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Breast Cancer Research and Treatment

, Volume 149, Issue 2, pp 505–515 | Cite as

History of oral contraceptive use in breast cancer patients: impact on prognosis and endocrine treatment response

  • Louise Huzell
  • Mia Persson
  • Maria Simonsson
  • Andrea Markkula
  • Christian Ingvar
  • Carsten Rose
  • Helena JernströmEmail author
Epidemiology

Abstract

The purpose was to study oral contraceptive (OC) use in relation to breast cancer events and endocrine treatment response in a prospective population-based cohort, because it is unclear whether history of OC use impacts on prognosis in breast cancer patients. Between 2002 and 2011, 994 primary breast cancer patients without preoperative treatment were enrolled in Lund, Sweden and followed until December 2012. History of OC use was obtained from preoperative questionnaires. Tumor characteristics, clinical data, and date of death were obtained from pathology reports, patient charts, and population registries. Among the 948 patients with invasive cancer and no metastasis detected on the post-operative screen, 74 % had ever used OCs. Patients were followed for up to nine years (median follow-up 3 years), and 100 breast cancer events were recorded. Ever OC use was not associated with prognosis, irrespective of duration. However, any OC use before age 20 was associated with a threefold increased risk for breast cancer events in patients <50 years but not in patients ≥50 years (P interaction = 0.009). In patients ≥50 years with estrogen receptor positive tumors, previous OC use at any age was associated with a significantly decreased risk of breast cancer events among patients who received aromatase inhibitors compared to patients who never used OCs (adjusted HR 0.37: 95 % CI 0.15–0.87). OC use was not associated with tamoxifen-response. If confirmed, history of OC use may yield valuable prognostic and treatment predictive information in addition to currently used criteria.

Keywords

Breast cancer Oral contraceptives Tumor characteristics Prognosis Treatment prediction Endocrine therapy 

Notes

Acknowledgments

This work was supported by grants from The Medical Research Council, The Swedish Cancer Society, The Medical Faculty at Lund University, The Mrs Berta Kamprad’s Foundation, The Gunnar Nilsson Foundation, The King Gustaf Vs Jubileumsfond, The South Swedish Health Care Region (ALF), The Swedish Breast Cancer Group (BRO), and the Skåne University Hospital, Lund Fund. The authors thank our research nurses Linda Ågren, Maj-Britt Hedenblad, Karin Henriksson, Anette Möller, Monika Meszaros, Anette Ahlin Gullers, Anita Schmidt Casslén, Helén Thell, and Jessica Åkesson. We thank Dr Eric Dryver for proofreading.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Louise Huzell
    • 1
  • Mia Persson
    • 1
  • Maria Simonsson
    • 1
  • Andrea Markkula
    • 1
  • Christian Ingvar
    • 2
  • Carsten Rose
    • 3
  • Helena Jernström
    • 1
    Email author
  1. 1.Division of Oncology and Pathology, Department of Clinical SciencesLund UniversityLundSweden
  2. 2.Division of Surgery, Department of Clinical SciencesLund University and Skåne University HospitalLundSweden
  3. 3.CREATE Health and Department of ImmunotechnologyLund UniversityLundSweden

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