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Age at first birth and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers

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Abstract

An early age at first full-term birth is associated with a reduction in the subsequent development of breast cancer among women in the general population. A similar effect has not yet been reported among women who carry an inherited BRCA1 or BRCA2 mutation. We conducted a matched case–control study on 1816 pairs of women with a BRCA1 (n = 1405) or BRCA2 (n = 411) mutation in an attempt to elucidate the relationship between age at first full-term pregnancy and the risk of developing breast cancer. Information about the age at first childbirth and other pregnancy-related variables was derived from a questionnaire administered to women during the course of genetic counselling. There was no difference in the mean age at first full-term birth in the cases and controls (24.9 years vs. 24.8 years; P = 0.81, respectively). Compared to women whose first child was born at or before 18 years of age, a later age at first full-term birth did not influence the risk of developing breast cancer (OR = 1.00 per year; 95% CI 0.98–1.03; P-trend = 0.67). Stratification by mutation status did not affect the results. These findings suggest that an early first full-term birth does not confer protection against breast cancer in BRCA mutation carriers. Nonetheless, BRCA mutation carriers opting for a prophylactic oophorectomy as a breast and/or ovarian cancer risk-reducing strategy should complete childbearing prior to age 40 when this prevention modality is most effective.

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Acknowledgements

Joanne Kotsopoulos is supported by a fellowship from the Canadian Breast Cancer Foundation, Ontario Chapter. Charis Eng is a recipient of the Doris Duke Distinguished Clinical Scientist Award. Susan L. Neuhausen is supported by NIH CA74415.

Author information

Authors and Affiliations

  1. Centre for Research in Women’s Health, Women’s College Hospital, University of Toronto, Room 750, 790 Bay Street, 7th Floor, Toronto, ON, Canada, M5G 1N8

    Joanne Kotsopoulos, Ping Sun & Steven A. Narod

  2. Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada

    Joanne Kotsopoulos & Steven A. Narod

  3. Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland

    Jan Lubinski

  4. Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, NE, USA

    Henry T. Lynch

  5. Department of Medical Oncology, Rotterdam Cancer Institute, Daniel Den Hoed Kliniek, The Netherlands

    Jan Klijn

  6. Epidemiology Research Unit, Research Centre, Centre Hospitalier de l’Universitaire Montréal, CHUM Hôtel Dieu, Montreal, QC, Canada

    Parviz Ghadirian

  7. Département de Nutrition, Faculte du Medicine, University of Montreal, Montreal, QC, Canada

    Parviz Ghadirian

  8. Epidemiology Division, Department of Medicine, University of California, Irvine, CA, USA

    Susan L. Neuhausen

  9. British Columbia Cancer Agency, Vancouver, BC, Canada

    Charmaine Kim-Sing

  10. Departments of Medicine, Human Genetics, and Oncology, McGill University, Montreal, QC, Canada

    William D. Foulkes

  11. Department of Cancer Genetics, Norwegian Radium Hospital, Oslo, Norway

    Pal Moller

  12. Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC, USA

    Claudine Isaacs

  13. Departments of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA, USA

    Susan Domchek

  14. Department of Gynecologic Oncology, Princess Margaret Hospital, Toronto, Canada

    Susan Randall

  15. Department of Human Genetics and Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Kenneth Offit

  16. Beth Israel Deaconess Medical Center, Boston, MA, USA

    Nadine Tung

  17. London Regional Program, London Health Sciences Centre, London, ON, Canada

    Peter Ainsworth

  18. Institute of Genetics, Rambam Medical Center, Haifa, Israel

    Ruth Gershoni-Baruch

  19. Toronto-Sunnybrook Regional Cancer Center, Toronto, ON, Canada

    Andrea Eisen

  20. Division of Population Science, Fox Chase Cancer Center, Philadelphia, PA, USA

    Mary Daly

  21. Gynecology Oncology, Cedars Sinai Medical Center, Los Angeles, CA, USA

    Beth Karlan

  22. Hereditary Cancer Program, Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati, OH, USA

    Howard M. Saal

  23. Mayo Clinic, Rochester, NY, USA

    Fergus Couch

  24. Section of Genetics, University of Turin, Turin, Italy

    Barbara Pasini

  25. Division of Senology, Department of Gynecology, Medical University of Vienna, Vienna, Austria

    Teresa Wagner

  26. Private Trust for Breast Health, Vienna, Austria

    Teresa Wagner

  27. The Suzanne Levy Gertner Oncogenetics Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Israel

    Eitan Friedman

  28. The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Eitan Friedman

  29. National Cancer Control Center, Carmel Medical Center, Haifa, Israel

    Gad Rennert

  30. Clinical Cancer Genetics Program, Comprehensive Cancer Center, Division of Human Genetics, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA

    Charis Eng

  31. Genomic Medicine Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Charis Eng

  32. Department of Cancer Genetics, City of Hope National Medical Center, Duarte, CA, USA

    Jeffrey Weitzel

Authors
  1. Joanne Kotsopoulos
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  2. Jan Lubinski
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  3. Henry T. Lynch
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  4. Jan Klijn
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  5. Parviz Ghadirian
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  6. Susan L. Neuhausen
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  7. Charmaine Kim-Sing
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  8. William D. Foulkes
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  9. Pal Moller
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  10. Claudine Isaacs
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  11. Susan Domchek
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  12. Susan Randall
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  13. Kenneth Offit
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  14. Nadine Tung
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  15. Peter Ainsworth
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  16. Ruth Gershoni-Baruch
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  17. Andrea Eisen
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  18. Mary Daly
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  19. Beth Karlan
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  20. Howard M. Saal
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  21. Fergus Couch
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  22. Barbara Pasini
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  23. Teresa Wagner
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  24. Eitan Friedman
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  25. Gad Rennert
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  26. Charis Eng
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  27. Jeffrey Weitzel
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  28. Ping Sun
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  29. Steven A. Narod
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Consortia

The Hereditary Breast Cancer Clinical Study Group

Corresponding author

Correspondence to Steven A. Narod.

Additional information

Other members of the Hereditary Breast Cancer Clinical Study Group—J. Garber, Dana Farber Cancer Center, D. Gilchrist, University of Alberta, M. Osborne, Strang Cancer Prevention Centre, New York, NY, USA, D. Fishman, Northwestern University, E. Warner, Toronto-Sunnybrook Regional Cancer Center, Toronto, ON, Canada, J. McLennan, University of San Francisco, W. McKinnon, University of Vermont, S. Merajver, University of Michigan Comprehensive Cancer Center, H. Olsson, Jubileum Institute, Department of Oncology, Lund University Hospital, Lund, Sweden, D. Provencher, University of Montreal, B. Pasche, Northwestern Medical Facility, Chicago, IL, USA, G. Evans, Regional Genetics Service, St. Mary’s Hospital, Manchester, UK, WS Meschino, North York General, North York, ON, Canada, E. Lemire, Division of Medical Genetics, Royal University Hospital and the University of Saskatchewan, Canada, A. Chudley, Children’s Hospital, Winnipeg, Manitoba, Canada, D. Rayson, Queen Elizabeth Health Sciences Centre, Halifax, Nova Scotia, Canada and C. Bellati, Dipartimento di Genetica, Biologia e Biochimica, Università di Torino, Italy.

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Kotsopoulos, J., Lubinski, J., Lynch, H.T. et al. Age at first birth and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Res Treat 105, 221–228 (2007). https://doi.org/10.1007/s10549-006-9441-3

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  • DOI: https://doi.org/10.1007/s10549-006-9441-3

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