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Polycystic ovarian syndrome (PCOS), related symptoms/sequelae, and breast cancer risk in a population-based case-control study.
Cancer Causes Control 2016; 27(3):403-14CC

Abstract

PURPOSE

Despite the overlap between the clinical symptoms/sequelae of polycystic ovarian syndrome (PCOS) and many known reproductive risk factors for breast cancer, the relationship between PCOS and breast cancer remains unclear, possibly because of the complex heterogeneity and challenges in diagnosing PCOS over time. We hypothesized that PCOS, specific PCOS-related symptoms/sequelae, or clusters of PCOS-related symptoms/sequelae may be differentially associated with pre- versus postmenopausal breast cancer risk.

MATERIALS AND METHODS

Cases were 1,508 women newly diagnosed with a first primary in situ or invasive breast, and the 1,556 population-based controls were frequency-matched by age.

RESULTS

History of physician-diagnosed PCOS was reported by 2.2 % (n = 67), among whom oral contraceptive (OC) use, irregular menstruation, and infertility due to ovulatory dysfunction were common. Using unconditional logistic regression, adjusted odds ratios (95 % CI) for PCOS were increased for premenopausal [2.74 (1.13, 6.63)], but not postmenopausal breast cancer [0.87 (0.44, 1.71)]. We used cluster analysis to investigate whether risk among all women varied by PCOS-related symptoms/sequelae, such as reproductive irregularities, OC use, and components of insulin resistance. In the cluster analysis, odds ratios were elevated among premenopausal women who had a history of OC use and no ovulatory dysfunction [1.39 (1.03, 1.88)], compared to those with fewer number of PCOS-related symptoms/sequelae.

CONCLUSION

PCOS and associated PCOS-related symptoms/sequelae including OC use may play a role in the development of premenopausal breast cancer. Our findings require confirmation in studies with a larger number of premenopausal women with systematically applied diagnostic criteria for PCOS.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, 596 Nonhyun-ro, Gangnam-gu, Seoul, 135-907, South Korea. dr.jykim76@gmail.com. Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA. dr.jykim76@gmail.com. Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA. dr.jykim76@gmail.com.Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA.Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.Glaxo-Smith-Kline, Inc., Singapore, Singapore.Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.Department of Medicine, Columbia University, New York, NY, USA.Department of Epidemiology, Columbia University, New York, NY, USA.Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26797454

Citation

Kim, Jayeon, et al. "Polycystic Ovarian Syndrome (PCOS), Related Symptoms/sequelae, and Breast Cancer Risk in a Population-based Case-control Study." Cancer Causes & Control : CCC, vol. 27, no. 3, 2016, pp. 403-14.
Kim J, Mersereau JE, Khankari N, et al. Polycystic ovarian syndrome (PCOS), related symptoms/sequelae, and breast cancer risk in a population-based case-control study. Cancer Causes Control. 2016;27(3):403-14.
Kim, J., Mersereau, J. E., Khankari, N., Bradshaw, P. T., McCullough, L. E., Cleveland, R., ... Gammon, M. D. (2016). Polycystic ovarian syndrome (PCOS), related symptoms/sequelae, and breast cancer risk in a population-based case-control study. Cancer Causes & Control : CCC, 27(3), pp. 403-14. doi:10.1007/s10552-016-0716-7.
Kim J, et al. Polycystic Ovarian Syndrome (PCOS), Related Symptoms/sequelae, and Breast Cancer Risk in a Population-based Case-control Study. Cancer Causes Control. 2016;27(3):403-14. PubMed PMID: 26797454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polycystic ovarian syndrome (PCOS), related symptoms/sequelae, and breast cancer risk in a population-based case-control study. AU - Kim,Jayeon, AU - Mersereau,Jennifer E, AU - Khankari,Nikhil, AU - Bradshaw,Patrick T, AU - McCullough,Lauren E, AU - Cleveland,Rebecca, AU - Shantakumar,Sumitra, AU - Teitelbuam,Susan L, AU - Neugut,Alfred I, AU - Senie,Ruby T, AU - Gammon,Marilie D, Y1 - 2016/01/21/ PY - 2015/07/31/received PY - 2016/01/09/accepted PY - 2017/03/01/pmc-release PY - 2016/1/23/entrez PY - 2016/1/23/pubmed PY - 2016/9/30/medline KW - Breast cancer KW - Oral contraceptives KW - Polycystic ovarian syndrome KW - Premenopausal SP - 403 EP - 14 JF - Cancer causes & control : CCC JO - Cancer Causes Control VL - 27 IS - 3 N2 - PURPOSE: Despite the overlap between the clinical symptoms/sequelae of polycystic ovarian syndrome (PCOS) and many known reproductive risk factors for breast cancer, the relationship between PCOS and breast cancer remains unclear, possibly because of the complex heterogeneity and challenges in diagnosing PCOS over time. We hypothesized that PCOS, specific PCOS-related symptoms/sequelae, or clusters of PCOS-related symptoms/sequelae may be differentially associated with pre- versus postmenopausal breast cancer risk. MATERIALS AND METHODS: Cases were 1,508 women newly diagnosed with a first primary in situ or invasive breast, and the 1,556 population-based controls were frequency-matched by age. RESULTS: History of physician-diagnosed PCOS was reported by 2.2 % (n = 67), among whom oral contraceptive (OC) use, irregular menstruation, and infertility due to ovulatory dysfunction were common. Using unconditional logistic regression, adjusted odds ratios (95 % CI) for PCOS were increased for premenopausal [2.74 (1.13, 6.63)], but not postmenopausal breast cancer [0.87 (0.44, 1.71)]. We used cluster analysis to investigate whether risk among all women varied by PCOS-related symptoms/sequelae, such as reproductive irregularities, OC use, and components of insulin resistance. In the cluster analysis, odds ratios were elevated among premenopausal women who had a history of OC use and no ovulatory dysfunction [1.39 (1.03, 1.88)], compared to those with fewer number of PCOS-related symptoms/sequelae. CONCLUSION: PCOS and associated PCOS-related symptoms/sequelae including OC use may play a role in the development of premenopausal breast cancer. Our findings require confirmation in studies with a larger number of premenopausal women with systematically applied diagnostic criteria for PCOS. SN - 1573-7225 UR - https://www.unboundmedicine.com/medline/citation/26797454/Polycystic_ovarian_syndrome__PCOS__related_symptoms/sequelae_and_breast_cancer_risk_in_a_population_based_case_control_study_ L2 - https://doi.org/10.1007/s10552-016-0716-7 DB - PRIME DP - Unbound Medicine ER -