Angiogenic Balance in Pregnancy and Subsequent Breast Cancer Risk and Survival: A Population Study
- 1Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway; 2Department of Microbiology, Asker and Bærum Hospital, Bærum, Norway; 3Department of Obstetrics and Gynecology and the Medical Faculty Division, University of Oslo; 4Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway; and 5Akershus University Hospital, Lørenskog, Norway
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Lars Vatten, Department of Public Health, Norwegian University of Science and Technology, NO-7489 Trondheim, Norway. Phone: 47-7359-8787; Fax: 47-7359-7577. E-mail: Lars.Vatten{at}ntnu.no.
Abstract
Background: Women with a history of preeclampsia have reduced breast cancer risk. Because preeclampsia is characterized by an imbalance in angiogenic factors, we assessed pregnancy levels of placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and soluble endoglin (s-endoglin) and subsequent breast cancer risk.
Methods: In a case-control study among 26,744 pregnant women, we compared angiogenic factors between 145 women who later developed invasive breast cancer and 400 controls. The angiogenic factors were determined with ELISA in blood samples collected in weeks (median) 10, 23, and 35 of the baseline pregnancy.
Results: Concentrations of PlGF, sFlt-1, and s-endoglin did not differ between women who later developed breast cancer and control women, and odds ratios across quartiles of each factor did not indicate any association in blood samples from gestational week 10, 23, or 35. During pregnancy, there was a general increase in each angiogenic factor, but degree of increase from one sampling period to the next was not associated with later breast cancer risk. Among cases, 22 of 145 died from breast cancer during 10 years of follow-up, but there was no consistent indication that angiogenic factors measured in pregnancy up to several years before diagnosis were associated with case fatality.
Conclusions: The results of this nested case-control study, based on blood samples collected up to three time points during pregnancy, and subsequent cancer follow-up, do not provide any evidence that pregnancy levels of PlGF, sFlt-1, and s-endoglin are associated with breast cancer risk later in life. (Cancer Epidemiol Biomarkers Prev 2009;18(7):2074–8)
- breast cancer
- soluble fms-like tyrosine kinase-1
- placental growth factor
- soluble endoglin
- population study
Footnotes
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Grant support: Norwegian Institute of Public Health, Norwegian Research Council, and Norwegian Ministry of Health Care.
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Note: Contributors: L.J. Vatten conceived the idea, participated in the analyses, interpreted the results, and wrote the paper. P.R. Romundstad analyzed the data and interpreted the results. P.A. Jenum conceived the original study and participated in interpretation of the results. A. Eskild interpreted the results and wrote the paper. All authors have read and approved the final version of the manuscript. L.J. Vatten has access to all data of this study and is guarantor.
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted May 13, 2009.
- Received March 6, 2009.
- Revision received April 22, 2009.
