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Query: UMLS:C0006142 (breast cancer)
 160,383 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To investigate whether a history of infertility affects a woman's risk of developing breast cancer, the authors analyzed case-control data collected between 1980 and 1982 as part of the Cancer and Steroid Hormone Study. The 4,730 cases were women aged 20-54 years with a first diagnosis of breast cancer ascertained from eight population-based cancer registries; the 4,688 controls were women randomly selected from the general population of these same eight areas. After controlling for age, age at first birth, and parity, the odds ratio (OR) for breast cancer associated with infertility was 1.01 (95% confidence interval (CI) 0.89-1.15) among gravid women. Controlling for age, the odds ratio was 0.82 (95% CI 0.59-1.14) among nulligravid women. Women who reported that the reason for their infertility was a problem with their ovaries had a risk similar to that for women without a history of infertility (OR = 0.75, 95% CI 0.48-1.24). Women whose physicians reported that the reason for their infertility was anovulation or Stein-Leventhal syndrome also had risks similar to those for women without a history of infertility (OR = 1.26 (95% CI 0.67-2.34) and OR = 1.13 (95% CI 0.46-2.78), respectively). Menopausal status, age at menarche, history of spontaneous abortions, drinking or smoking behavior, use of exogenous hormones, or family history of breast cancer did not appreciably alter the observed odds ratios. If infertility has an effect on breast cancer that is independent of age at first birth, then the effect is small.
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PMID:Infertility and breast cancer: a population-based case-control study. 240 11

The present study investigated the relation between the reproductive activity and the risk for cervical and endometrial cancers using both domestic and international materials. An association of increased risk for cervical cancer (C) with fertility at the levels of both an individual and a population was contrasted to another association of increased risk for endometrial cancer (E) with infertility at the same two levels. Both C and E patients experienced a delay of menstrual cycle (over 30 days) at high incidences (35-49%), whereas healthy controls and breast cancer patients were essentially free from such menstrual delay. The possible impact of the above hormonal characteristics of C and E patients on uterine carcinogenesis is discussed in the light of comparative endocrinology.
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PMID:Reproductive activity is a magic spell to connect the genesis of cancers of the uterine cervix and endometrium. 262 38

Tamoxifen, a non-steroidal antioestrogen, represents a significant advance in treatment of female breast cancer. In trials of tamoxifen as postsurgical adjuvant treatment of early breast cancer, disease-free survival is consistently prolonged, representing an enhanced quality of life in association with tamoxifen's favourable adverse effect profile. Moreover, overview analysis indicates a survival benefit of approximately 20% at 5 years for all women, most clearly evident in women over 50 years, while a survival benefit independent of menopausal, nodal or oestrogen receptor status has been demonstrated in some individual trials. Thus, for postmenopausal women, tamoxifen is clearly optimal adjuvant treatment, although the relative benefit of adjuvant chemotherapy in node-negative patients requires clarification. A survival benefit for women under 50 has not been clearly demonstrated in overview analysis, but is not precluded by these rather limited data, and adjuvant treatment of premenopausal women with tamoxifen may also warrant serious consideration. Response rates to tamoxifen in advanced breast cancer are around 30 to 35%, increasing with patient selection for oestrogen receptor positivity. Tamoxifen must be regarded as first-line endocrine treatment in postmenopausal women, and may represent an alternative to first-line ovarian ablation in premenopausal women. An emergent role in primary therapy of elderly and frail patients with operable disease is apparent. Tamoxifen is also of benefit following surgery in male breast cancer, and may have a role as first-line endocrine treatment. Tamoxifen also has a potential role in other hormone-sensitive malignancies such as pancreatic carcinoma, and in treatment of benign breast disease. Finally, tamoxifen has a place in treatment of male and female infertility. because of adverse effects is rarely necessary. The most frequent adverse effects are related to the drug's anti-oestrogenic activity, and include hot flushes, nausea and/or vomiting, vaginal bleeding or discharge, and menstrual disturbances in premenopausal patients. Thus, tamoxifen continues to play a major role in management of female breast cancer in both early and advanced stages of disease, with a place also in treatment of male breast cancer and of infertility.
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PMID:Tamoxifen. A reappraisal of its pharmacodynamic and pharmacokinetic properties, and therapeutic use. 266 Nov 95

Infertility is a major concern in Norwegian society. There is an increase in the demand for treatment of reproductive impairment in many countries today. It is not known if this is due to an increase in the frequency of subfertility. In this study the frequency of permanent unvoluntary childlessness among women participating in a case-control study on breast cancer is 3.2%. Infertility is experienced throughout the reproductive period by 9%, and 15% have sought medical services for infertility problems. These results agree with comparable results in other studies. We discuss the consequences for the amount of infertility health services that will be needed.
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PMID:[Subfertility and infertility. A sample of Norwegian women]. 274 86

