Antibiotic exposure and risk of breast cancer: A causal association or a skyfall?

e12524 Background: Although it has long been hypothesized that the use of antibiotics may increase the risk of breast cancer, through effects on inflammation, immunity and gastrointestinal microflora that alter the metabolism of phytochemicals, clinical data on this association are sparse. Methods: Matched case-control study among 158 women with newly diagnosed primary invasive breast cancer from a single cancer unit and 158 age-matched controls (± 12 months) from healthy individuals accompanying patients to the outpatient clinics between January 1, 2006 and December 30, 2007. Clinical examination and a standard questionnaire for the collection of baseline characteristics and known aggravating factors, such as body mass index, smoking, age of menarche and menopause, parity, breastfeeding, history of respiratory, urinary or other infections and previous estrogen use, were carried out in all individuals. All antibiotic classes, such as β-lactams, amoxyl and clavulanic acid, cephalosporins, macrolides, quinolones, tetracyclines, trimethoprim, clindamycin and imidazoles, were recorded. Type of antibiotic and dose was ascertained from health insurance’s pharmacy records. Data were analyzed using multivariable conditional logistic regression models including adjustments for potential confounding factors. Results: The age matched groups of patients and controls were found to have statistically significant differences in the considered parameters such as delayed age of menopause, less parity and less smoking in the control group and more antibiotic intake in the patient population. The cumulative use for more than 21 days of any antibiotic classes were found to statistically significant correlate with increased risk of breast cancer [odds ratio(OR):3.5, 95%confidence interval(CI):1.7-7.3, p=0.001]. By subanalyses according to antibiotic class this increased risk was mainly associated with β-lactams (OR:11.4, 95%CI:3.8, 34.1, p<0.001) and less with macrolides (OR:2.8, 95%CI:1.1-7.5, p=0.039). Conclusions: Our study links β-lactam and macrolide consumption with increased breast cancer risk but further investigation of this association in large cohorts together with exploration of the underlying cause are needed.

Download Full-text

Insulin Resistance and Inflammation in Black Women with and without Breast Cancer: Cause for Concern

Ethnicity & Disease ◽

10.18865/ed.26.4.513 ◽

2016 ◽

Vol 26 (4) ◽

pp. 513 ◽

Cited By ~ 2

Author(s):

Kathleen A. Griffith ◽

Seon Yoon Chung ◽

Shijun Zhu ◽

Alice S. Ryan

Keyword(s):

Breast Cancer ◽

Insulin Resistance ◽

Black Women ◽

White Women ◽

Cancer Recurrence ◽

Control Group ◽

Study Objective ◽

Increased Risk ◽

Tnf Α ◽

History Of

Objective: After chemotherapy for breast cancer, Black women gain more weight and have an increased mortality rate compared with White women. Our study objective was to compare biomarkers associated with obesity in Black women with and without a history of breast cancer.Design: Case-controlSetting: Academic/federal institutionParticipants: Black women with a history of breast cancer (cases) and age-matched controls.Methods: We compared insulin resistance, inflammation, and lipids in overweight and obese Black women with a history of breast cancer (n=19), age similar controls (n=25), and older controls (n=32). Groups did not differ on mean body mass index (BMI), which was 35.4 kg/m2, 36.0 kg/m2, and 33.0 kg/m2, respectively.Main Outcome Measures: Insulin resistance (HOMA-IR); inflammation (TNF-α, IL-1b, IL-6, IL-8, CRP); lipids (cholesterol, triglycerides).Results: Cases had 1.6 and 1.38 times higher HOMA-IR values compared with age similar and older controls, respectively (P≤.001 for both). TNF-α and IL-1b were significantly higher in cases compared with both control groups (P<.001 for both). IL-6 was also higher in cases compared with age-similar controls (P=.007), and IL-8 was lower in cases compared with older controls (P<.05). Lipids did not differ between cases and either control group.Conclusions: Black women with breast cancer were significantly more insulin resistant with increased inflammation compared not only with age similar controls but with women who were, on average, a decade older. These biomarkers of insulin resistance and inflammation may be associated with increased risk of breast cancer recurrence and require ongoing evaluation, especially given the relatively abnormal findings compared with the controls in this underserved group. Ethn Dis. 2016;26(4):513-520; doi:10.18865/ed.26.4.513

