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Fertility drugs and the risk of breast cancer: a meta-analysis and review

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Abstract

The risk of breast cancer has been associated with reproductive history. The purpose of this study was to determine the relationship between fertility drugs used in assisted reproductive procedures and the risk of breast cancer. We performed a literature search using the MEDLINE, the COCHRANE Library, and Scopus to identify studies linking breast cancer to fertility drugs. We excluded case series, case reports, and review articles from our analysis. The study populations included women who were treated for infertility with clomiphene, gonadotropins, gonadotropin-releasing hormones, or other unspecified fertility agents. We extracted information on study design, sample size, type of fertility drugs and number of treatment cycles, breast cancer incidence, and follow-up time from these studies. Eight case–control studies and fifteen cohort studies were included in the quantitative analyses. The Newcastle–Ottawa Quality Assessment Scales were used. Two investigators independently extracted study methods, sources of bias, and outcomes. We found that the risk of breast cancer was not significantly associated with fertility drug treatment. The follow-up periods were short in some of the studies analyzed in our study; however, we proceeded to test the trend in risk estimates across different durations of follow-up and found a trend for association using the nonparametric test; this was interpreted with caution in view of the lack of adjustment with other confounding factors. The current published data do not suggest higher risk of breast cancer in women who receive fertility treatment, but the lack of long-term follow up and the inherent weaknesses in some of the published studies have to be cautiously taken into account.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Lebanese American University, Beirut, Lebanon

    Tony G. Zreik, Nadia Asmar & Pierre Zalloua

  2. Division of Management, Policy and Community Health, The University of Texas School of Public Health, Houston, TX, USA

    Ali Mazloom

  3. Department of Statistics, Rice University, Houston, TX, USA

    Yanli Chen & Marina Vannucci

  4. Research Medical Library, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

    Stephanie Fulton

  5. Department of Radiation Oncology, Unit 97, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA

    Chelsea C. Pinnix, Mersiha Hadziahmetovic, Ferial Shihadeh, Christine Wogan & Bouthaina Dabaja

  6. Department of Obstetrics and Gynecology, Henry Ford University, Detroit, MI, USA

    Adnan R. Munkarah

  7. Department of Anesthesiology, American University of Beirut Medical Center, Beirut, Lebanon

    Chakib M. Ayoub

  8. Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon

    Ghina Berjawi

  9. Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon

    Antoine Hannoun

Authors
  1. Tony G. Zreik
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  2. Ali Mazloom
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  3. Yanli Chen
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  4. Marina Vannucci
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  10. Chakib M. Ayoub
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  14. Pierre Zalloua
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  16. Bouthaina Dabaja
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Correspondence to Bouthaina Dabaja.

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Zreik, T.G., Mazloom, A., Chen, Y. et al. Fertility drugs and the risk of breast cancer: a meta-analysis and review. Breast Cancer Res Treat 124, 13–26 (2010). https://doi.org/10.1007/s10549-010-1140-4

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  • DOI: https://doi.org/10.1007/s10549-010-1140-4

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