To evaluate cancer risk by various causes of infertility, the authors conducted a retrospective cohort study among 2,335 women evaluated for infertility at the Mayo Clinic between 1935 and 1964. Most cancers occurred at expected frequencies, with the exception of cancers of the thyroid (standardized incidence ratio (SIR) = 2.6) and other endocrine glands (SIR = 6.7), although analyses were based on small numbers. Patients with progesterone deficiencies (31 per cent of the study subjects) had a 20 per cent higher cancer risk than did those with other causes of infertility, with excesses deriving primarily from cancers of the lung, cervix, ovary, and thyroid and from melanoma. Breast cancer risk, however, was not elevated in either patients with progesterone deficiencies (SIR = 0.9) or patients with other causes of infertility (SIR = 1.0). Examination of other parameters of infertility, including age at evaluation, type of infertility (primary vs. secondary), and years of attempted conception, showed no elevated risks of breast cancer in any subgroup. These results fail to support previous studies that have linked progesterone deficiencies among infertile women to elevated breast cancer risk. However, the data suggest a possible involvement of a progesterone deficiency in the etiology of other cancers, particularly thyroid cancer and melanoma.
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PMID:Cancer risk after evaluation for infertility. 292 19

The synthetic hormone diethylstilbestrol (DES) was widely prescribed between 1943 and 1971 to minimize pregnancy complications. It has caused serious physical and psychological damage to the women who took it and to their offspring. DES-exposed mothers may suffer a higher incidence of breast cancer, their exposed daughters are at risk for reproductive tract cancers and infertility, and their exposed sons are more likely to have genital abnormalities and reproductive dysfunction. Psychiatric disorders among DES-exposed persons are reportedly twice as common as for nonexposed persons, with anger, anxiety, low self-worth, identity confusion, and guilt the most frequent symptoms. The author describes therapeutic interventions designed to alleviate these problems.
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PMID:Physical and psychological problems associated with exposure to diethylstilbestrol (DES). 327 94

This study, a detailed report of the methods used to conduct the Cancer and Steroid Hormone study, is presented in order to aid other researchers in designing and carrying out multicenter case-control studies. Data collection for the study was carried out by the Division of Reproductive Health of the Centers for Disease Control in 8 locations: Atlanta, Detroit, San Francisco, Seattle, Connecticut, Iowa, New Mexico, and Utah. Case ascertainment, interviewing, and retrieval of pathology slides and medical records were carried out by the Surveillance, Epidemiology, and End Results centers of the National Cancer Institute. Cases were women, aged 20-54, newly diagnosed for breast, ovarian or endometrial cancer between December 1, 1980, and December 31, 1982 -- 20 years after the 1st sales of oral contraceptives in the US. Controls were women aged 20-54, selected by random digit dialing of households with telephones. 1 control was selected for each breast cancer case of matching age and geographic location. Interviewers were trained and administered standardized questionnaires to determine medical, reproductive, and oral contraceptive use histories. To aid in accuracy of recall, respondents recorded dates of major life events in a women's health study calendar. They were also given color photographs of all oral contraceptives marketed in the US. Field personnel collected slides of ovarian and endometrial cancers. Slides of benign breast lesions reported by both cases and controls were collected, as were medical records of women who reported diagnoses of infertility or loss of one or both ovaries. 80% of the breast cancer cases, 70% of the ovarian, and 74% of the endometrial cancer cases were interviewed, as were 83% of the controls. Only 2%, 7%, and 6% of the interviews for the breast, ovarian, and endometrial cancers respectively failed to match the Surveillance, Epidemiology, and End Results data. Retrieval for expert review of the pathology slides of recently diagnosed ovarian or endometrial cancer was 97% and 95%. Retrieval of pathologic proof of benign breast disease, infertility diagnoses, and ovary removal was high for the period after 1970 but low for conditions reported to have occurred before 1950. The study concludes that Surveillance, Epidemiology, and End Results tumor registry records are an excellent source for cancer epidemiology data; that random digit dialing is an effective source of controls; that histologic specimen slides can be retrieved to confirm over 95% of cancer cases interviewed; and that data reported during interviews can be substantiated by medical records for over 75% of study participants.
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PMID:The evaluation of the data collection process for a multicenter, population-based, case-control design. 265 57

