Patient X was diagnosed with Stage 3 right sided triple-negative breast cancer (TNBC). TNBC is a breast cancer subtype that demonstrates the absence of oestrogen receptor and progesterone receptor and no overexpression of human epidermal growth factor receptor 2 (HER2).
Breast cancer is the most frequently diagnosed malignancy in women worldwide. TNBC accounts for 10-25% of invasive cases and is the second most common subtype.2 This more aggressive subtype is associated with high mortality and inadequate therapeutic options.
Therefore, to provide critical strategies for TNBC prevention, the need to identify specific risk factors is of utmost importance. The risk of developing breast cancer is largely linked to reproductive factors such as breastfeeding. Breast milk is the natural first food for new-borns which provides the ideal amount of energy and nutrients for infants.
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Women breastfeed only after they have given birth to a child, and the earlier they begin childbearing, the more children they have and the longer their duration of breastfeeding. This exemplifies the close relation that breastfeeding has with other aspects of childbearing.
This poster will focus on the association of breastfeeding, mainly the duration of breastfeeding and the overall risk of breast cancer. Several studies have shown that breastfeeding, particularly for an extended period, may be associated with a lowered risk of breast cancer.3 Table 1 shows that women who breastfed experienced a reduced risk of developing breast cancer as opposed to women that have never breastfed, by a percentage of 22% (odds ratio, OR = 0.78; 95% confidence interval, CI = 0.74-0.82).
The indirect relationship between breastfeeding and the risk of developing breast cancer is apparent as women breastfeed only after they have given birth and the lifetime duration of breastfeeding increases with increasing parity.4In a pooled analysis of 50 302 carcinoma cases from 47 epidemiological studies conducted in 30 countries, it was revealed that the relative risk of breast cancer declines with increasing duration of breastfeeding, the estimated reduction in the relative risk per 12 months of breastfeeding being 4.3% (Figure 1).4 In a recent report, Ma et al.6, showed a 31% risk reduction of TNBC in parous women who breastfed for at least one year compared to parous women who had never breastfed (OR = 0.69; 95CI = 0.50–0.96).Prolonged breastfeeding significantly reduces the risk of breast cancer and this protective effect was supported by a dose–response relationship (Figure 2). There is a significant inverse association between the duration of breastfeeding and the risk of breast cancer. The adjusted odds ratios for women who breastfed for 12–23, 24–35 and 36–47 months were 0.34 (95%CI = 0.13-0.85), 0.13 (95%CI = 0.04-0.36) and 0.06 (95%CI = 0.02-0.20), respectively when compared to women who breastfed for 0–11 months.
Women who breastfed for 12–23 months relative to 0–11 months of breastfeeding including those that had never breastfed revealed to have a 66.3% reduction in breast cancer risk.5A significant inverse association between breastfeeding and the risk of breast cancer has now been consistently observed across numerous studies and could account for almost two-thirds of this estimated reduction in breast cancer incidence. It was found that the longer the duration of breastfeeding, the greater the protective effect against breast cancer.5Furthermore, breastfeeding could be of great significance and complement other risk reduction strategies in women, such as sustained weight management.
This poster might have been able to help patient X by providing prevention recommendations for breast cancer if she had read it prior to her diagnosisIn isues4life5, it is difficult to isolate the independent contribution of breastfeeding on breast cancer risk reduction due to the relationship between breastfeeding and other risk factors such as parity, anovulation, and adiposity as well as other reproductive factors.