Download Full-text

The Relationship of Drug Abuse to Unexplained Sudden Death

Archives of Pathology & Laboratory Medicine ◽

10.5858/132.12.1903 ◽

2008 ◽

Vol 132 (12) ◽

pp. 1903-1906

Author(s):

Amy C. Gruszecki ◽

Gerald McGwin, Jr ◽

C. Andrew Robinson, Jr ◽

Gregory G. Davis

Keyword(s):

Drug Abuse ◽

Cause Of Death ◽

Control Group ◽

Manner Of Death ◽

Increased Risk ◽

History Of ◽

Matched Case ◽

Relationship Of ◽

The Relationship ◽

Control Study

Abstract Context.—Forensic pathologists regularly investigate the deaths of individuals with a history of drug abuse. Autopsy, including toxicology testing, reveals no cause for death in a subset of this cohort. Objective.—To determine whether deaths with an undetermined cause and manner of death are associated with a history of drug abuse. Design.—Retrospective matched case-control study of 52 decedents whose cause of death remained undetermined following autopsy, matched 1:2 to a control group of living patients admitted for cholecystectomy according to age and date of death or procedure. Results.—Individuals whose cause of death was undetermined were 5.3 times (95% confidence interval, 1.9– 14.5) more likely to have a history of drug abuse than were patients with cholecystitis. Conclusions.—Decedents with a history of chronic drug abuse appear to be at an increased risk of dying by their chronic drug abuse, even in the absence of any anatomical or toxicologic finding at autopsy to account for death.

Download Full-text

HUBUNGAN FAKTOR REPRODUKSI DENGAN KEJADIAN KANKER PAYUDARA PADA WANITA DI RSUP DR. M. DJAMIL PADANG

Jurnal Riset Hesti Medan Akper Kesdam I/BB Medan ◽

10.34008/jurhesti.v3i2.45 ◽

2018 ◽

Vol 3 (2) ◽

pp. 58

Author(s):

Sukmayenti Sukmayenti ◽

Nirmala Sari

Keyword(s):

Breast Cancer ◽

At Risk ◽

Reproductive Factors ◽

Bivariate Analysis ◽

Control Group ◽

Case Group ◽

Major Health Problem ◽

Risk Parity ◽

History Of ◽

Age Of Menarche

Breast cancer is a non-contagious disease, currently a major health problem both in the world and in Indonesia. The incidence of breast cancer is believed to be related to several risk factors. This study aims to determine the relationship of reproductive factors (age of menarche, parity and history of breastfeeding) with the incidence of breast cancer in women. Case control research was carried out at DR. M. Djamil Padang with univariate and bivariate analysis using Chi-square test. Of the 72 samples (36 cases and 36 controls) it was found that respondents with menarche age were 80.6% at risk in the case group and 19.4% in the control group, respondents with risk parity were 33.3% in the case group and 66 , 7% in the control group, respondents with a breastfeeding history were at risk of 65.6% in the case group and 34.4% in the control group. There is a relationship between age of menarche and history of breastfeeding with the incidence of breast cancer. There is no relationship between parity and the incidence of breast cancer. Strengthen health promotion efforts as an effort to prevent breast cancer.Keywords: Reproductive factors, breast cancer

Download Full-text

Exposure to airborne cadmium and breast cancer stage, grade and histology at diagnosis: findings from the E3N cohort study

Scientific Reports ◽

10.1038/s41598-021-01243-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Amina Amadou ◽

Delphine Praud ◽

Thomas Coudon ◽

Aurélie M. N. Danjou ◽

Elodie Faure ◽

...

Keyword(s):

