The Possible Association between IVF and Breast Cancer Incidence

Background The possible association between ovulation-inducing drugs and breast cancer development has been debated. Our aim was to evaluate the incidence of breast cancer in a cohort of women exposed to in vitro fertilization (IVF). Methods A retrospective cohort analysis was performed by linkage o...

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Bibliographic Details
Published in:Annals of surgical oncology 2008-04, Vol.15 (4), p.1048-1055
Main Authors: Pappo, I., Lerner-Geva, L., Halevy, A., Olmer, L., Friedler, S., Raziel, A., Schachter, M., Ron-El, R.
Format: Article
Language:English
Subjects:
Adult
Breast cancer
Breast Neoplasms - epidemiology
Breast Neoplasms - etiology
Breast Oncology
Female
Fertility Agents, Female - adverse effects
Fertilization in Vitro - adverse effects
Humans
Incidence
Infertility, Female - therapy
Medicine
Medicine & Public Health
Middle Aged
Oncology
Ovulation Induction - adverse effects
Retrospective Studies
Surgery
Surgical Oncology
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Summary:Background The possible association between ovulation-inducing drugs and breast cancer development has been debated. Our aim was to evaluate the incidence of breast cancer in a cohort of women exposed to in vitro fertilization (IVF). Methods A retrospective cohort analysis was performed by linkage of the computerized database of all women treated at the IVF Unit at Assaf Harofeh Medical Center between 1986 and 2003, and the Israeli National Cancer Registry. The standardized incidence ratio (SIR) was computed as the ratio between the observed number of breast cancer cases and the expected cases, adjusted for age and continent of birth, in the general population. Tumor characteristics of the IVF patients were studied by reviewing original medical records. Results 35 breast carcinomas were diagnosed among 3,375 IVF-treated women, compared to 24.8 cases expected (SIR = 1.4; 95% CI 0.98–1.96). Age ≥40 years at IVF treatment (SIR = 1.9; 95% CI 0.97–3.30), hormonal infertility (SIR = 3.1; 95% CI 0.99–7.22), and ≥4 IVF cycles (SIR = 2.0; 95% CI 1.15–3.27) were found to be risk factors to develop breast cancer compared to the general population. Multivariate analysis revealed that women who underwent ≥4 IVF cycles compared to those with one to three cycles were at risk to develop breast cancer, although not significantly (SIR = 1.9; 95% CI 0.95–3.81). Of IVF-treated women 85% had ER(+) tumors and 29% had positive family history. Conclusions A possible association between IVF therapy and breast cancer development was demonstrated, especially in women ≥40 years of age. These preliminary findings need to be replicated in other cohort studies.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-007-9800-2