DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20194371

Hormonal risk factors for breast cancer in Morocco: case-control study

Drissi Houda, Imad Fatima Ezzahra, Bendahhou Karima, Benider Abdelatif, Radallah Driss

Abstract


Background: The purpose of the study is to investigate hormonal risk factors and their impact on the development of this cancer.

Methods: This is a case-control study conducted at the Mohammed VI Centre for Cancer Treatment in Casablanca.

Results: The average age of the patients is 50.43 years with a standard deviation of 11.21. Exposure to endogenous estrogens appears to have an impact on the occurrence of breast cancer in the population. The early age of menarche in patients is on average 13.31±1.69 years compared to 13.65±1.54 years in controls, with a significant difference (p = 0.01). Parity is on average 2.54 children in cases versus 2.94 in controls with a significant difference (p = 0.02). Regarding the distribution of the cumulative duration of breastfeeding, 19.3% of patients compared to 12.3% of controls breastfed their children for less than one year; 80.7% of cases compared to 87.7% of controls breastfed their children for more than one year (OR=0.58; 95% CI: 0.35 - 0.97; P trend=0.03). In addition, hypovitaminosis D was noted in 2.3% of patients compared to 0.3% of controls with OR=7.14; 95% CI: 0.87 - 58.39; P trend=0.06. In addition, the supply of exogenous estrogen would also be incriminated. The risk of breast cancer appears to be influenced mainly by oral contraceptive use, which was found in 60% of cases vs. 41.3% of controls with OR=2.07; 95% CI: 1.50 - 2.86; P trend=0.0001.

Conclusions: The results highlighted that breast cancer risk is highly dependent on early and prolonged exposure to estrogenic impregnation. This effect would be modulated by ovarian activity, puberty or menopause age, parity and breastfeeding.


Keywords


Breast cancer, Case-control study, Hormonal factors, Hypovitaminosis D, History of hormone therapy, Morocco

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References


Tazi MA, Benjaafar N, Raki A. Cancer incidence in Rabat, Morocco: 2006-2008. Ecancermedicalscience. 2013;7:338.

Benider A, Othmani BM, Harif M, Karkouri M, Quessar A, Sahraoui S, et al. Registre des cancers de la région du Grand Casablanca, Année. 2004;2007.

Nkondjock A, Ghadirian P. Risk factors for breast cancer. Medical Sciences. 2005;21(2):175-80.

Odermatt, R. Wolfer, A. Zaman, K. Hormone therapy in breast cancer: efficacy and adverse effects. Rev Med Switzerland. 2013;9:1090-4.

Chapelon C, Touillaud F, Fournier MA. What risks, for which women? Breast cancer risk factors; 30th SFSPM days, La Baule. 2008.

Russo J, Hu Yf, Yang X, Russo IH. Developmental, cellular, and molecular basis of human breast cancer. J Natl Cancer InstMonogr. 2000;8:17-37.

Mathelin C, Guldenfels C, Croce S. Epithelial breast lesions with atypia: diagnostic, therapeutic and monitoring management. Therapeutic Medicine. 2009;15(4):312-21.

Lesieur B, Vercambre M, Dubernard G, Khosrotehrani K, Uzan S, Aractingi S, Rouzier R. Risk of pregnancy-related breast cancer. J Obstet Gynecol Repro Biol. 2008;37(1):77-81.

Kelsey JL. A review of the epidemiology of human breast cancer. Epidemiol Rev. 1979;1:74-109.

Ramon JM, Escriba JM, Casas I, Benet J, Iglesias C, Gavalda L, et al. Age at first full-term pregnancy, lactation and parity and risk of breast cancer: a case-control study in Spain. Eur J Epidemiol. 1996;12(5):449-53.

Freund C, Mirabel L, Annane K, Mathelin C. Breastfeeding and breast cancer. Gynecol Obst Fertility. 2005;33(10):739-44.

Kwan, Marilyn L, Bernard, Philip S, Kroenke, Candyce H. Breastfeeding, PAM50 tumor subtype, and breast cancer prognosis and survival. J National Cancer Institute. 2015;107:7-087.

Helewa M, Levesque P, Provencher D. Breast cancer, pregnancy and lactation. J Obstet Gynaecol Can. 2002;24(2):164-71.

Engel P, Fagherazzi G, Boutten A, Dupré T, Mesrine S, Ruault MC, Chapelon CF. Serum 25(OH) vitamin D and risk of breast cancer: a nested case-control study from the French E3N cohort. Cancer Epidemiol Biomarkers Prev. 2010;19(9):2341-50.

Morère JF, Penault LF, Aapro MS, Salmon R. Le cancer du sein. Springer Sci Business Media. 2008;316:25-6.

Agence française de sécurité sanitaire des produits de santé. Traitement hormonal substitutif de la ménopause, 2005. Available at https://www.ansm.sante.fr/var/ansm_site/storage/original/application/9f6f8e565b5c23b497549ef4c50b2fe2.pdf. Accessed on 9 June 2019.

Reeves GK, Beral V, Green VT, Gathani D. Million women study collaborators hormonal therapy for menopause and breast-cancer risk by histological type: a cohort study and meta-analysis. Lancet Oncol. 2006;7(11):910-8.

Chlebowski RT, Hendrix SL, Langer RD. Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the women’s health initiative randomized trial. JAMA. 2003;289(24):3243-53.

Cogliano V, Grosse Y, Baan R. Carcinogenicity of combined oestrogen-progestagen contraceptives and menopausal treatment. Lancet Oncol. 2005;6(8):552-3.

Mosekilde L. Vitamin D and the elderly. Clin Endocrinol. 2005;62:265-81.

Mohr SB. Meta-analysis of Vitamin D sufficiency for improving survival of patients with breast cancer. Anticancer Research. 2014;34:1163-6.

Krishnan AV, Swami S, Peng L, Wang J, Moreno J, Feldman D. Tissue-selective regulation of aromatase expression by calcitriol: implications for breast cancer therapy. Endocrin. 2010 ;151(1):32-42.