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The association of infectious mononucleosis and invasive breast cancer in The Health of Women (HOW) Study®

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Abstract

Background

The link between Epstein-Barr Virus (EBV) and breast cancer (BC) etiology remains unclear. We utilized the Health of Women (HOW) Study® to understand the association between infectious mononucleosis (IM), a surrogate for EBV infection, and invasive BC.

Methods

The HOW Study® was a web-based survey of BC risk factors with > 40, 000 participants; 183 had IM at < 10 years old, 3, 654 had IM between 10 and 22 years old, 764 had IM at > 22 years old, and 17, 026 never developed IM. Of these 21, 627 women, 2093 had Stages I–III BC and 14, 143 were cancer-free. Binary logistic regression ascertained the association between IM and invasive BC risk by controlling for confounders.

Results

A history of IM was associated with a lower likelihood of developing invasive BC compared to women who did not develop IM (adjusted OR = 0.83, 95% CI 0.72–0.94). That finding was driven by women who had IM between 10 and 22 years old (adjusted OR = 0.83, 95% CI 0.72–0.97) albeit no linear association between age at developing IM and breast cancer (p-trend > 0.05). Women who had IM between 10 and 22 years old were less likely to develop estrogen receptor positive (ER+ ; adjusted OR = 0.84, 95% CI 0.71–0.99) or hormone receptor positive (HR+ ; adjusted OR = 0.86, 95% CI 0.73–1.01) BC. There was no association between IM and ER− or HR− BC.

Conclusion

In the HOW Study®, women diagnosed with IM between the ages of 10 and 22 had a lower risk of developing invasive BC compared to women who never developed IM.

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Acknowledgements

We thank the staff and participants of the HOW Study ® and the Dr. Susan Love Research Foundation for providing this dataset. GMW is supported by the AVON Foundation, the Breast Cancer Research Foundation, and the Ludwig Center at Harvard Medical School. We thank Leah Eshraghi and Katherine M. Peterson for reading this manuscript.

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Authors and Affiliations

  1. Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02115, USA

    Yujing Jan Heng

  2. Dr. Susan Love Research Foundation, West Hollywood, CA, USA

    Susan Love

  3. School of Community and Global Health, Claremont Graduate University, Claremont, CA, USA

    Jessica Clague DeHart

  4. Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA

    Joyce D. Fingeroth

  5. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Gerburg M. Wulf

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  1. Yujing Jan Heng
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  2. Susan Love
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  3. Jessica Clague DeHart
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  4. Joyce D. Fingeroth
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  5. Gerburg M. Wulf
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Correspondence to Yujing Jan Heng.

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Heng, Y.J., Love, S., DeHart, J.C. et al. The association of infectious mononucleosis and invasive breast cancer in The Health of Women (HOW) Study®. Breast Cancer 29, 731–739 (2022). https://doi.org/10.1007/s12282-022-01351-3

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  • DOI: https://doi.org/10.1007/s12282-022-01351-3

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