Breast Cancer ◽

Conditional Logistic Regression ◽

Positive Association ◽

Cadmium Exposure ◽

Tubular Carcinoma ◽

Logistic Regression Models ◽

Increased Risk ◽

Estrogenic Properties ◽

Nested Case Control

AbstractMolecular studies suggest that cadmium due to its estrogenic properties, might play a role in breast cancer (BC) progression. However epidemiological evidence is limited. This study explored the association between long-term exposure to airborne cadmium and risk of BC by stage, grade of differentiation, and histological types at diagnosis. A nested case–control study of 4401 cases and 4401 matched controls was conducted within the French E3N cohort. A Geographic Information System (GIS)-based metric demonstrated to reliably characterize long-term environmental exposures was employed to evaluate airborne exposure to cadmium. Multivariable adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. There was no relationship between cadmium exposure and stage of BC. Also, no association between cadmium exposure and grade of differentiation of BC was observed. However, further analyses by histological type suggested a positive association between cadmium and risk of invasive tubular carcinoma (ITC) BC [ORQ5 vs Q1 = 3.4 (95% CI 1.1–10.7)]. The restricted cubic spline assessment suggested a dose–response relationship between cadmium and ITC BC subtype. Our results do not support the hypothesis that airborne cadmium exposure may play a role in advanced BC risk, but suggest that cadmium may be associated with an increased risk of ITC.

Download Full-text

Evaluation of female breast cancer risk among the betel quid chewer: A bio-statistical assessment in Assam, India

Nepal Journal of Epidemiology ◽

10.3126/nje.v5i2.12832 ◽

2015 ◽

Vol 5 (2) ◽

pp. 494-498 ◽

Cited By ~ 1

Author(s):

Nijara Rajbongshi ◽

Lipi B Mahanta ◽

Dilip C Nath

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Family Income ◽

Conditional Logistic Regression ◽

Female Breast Cancer ◽

Betel Quid ◽

P Value ◽

Female Population ◽

Logistic Regression Models ◽

Matched Case

Background: Breast cancer is the most commonly diagnosed cancer among the female population of Assam, India. Chewing of betel quid with or without tobacco is common practice among female population of this region. Moreoverthe method of preparing the betel quid is different from other parts of the country.So matched case control study is conducted to analyse whetherbetel quid chewing plays a significant role in the high incidence of breast cancer occurrences in Assam. Methods and Material: Here, controls are matched to the cases by age at diagnosis (±5 years), family income and place of residence with matching ratio 1:1. Conditional logistic regression models and odd ratios (OR) was used to draw conclusions. Results: It is observed that cases are more habituated to chewing habits than the controls.Further the conditional logistic regression analysis reveals that betel quid chewer faces 2.353 times more risk having breast cancer than the non-chewer with p value 0.0003 (95% CI 1.334-4.150). Conclusion:Though the female population in Assam usually does not smoke, the addictive habits typical to this region have equal effect on the occurrence of breast cancer.DOI: http://dx.doi.org/10.3126/nje.v5i2.12832Nepal J Epidemiol. 2015;5(2); 494-498.

Download Full-text

Examining the Etiology of Early-Onset Breast Cancer in the Canadian Partnership for Tomorrow’s Health (CanPath)

10.21203/rs.3.rs-312244/v1 ◽

2021 ◽

Author(s):

Joy Pader ◽

Robert B. Basmadjian ◽

Dylan E. O’Sullivan ◽

Nicole E. Mealey ◽

Yibing Ruan ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Early Onset ◽

Vegetable Consumption ◽

Conditional Logistic Regression ◽

Breast Cancer Incidence ◽

Health Study ◽

Early Onset Breast Cancer ◽

Increased Risk ◽

History Of

Abstract Purpose: Breast cancer incidence among younger women (under age 50) has increased over the past 25 years, yet little is known about the etiology among this age group. The objective of this study was to investigate relationships between modifiable and non-modifiable risk factors and early-onset breast cancer among three prospective Canadian cohorts.Methods: A matched case-control study was conducted using data from Alberta’s Tomorrow Project, BC Generations Project, and the Ontario Health Study. Participants diagnosed with breast cancer before age 50 were identified through provincial registries and matched to three control participants of similar age and follow-up. Conditional logistic regression was used to examine the association between factors and risk of early-onset breast cancer. Results: In total, 609 cases and 1,827 controls were included. A body mass index ≥30kg/m2 was associated with a lower risk of early-onset breast cancer (OR=0.65; 95% CI: 0.47-0.90), while a waist circumference ≥88 cm was associated with an increased risk (OR=1.40; 95% CI: 1.06-1.84). A reduced risk was found for women with ≥2 pregnancies (OR=0.80; 95% CI: 0.64-1.00) and a first-degree family history of breast cancer was associated with an increased risk (OR=2.06; 95% CI: 1.54-2.75).Conclusions: In this study, measures of adiposity, pregnancy history, and familial history of breast cancer are important risk factors for early-onset breast cancer. Evidence was insufficient to conclude if smoking, alcohol intake, fruit and vegetable consumption, and physical activity are meaningful risk factors. The results of this study could inform targeted primary and secondary prevention for early-onset breast cancer.

