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Oral Contraceptive Use and Cyclin D1 Overexpression in Breast Cancer among Young Women

Department of Epidemiology, Mailman School of Public Health [M. B. T.], Herbert Irving Comprehensive Cancer Center [M. B. T., H. H.], and Department of Pathology, College of Physicians and Surgeons [H. H.], Columbia University, New York, New York 10032; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina 27599-7345 [M. D. G.]; New Jersey State Department of Health and Senior Services, Cancer Epidemiology Services, Trenton, New Jersey 08625-0369 [J. B. S]; National Cancer Institute, Environmental Epidemiology Branch, Bethesda, Maryland 20892-7234 [L. A. B.]; and Department of Gastroenterology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel 55454 [N. A.]

Cyclin D1, an important cell cycle regulator, is overexpressed in several human cancers including breast. Both estrogens and progestins activate the transcription of the gene; antiestrogens have been shown to reduce cyclin D1 protein levels. Cyclin D1 protein overexpression has been strongly associated with well-differentiated, estrogen receptor-positive tumors. Little is known, however, as to whether epidemiological risk factors are related to this molecularly defined subset of tumors. Using a population-based study of young women <45 years in New Jersey, we analyzed whether oral contraceptives (OCs) and other risk factors were associated with the overexpression of cyclin D1 in breast cancer tissue. We measured cyclin D1 status in paraffin-embedded, archived tissue from 78.8% of the breast cancer cases using immunohistochemistry. Cyclin D1 was overexpressed in 33.7% of the cases (123 of 365). We used unordered polytomous logistic regression to estimate the odds ratios (ORs) for two case groups—(a) breast cancer with cyclin D1 overexpression (n = 123) and (b) breast cancer without overexpression (n = 242)—compared with 462 population-based controls. The multivariate-adjusted OR for ever use of OCs was 1.6 [95% confidence interval (CI), 1.0–2.5] for cases that overexpressed cyclin D1 and 1.0 (95% CI, 0.7–1.5) for those with no overexpression. Among women who started using OCs at least 20 years before the reference date, the OR was increased 2-fold for breast cancer with cyclin D1 overexpression (OR, 2.2; 95% CI, 1.2–4.0) but not for breast cancer without cyclin D1 overexpression (OR, 1.1; 95% CI, 0.7–1.8). If replicated, these findings suggest that early OC use may be associated with the subset of mammary tumors that overexpress cyclin D1.

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