Cancer Causes & Control

, Volume 26, Issue 10, pp 1487–1493 | Cite as

History of uterine leiomyomata and incidence of breast cancer

  • Lauren A. WiseEmail author
  • Rose G. Radin
  • Lynn Rosenberg
  • Lucile Adams-Campbell
  • Julie R. Palmer
Original paper



Uterine leiomyomata (UL), benign tumors of the myometrium, are influenced by sex steroid hormones. A history of UL diagnosis has been associated with a higher risk of uterine malignancies. The relation between UL and breast cancer, another hormonally responsive cancer, has not been studied.


We investigated the association between self-reported physician-diagnosed UL and incidence of breast cancer in the Black Women’s Health Study, a prospective cohort study. We followed 57,747 participants without a history of breast cancer from 1995 to 2013. UL diagnoses were reported at baseline and biennially. Breast cancer was reported on biennial questionnaires and confirmed by pathology data from medical records or cancer registries. Cox regression was used to derive incidence rate ratios (IRRs) and 95 % confidence intervals (CI) and adjust for potential confounders.


There were 2,276 incident cases of breast cancer (1,699 invasive, 394 in situ, and 183 unknown) during 879,672 person-years of follow-up. The multivariable IRR for the overall association between history of UL and breast cancer incidence was 0.99 (95 % CI 0.90–1.08), with similar results for ER + (IRR = 1.03) and ER − breast cancer (IRR = 1.05). IRRs for early diagnosis of UL (before age 30) were slightly above 1.0, with IRRs of 1.14 (95 % CI 0.99–1.31) for overall breast cancer, 1.14 (95 % CI 0.93–1.40) for ER + breast cancer, and 1.20 (95 % CI 0.89–1.61) for ER − breast cancer. IRRs for early diagnosis of UL were elevated for breast cancer diagnosed before 40 years of age (IRR = 1.39, 95 % CI 0.97–1.99) and premenopausal breast cancer (IRR = 1.26, 95 % CI 1.01–1.58). No consistent patterns in risk were observed across estrogen receptor subtypes, and IRRs did not differ appreciably within strata of BMI, female hormone use, mammography recency, or family history of breast cancer.


The present study of US black women suggests that a history of UL diagnosis is unrelated to the incidence of breast cancer overall. The positive associations observed for early diagnosed UL with breast cancer before age 40 and with premenopausal breast cancer require confirmation in future studies.


Black women Uterine leiomyoma Breast carcinoma Estrogen receptor Prospective studies 



Body mass index


Black Women’s Health Study


Confidence interval


Estrogen receptor


Incidence rate ratio



The authors gratefully acknowledge the contributions of participants & staff. This work was supported by National Cancer Institute grants R01-CA058420 (PI: Rosenberg) and UM1-CA164974 (PI: Rosenberg) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development grant R01-HD057966 (PI: Wise). Data on breast cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA). The content is solely the responsibility of the authors and does not necessarily represent the views of the National Cancer Institute or participating registries.

Authors’ contributions

Conception and design of parent study (L.R., J.R.P., L.A.C.), obtaining of funding (L.R., L.A.C., J.R.P.), data collection, validation, and interpretation (L.A.W., L.R., L.A.C., J.R.P.), data analysis (L.A.W., R.G.R.), literature search (L.A.W.), writing of article (L.A.W.), critical revision of the article (L.A.W., R.G.R., L.R., L.A.C., J.R.P.), and final approval of manuscript (L.A.W., R.G.R., L.R., L.A.C., J.R.P.).

