of Health and Dow Corning Corporation; research support for pills and/or packaging from Bayer Health Care and the Natural Source Vitamin E Association. Dr. Tamimi has received investigator-initiated research funding from the National Institutes of Health. She has also received honoria from Pfizer pharmaceuticals for contributing to a scientific advisory panel. Dr. Kurth has received investigator-initiated research funding from the French National Research Agency, the US National Institutes of Health, the Migraine Research Foundation, and the Parkinson’s disease Foundation. He has received honoraria from Allergan, the American Academy of Neurology and Merck for educational lectures, from MAP Pharmaceutical for contributing to a scientific advisory panel, and from the British Medical Journal for editorial services.
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Rulla M. Tamimi and Tobias Kurth contributed equally.
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Winter, A.C., Rexrode, K.M., Lee, IM. et al. Migraine and subsequent risk of breast cancer: a prospective cohort study. Cancer Causes Control 24, 81–89 (2013). https://doi.org/10.1007/s10552-012-0092-x
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DOI: https://doi.org/10.1007/s10552-012-0092-x