Association between cumulative number of times reported antidepressant use at each cycle and invasive breast cancer risk, NHS (2000–2012), and NHSII (2003–2013)
| All invasive cases | ER positive | ER negative | Postmenopausal at diagnosis | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Cases/person-years | Age- and calendar year adjusted | Fully adjusteda | Cases/person-years | Fully adjusteda | Cases/person-years | Fully adjusteda | Cases/person-years | Fully adjusteda | |
| NHS (n= 2,667 cases) | |||||||||
| 0 | 2,194/666,501 | 1 (ref) | 1 (ref) | 1,816/666,501 | 1 (ref) | 269/666,501 | 1 (ref) | 2,186/666,489 | 1 (ref) |
| 1 | 159/52,826 | 0.94 (0.80–1.11) | 0.93 (0.79–1.10) | 126/52,826 | 0.90 (0.75–1.09) | 23/52,826 | 1.01 (0.65–1.58) | 158/52,825 | 0.93 (0.78–1.10) |
| 2 | 100/30,851 | 1.03 (0.84–1.26) | 0.99 (0.80–1.23) | 77/30,851 | 0.93 (0.73–1.18) | 15/30,851 | 1.10 (0.63–1.92) | 100/30,851 | 1.00 (0.81–1.23) |
| 3+ | 214/71,179 | 1.03 (0.89–1.19) | 0.97 (0.82–1.15) | 168/71,179 | 0.91 (0.76–1.10) | 36/71,179 | 1.26 (0.82–1.94) | 214/71,179 | 0.98 (0.82–1.16) |
| NHS II (n= 1,347 cases) | |||||||||
| 0 | 905/478,115 | 1 (ref) | 1 (ref) | 716/478,115 | 1 (ref) | 151/478,115 | 1 (ref) | 524/477,328 | 1 (ref) |
| 1 | 127/61,702 | 1.09 (0.90–1.31) | 1.06 (0.87–1.29) | 103/61,702 | 1.09 (0.87–1.35) | 21/61,702 | 1.03 (0.63–1.68) | 78/61,620 | 1.06 (0.83–1.37) |
| 2 | 109/61,140 | 0.92 (0.75–1.12) | 0.88 (0.71–1.08) | 85/61,140 | 0.87 (0.68–1.10) | 21/61,140 | 0.99 (0.61–1.61) | 71/61,061 | 0.87 (0.67–1.14) |
| 3+ | 206/111,165 | 0.94 (0.80–1.09) | 0.85 (0.69–1.03) | 177/111,165 | 0.91 (0.73–1.13) | 24/111,165 | 0.62 (0.36–1.05) | 145/111,031 | 0.84 (0.66–1.07) |
| Pooled (n= 4,014 cases) | |||||||||
| 0 | 3,099/1,144,616 | 1 (ref) | 1 (ref) | 2,532/1,144,616 | 1 (ref) | 420/1,144,616 | 1 (ref) | 2,710/1,143,817 | 1 (ref) |
| 1 | 286/113,988 | 1.01 (0.87–1.16) | 0.98 (0.86–1.12) | 229/113,988 | 0.98 (0.82–1.18) | 44/113,988 | 1.02 (0.73–1.42) | 236/114,445 | 0.97 (0.84–1.11) |
| 2 | 209/91,991 | 0.97 (0.84–1.12) | 0.93 (0.80–1.08) | 162/91,991 | 0.90 (0.76–1.06) | 36/91,991 | 1.03 (0.72–1.50) | 171/91,912 | 0.95 (0.80–1.12) |
| 3+ | 420/182,344 | 0.99 (0.89–1.09) | 0.92 (0.80–1.05) | 345/182,344 | 0.91 (0.79–1.05) | 60/182,344 | 0.90 (0.44–1.81) | 359/182,210 | 0.93 (0.81–1.07) |
↵aAdjusted for age, calendar year, BMI, count of clinical depression, age at menarche, current oral contraceptive use (NHSII only), type of PMH use, age at menopause, age at first birth & parity, history of biopsy-confirmed benign breast disease, family history of breast cancer, mammogram in prior 2 years, smoking status, physical activity, alcohol intake, and AHEI score.