Download Full-text

Exposure to airborne cadmium and breast cancer stage, grade and histology at diagnosis: Findings from the E3N cohort study

10.21203/rs.3.rs-278246/v1 ◽

2021 ◽

Author(s):

Amina Amadou ◽

Delphine Praud ◽

Thomas Coudon ◽

Aurélie M N Danjou ◽

Elodie Faure ◽

...

Keyword(s):

Breast Cancer ◽

Conditional Logistic Regression ◽

Epidemiological Studies ◽

Cadmium Exposure ◽

Tubular Carcinoma ◽

Logistic Regression Models ◽

Airborne Exposure ◽

Increased Risk ◽

Multivariable Analyses ◽

Nested Case Control

Abstract Purpose Molecular and cellular studies reported a role of cadmium in risk of advanced breast cancer (BC). However epidemiological evidence is limited. Our previous study suggests that cadmium might be related to a decreased risk of ER- and ER-PR- breast tumors. In this study, we further explored the association between long-term exposure to airborne cadmium and risk of BC by stage, grade of differentiation, and histological types at diagnosis. Methods A nested case-control study of 4,401 cases and 4,401 matched controls was conducted within the French E3N cohort. A Geographic Information System (GIS) based metric was employed to evaluate outdoor airborne exposure to cadmium. Multivariable adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. Results There was no statistically significant association between cadmium exposure and stage of BC in the multivariable analyses. The adjusted ORs for the fifth versus first quintile were 1.02 (95% CI: 0.83–1.25), 1.11 (95% CI: 0.84–1.49), and 0.67 (95% CI: 0.37–1.24) for stages I, II, and III-IV BC, respectively. The subgroup analyses showed no statistically significant association between cadmium exposure and grade of differentiation of BC at diagnosis. However, further analyses by histological type suggested a positive dose-response association between cadmium and risk of invasive tubular carcinoma (ITC) BC (OR for the fifth versus first quintile = 3.44 (95% CI: 1.10–10.7)). Conclusions Our results do not support the hypothesis that airborne cadmium exposure may have a role in advanced BC risk, but suggest that cadmium may be associated with an increased risk of ITC. However, these results should be considered with caution, and more epidemiological studies are needed to confirm our findings and to improve our understanding of the effects of cadmium exposure according to several clinic-pathological characteristics of BC.

Download Full-text

Prior Bariatric Surgery in COVID-19 Positive Patients May Be Protective

10.1101/2020.12.29.20248991 ◽

2021 ◽

Author(s):

Megan Jenkins ◽

Gabrielle Maranga ◽

G. Craig Wood ◽

Christopher M. Petrilli ◽

Christine Ren-Fielding

Keyword(s):

