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Prenatal Diethylstilbestrol Exposure and Risk of Breast Cancer
Ist Teil von
Cancer epidemiology, biomarkers & prevention, 2006-08, Vol.15 (8), p.1509-1514
Ort / Verlag
Philadelphia, PA: American Association for Cancer Research
Erscheinungsjahr
2006
Quelle
MEDLINE
Beschreibungen/Notizen
It has been hypothesized that breast cancer risk is influenced by prenatal hormone levels. Diethylstilbestrol (DES), a synthetic
estrogen, was widely used by pregnant women in the 1950s and 1960s. Women who took the drug have an increased risk of breast
cancer, but whether risk is also increased in the daughters who were exposed in utero is less clear. We assessed the relation of prenatal DES exposure to risk of breast cancer in a cohort of DES-exposed and
unexposed women followed since the 1970s by mailed questionnaires. Eighty percent of both exposed and unexposed women completed
the most recent questionnaire. Self-reports of breast cancer were confirmed by pathology reports. Cox proportional hazards
regression was used to compute incidence rate ratios (IRR) for prenatal DES exposure relative to no exposure. During follow-up,
102 incident cases of invasive breast cancer occurred, with 76 among DES-exposed women (98,591 person-years) and 26 among
unexposed women (35,046 person-years). The overall age-adjusted IRR was 1.40 [95% confidence interval (95% CI), 0.89-2.22].
For breast cancer occurring at ages ≥40 years, the IRR was 1.91 (95% CI, 1.09-3.33) and for cancers occurring at ages ≥50
years, it was 3.00 (95% CI, 1.01-8.98). Control for calendar year, parity, age at first birth, and other factors did not alter
the results. These results, from the first prospective study on the subject, suggest that women with prenatal exposure to
DES have an increased risk of breast cancer after age 40 years. The findings support the hypothesis that prenatal hormone
levels influence breast cancer risk. (Cancer Epidemiol Biomarkers Prev 2006;15(8):1509–14)