Compliance with ethical standards

Conflict of interests



  1. 1.
    Jung BH, Bai SW, Chung BC (2004) Endogenous urinary steroids in premenopausal women with uterine leiomyomas. Int J Gynecol Obstet 84(1):55–60CrossRefGoogle Scholar
  2. 2.
    Brinton LA et al (2005) Relationship of benign gynecologic diseases to subsequent risk of ovarian and uterine tumors. Cancer Epidemiol Biomarkers Prev 14(12):2929–2935CrossRefPubMedGoogle Scholar
  3. 3.
    Anastasiadis PG et al (2000) Endometrial polyps: prevalence, detection, and malignant potential in women with abnormal uterine bleeding. Eur J Gynaecol Oncol 21(2):180–183PubMedGoogle Scholar
  4. 4.
    Pasquali R et al (1994) Body fat distribution has weight-independent effects on clinical, hormonal, and metabolic features of women with polycystic ovary syndrome. Metabolism 43(6):706–713CrossRefPubMedGoogle Scholar
  5. 5.
    Savelli L et al (2003) Histopathologic features and risk factors for benignity, hyperplasia, and cancer in endometrial polyps. Am J Obstet Gynecol 188(4):927–931CrossRefPubMedGoogle Scholar
  6. 6.
    Silva EG, Jenkins R (1990) Serous carcinoma in endometrial polyps. Mod Pathol 3(2):120–128PubMedGoogle Scholar
  7. 7.
    Takamizawa S et al (1999) Risk of complications and uterine malignancies in women undergoing hysterectomy for presumed benign leiomyomas. Gynecol Obstet Invest 48(3):193–196CrossRefPubMedGoogle Scholar
  8. 8.
    Parker WH, Fu YS, Berek JS (1994) Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol 83(3):414–418PubMedGoogle Scholar
  9. 9.
    Escobedo LG et al (1991) Infertility-associated endometrial cancer risk may be limited to specific subgroups of infertile women. Obstet Gynecol 77:124–128PubMedGoogle Scholar
  10. 10.
    Spicer DV, Pike MC (1994) Sex steroids and breast cancer prevention. J Natl Cancer Inst Monogr 16:139–147PubMedGoogle Scholar
  11. 11.
    Key TJ et al (2013) Sex hormones and risk of breast cancer in premenopausal women: a collaborative reanalysis of individual participant data from seven prospective studies. Lancet Oncol 14(10):1009–1019CrossRefPubMedGoogle Scholar
  12. 12.
    Fortner RT et al (2013) Premenopausal endogenous steroid hormones and breast cancer risk: results from the Nurses’ Health Study II. Breast Cancer Res 15(2):R19CrossRefPubMedCentralPubMedGoogle Scholar
  13. 13.
    Kuhl H, Schneider HP (2013) Progesterone–promoter or inhibitor of breast cancer. Climacteric 16(Suppl 1):54–68CrossRefPubMedGoogle Scholar
  14. 14.
    Kim JJ, Kurita T, Bulun SE (2013) Progesterone action in endometrial cancer, endometriosis, uterine fibroids, and breast cancer. Endocr Rev 34(1):130–162CrossRefPubMedCentralPubMedGoogle Scholar
  15. 15.
    Baird DD et al (2003) High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol 188(1):100–107CrossRefPubMedGoogle Scholar
  16. 16.
    Potter JD et al (1995) Progesterone and estrogen receptors and mammary neoplasia in the Iowa Women’s Health Study: how many kinds of breast cancer are there? Cancer Epidemiol Biomarkers Prev 4(4):319–326PubMedGoogle Scholar
  17. 17.
    Althuis MD et al (2004) Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomarkers Prev 13(10):1558–1568PubMedGoogle Scholar
  18. 18.
    Wise LA et al (2005) Age-specific incidence rates for self-reported uterine leiomyomata in the Black Women’s Health Study. Obstet Gynecol 105(3):563–568CrossRefPubMedCentralPubMedGoogle Scholar
  19. 19.
    Zhang J et al (2004) Synergistic effects of androgen and estrogen on the mouse uterus and mammary gland. Oncol Rep 12(4):709–716PubMedGoogle Scholar
  20. 20.
    Andersen J (1996) Growth factors and cytokines in uterine leiomyomas. Seminar Reprod Endocrinol 14(3):269–282CrossRefGoogle Scholar
  21. 21.
    Andersen A, Barbieri RL (1995) Abnormal gene expression in uterine leiomyomas. J Soc Gynecol Invest 2(5):663–672CrossRefGoogle Scholar
  22. 22.
    Sadan O et al (1987) Oestrogen and progesterone receptor concentrations in leiomyoma and normal myometrium. Ann Clin Biochem 24(Pt 3):263–267CrossRefPubMedGoogle Scholar
  23. 23.
    Friedman AJ et al (1994) Long-term medical therapy for leiomyomata uteri: a prospective, randomized study of leuprolide acetate depot plus either oestrogen-progestin or progestin ‘add-back’ for 2 years. Hum Reprod 9(9):1618–1625PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Lauren A. Wise
    • 1
    • 2
    Email author
  • Rose G. Radin
    • 1
  • Lynn Rosenberg
    • 1
    • 2
  • Lucile Adams-Campbell
    • 3
  • Julie R. Palmer
    • 1
    • 2
  1. 1.Slone Epidemiology CenterBoston UniversityBostonUSA
  2. 2.Department of EpidemiologyBoston University School of Public HealthBostonUSA
  3. 3.Lombardi Cancer CenterGeorgetown UniversityWashingtonUSA

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