Bariatric Surgery ◽

Mechanical Ventilation ◽

Length Of Stay ◽

Emergency Room ◽

Conditional Logistic Regression ◽

The Body ◽

Control Group ◽

Cross Sectional ◽

Increased Risk ◽

History Of

IntroductionPatients infected with novel COVID-19 virus have a spectrum of illnesses ranging from asymptomatic to death. Data has shown that age, gender and obesity are strongly correlated with poor outcomes in COVID-19 positive patients. Bariatric surgery is the only treatment that provides significant, sustained weight loss in the severely obese. We look at whether prior bariatric surgery correlates with increased risk of hospitalization and outcome severity after COVID-19 infection.MethodsA cross-sectional retrospective analysis of a COVID-19 database from a single, NYC-based, academic institution was conducted. A cohort of COVID-19 positive patients with a history of bariatric surgery (n=124) were matched in a 4:1 ratio to a control cohort of COVID-19 positive patients who were eligible for bariatric surgery (BMI ≥40 kg/m2 or BMI ≥35 kg/m2 with a comorbidity) (n=496). A comparison of outcomes, including mechanical ventilation requirements and deceased at discharge, was done between cohorts using Chi-square test or Fisher’s exact test. Additionally, overall length of stay and duration of time in ICU were compared using Wilcoxon Rank Sum test. Conditional logistic regression analyses were done to determine both unadjusted (UOR) and adjusted odds ratios (AOR).ResultsA total of 620 COVID-19 positive patients were included in this analysis. The categorization of bariatric surgeries included 36% Roux-en-Y Gastric Bypass (RYGB, n=45), 35% laparoscopic adjustable gastric banding (LAGB, n=44), and 28% laparoscopic sleeve gastrectomy (LSG, n=35). The body mass index (BMI) for the bariatric group was 36.1 kg/m2 (SD=8.3), which was significantly lower than the control group, 41.4 kg/m2 (SD=6.5) (p<0.0001). There was also less burden of diabetes in the bariatric group (32%) compared to the control group (48%) (p=0.0019). Patients with a history of bariatric surgery were less likely to be admitted through the emergency room (UOR=0.39, p=0.0001), less likely to have had a ventilator used during the admission (UOR=0.42, p=0.028), had a shorter length of stay in both the ICU (p=0.033) and overall (UOR=0.44, p=0.0002), and were less likely to be deceased at discharge compared to the control group (OR=0.42, p=0.028).ConclusionA history of bariatric surgery significantly decreases the risk of emergency room admission, mechanical ventilation, prolonged ICU stay, and death in patients with COVID-19.

Download Full-text

A Case Report of Germline Compound Heterozygous Mutations in the BRCA1 Gene of an Ovarian and Breast Cancer Patient

International Journal of Molecular Sciences ◽

10.3390/ijms22020889 ◽

2021 ◽

Vol 22 (2) ◽

pp. 889

Author(s):

Ava Kwong ◽

Cecilia Y. S. Ho ◽

Vivian Y. Shin ◽

Chun Hang Au ◽

Tsun Leung Chan ◽

...

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Brca1 Gene ◽

Pathogenic Mutation ◽

Compound Heterozygous ◽

Strong Family History ◽

Breast And Ovarian Cancer ◽

Pathogenic Mutations ◽

Increased Risk ◽

History Of

The germline carrier of the BRCA1 pathogenic mutation has been well proven to confer an increased risk of breast and ovarian cancer. Despite BRCA1 biallelic pathogenic mutations being extremely rare, they have been reported to be embryonically lethal or to cause Fanconi anemia (FA). Here we describe a patient who was a 48-year-old female identified with biallelic pathogenic mutations of the BRCA1 gene, with no or very subtle FA-features. She was diagnosed with ovarian cancer and breast cancer at the ages of 43 and 44 and had a strong family history of breast and gynecological cancers.

Download Full-text

Estrogens and Progestogens in Triple Negative Breast Cancer: Do They Harm?

Cancers ◽

10.3390/cancers13112506 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2506

Author(s):

Mark van Barele ◽

Bernadette A. M. Heemskerk-Gerritsen ◽

Yvonne V. Louwers ◽

Mijntje B. Vastbinder ◽

John W. M. Martens ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative ◽

Hormone Replacement ◽

Breast Cancers ◽

Younger Women ◽

Alternative Pathways ◽

Increased Risk ◽

History Of ◽

Hormone Sensitive

Triple-negative breast cancers (TNBC) occur more frequently in younger women and do not express estrogen receptor (ER) nor progesterone receptor (PR), and are therefore often considered hormone-insensitive. Treatment of premenopausal TNBC patients almost always includes chemotherapy, which may lead to premature ovarian insufficiency (POI) and can severely impact quality of life. Hormone replacement therapy (HRT) is contraindicated for patients with a history of hormone-sensitive breast cancer, but the data on safety for TNBC patients is inconclusive, with a few randomized trials showing increased risk-ratios with wide confidence intervals for recurrence after HRT. Here, we review the literature on alternative pathways from the classical ER/PR. We find that for both estrogens and progestogens, potential alternatives exist for exerting their effects on TNBC, ranging from receptor conversion, to alternative receptors capable of binding estrogens, as well as paracrine pathways, such as RANK/RANKL, which can cause progestogens to indirectly stimulate growth and metastasis of TNBC. Finally, HRT may also influence other hormones, such as androgens, and their effects on TNBCs expressing androgen receptors (AR). Concluding, the assumption that TNBC is completely hormone-insensitive is incorrect. However, the direction of the effects of the alternative pathways is not always clear, and will need to be investigated further.

Download Full-text