To explore further the relation between infertility and breast and female reproductive cancers, cancer incidence among 2,632 Israeli women treated for infertility between 1964 and 1974 was evaluated. Cancer incidence through December 1981 was determined by matching the study cohort to the Israel Cancer Registry. The observed number of cancers was compared with sex-age-ethnic and calendar-year, site-specific national cancer rates. There were 42 cancers observed compared with 37.4 expected, yielding a standardized incidence ratio of 1.1 (95% confidence interval (CI) = 0.8-1.5). Analysis by infertility diagnosis demonstrated no significant excess of total cancer incidence; the standardized incidence ratio was 1.3 (95% CI = 0.8-1.8) for infertility due to hormonal deficiency, 0.7 (95% CI = 0.3-1.4) for mechanical infertility, 1.6 (95% CI = 0.6-3.6) for infertility of the male partner, and 1.1 (95% CI = 0.5-2.2) for unclassified diagnosis. Site-specific analyses revealed a significantly increased risk (8.0; 95% CI = 2.5-19.3; four cases observed, 0.50 expected) of endometrial cancer for the hormonal group and a nonsignificant excess of breast cancer and melanoma. Although numbers were small, women with disorders causing unopposed estrogen production had a risk of 1.4 (95% CI = 0.8-2.2) for all cancer sites, which reached 10.3 (95% CI = 2.6-28.2; three cases observed, 0.29 expected) for endometrial cancer and 1.8 (95% CI = 0.8-3.4; eight cases observed, 4.43 expected) for breast cancer. Among women with nonhormonal infertility, there was a suggestion of increased risks of carcinoma of the ovary (3.2; 95% CI = 0.3-32.9; two cases observed, 0.63 expected) and thyroid (3.0; 95% CI = 0.3-24.6; two cases observed; 0.67 expected). No evidence of an association between ovulation-inducing drugs and cancer was found. This study supports the hypothesis that infertility caused by hormone deficiency is a risk factor for uterine cancer, but is inconclusive regarding breast cancer.
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PMID:Cancer incidence in a cohort of infertile women. 356 53

There is evidence to suggest that breast and thyroid tumors occur together in the same woman more often than would be expected by chance. This study investigates the possibility that various known risk factors for breast cancer also influence the risk of thyroid cancer in women. Female residents of western Washington, in whom papillary, follicular, or mixed thyroid cancer had been diagnosed between 1974 and 1979 (N = 182), were interviewed regarding their medical and reproductive histories. For comparison, a random sample of 389 women from the same population were interviewed. Women who had a history of breast cancer were almost 3 times (95% confidence interval, 0.78-7.9) more likely to develop thyroid cancer than women with no such history. However, a history of breast cancer in a woman's mother did not increase her risk of thyroid cancer. Neither nulliparity, infertility, late age at first full-term pregnancy, early age at menarche, nor a history of abortion or miscarriage before first full-term pregnancy appeared to influence the occurrence of thyroid cancer. Increased weight was associated with an increased risk of thyroid cancer; relative to women who weighed 52 kg or less, those who weighed 60 kg or more had a 2.5-fold elevation in risk. These findings suggest that while cancers of the breast and thyroid are epidemiologically similar in a few ways, there are important differences in a number of their risk factors.
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PMID:Incidence of thyroid cancer in women in relation to known or suspected risk factors for breast cancer. 379 Dec 13

Gonadal steroids are altered by the reproductive system's adaptation to conditioning exercise. Contraceptive options for the athletic woman include all measures appropriate for the sedentary woman. Barrier methods (always with spermicidal jelly) are the preferred choice. The cardiovascular risks, decreased aerobic performance, and shorter time to muscular exhaustion related to oral contraceptives make this a less desirable option. Potential complications from the steroid changes of intense exercise include: low oestrogen and progesterone with risk of loss of trabecular bone and early osteoporosis, and absent progesterone with low normal oestrogen levels associated with risk of endometrial or breast cancer. Therapeutic options for the amenorrhoeic or young athlete include supplemental oral calcium, cyclic oral progesterone, or possibly cyclic physiological oestrogen and progesterone. The anovulatory (usually older) athlete with regular menses needs cyclic progesterone. Medroxyprogesterone 10mg on days 16 to 25 of the cycle or for 10 days monthly can potentially prevent endometrial and breast cancer, give predictable cycles, improve trabecular bone balance and stimulate the return of ovulatory cycles. A practical approach to anovulatory infertility in the athlete includes a 10% reduction in exercise intensity and/or an increase in percentage body fat to 18 to 20%. Cyclic vaginal progesterone (25mg bid) can then treat short luteal phase cycles. With improved understanding of the hormonal adaptations to conditioning exercise, we will be better able to outline contraceptive and therapeutic options in the future.
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PMID:Gonadal steroids in athletic women contraception, complications and performance. 384 58


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