Main Article Content
Endometriosis, Breast cancer, Risk factor, Laparoscopy.
Background: Endometriosis is a common chronic inflammatory, estrogen-dependent disease with characteristics similar to cancer. Epidemiological studies of the association between endometriosis and breast cancer have yielded inconsistent results. The present study aimed to investigate the association between endometriosis and breast cancer risk factors.
Methods: This case-control study (with 222 persons in each group) was conducted in Arash Women's Hospital from 2014 to 2017. Women with laparoscopically proven endometriosis were considered as cases. Controls were selected from women who had previous laparoscopic surgery due to any reason, and the absence of endometriosis was confirmed in them.
Results: Multivariate logistic regression analysis by considering the risk factors (age, body mass index, gravidity, age at first pregnancy, age at menarche, history of breast-feeding, history of oral contraceptive and hormone use, history of miscarriage and induced abortion, breast cancer in first-degree relatives, and physical activity) revealed that endometriosis was positively association with age at first pregnancy (OR = 1.16, 95% CI: 1.08-1.25; P < 0.001), history of oral contraceptive use (OR = 3.91, 95% CI: 1.92-7.95; P <0.001), and history of hormone use (OR = 5.82, 95% CI: 2.70-12.56; P <0.001), and negatively associated with gravidity (OR = 0.61, 95% CI: 0.42-0.91; P = 0.01), and history of breast-feeding (OR = 0.37, 95% CI: 0.16-0.86; P = 0.02).
Conclusion: Women with endometriosis have some of the breast cancer risk factors in their history, and these risk factors (gravidity, age at first pregnancy, history of breast-feeding, and OCP or hormone use) can change the risk of endometriosis as they increase or decrease the risk of breast cancer.
2. Kokcu A. Relationship between endometriosis and cancer from current perspective. Arch Gynecol Obstet. 2011;284(6):1473-9.
3. Swiersz LM. Role of endometriosis in cancer and tumor development. Ann N Y Acad Sci. 2002;955:281-92; discussion 93-5, 396-406.
4. Boruban MC, Jaishuen A, Sirisabya N, Li Y, Zheng HG, Deavers MT, et al. Ovarian endometriosis associated with carcinoma and sarcoma: case report. Eur J Gynaecol Oncol. 2008;29(4):393-6.
5. Efthymiou CA. Endometriosis-associated intestinal tumours: a consequence of long-term unopposed oestrogen? Ann R Coll Surg Engl. 2009;91(3):259-60.
6. Vlahos NF, Economopoulos KP, Fotiou S. Endometriosis, in vitro fertilisation and the risk of gynaecological malignancies, including ovarian and breast cancer. Best Pract Res Clin Obstet Gynaecol. 2010;24(1):39-50.
7. Sznurkowski JJ, Emerich J. Endometriomas are more frequent on the left side. Acta Obstet Gynecol Scand. 2008;87(1):104-6.
8. Brinton LA, Gridley G, Persson I, Baron J, Bergqvist A. Cancer risk after a hospital discharge diagnosis of endometriosis. Am J Obstet Gynecol. 1997;176(3):572-9.
9. Schairer C, Persson I, Falkeborn M, Naessen T, Troisi R, Brinton LA. Breast cancer risk associated with gynecologic surgery and indications for such surgery. Int J Cancer. 1997;70(2):150-4.
10. Bertelsen L, Mellemkjaer L, Frederiksen K, Kjaer SK, Brinton LA, Sakoda LC, et al. Risk for breast cancer among women with endometriosis. Int J Cancer. 2007;120(6):1372-5.
11. Melin A, Sparen P, Persson I, Bergqvist A. Endometriosis and the risk of cancer with special emphasis on ovarian cancer. Hum Reprod. 2006;21(5):1237-42.
12. Moseson M, Koenig KL, Shore RE, Pasternack BS. The influence of medical conditions associated with hormones on the risk of breast cancer. Int J Epidemiol. 1993;22(6):1000-9.
13. Weiss HA, Brinton LA, Potischman NA, Brogan D, Coates RJ, Gammon MD, et al. Breast cancer risk in young women and history of selected medical conditions. Int J Epidemiol. 1999;28(5):816-23.
14. Olson JE, Cerhan JR, Janney CA, Anderson KE, Vachon CM, Sellers TA. Postmenopausal cancer risk after self-reported endometriosis diagnosis in the Iowa Women's Health Study. Cancer. 2002;94(5):1612-8.
15. Matalliotakis IM, Cakmak H, Mahutte N, Goumenou AG, Koumantakis G, Arici A. The familial risk of breast cancer in women with endometriosis from Yale series. Surg Oncol. 2008;17(4):289-93.
16. Mousavi SM, Gouya MM, Ramazani R, Davanlou M, Hajsadeghi N, Seddighi Z. Cancer incidence and mortality in Iran. Ann Oncol. 2009;20(3):556-63.
17. Montazeri A, Vahdaninia M, Harirchi I, Harirchi AM, Sajadian A, Khaleghi F, et al. Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods. Asia Pac Fam Med. 2008;7(1):6.