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Grant Details

Grant Number: 3R01CA105041-05S1 Interpret this number
Primary Investigator: Li, Christopher
Organization: Fred Hutchinson Can Res Ctr
Project Title: Depo-Provera and Breast Cancer: Epidemiology/Pathology
Fiscal Year: 2009
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Abstract

DESCRIPTION (provided by applicant): The injectable contraceptive depot medroxy-progesterone acetate (DMPA) (Depo-Provera) is commonly used by women worldwide, and it contains the same progestin that is most commonly used in combined estrogen and progestin hormonal therapy (CHT) regimens taken by postmenopausal women in the United States. Data from several recent studies indicate that CHT increases a woman's risk of breast cancer, and that the progestin component of CHT may be particularly important with respect to this increased risk. There are limited data on the relationship between DMPA and breast cancer risk though. The available evidence suggests that current DMPA use is associated with a 1.5 to 1.65-fold increased risk of breast cancer. However, additional studies of the relationship between DMPA use and breast cancer are needed because these studies had methodologic limitations (sample size and/or study design issues), none were conducted in the U.S. and so it is unclear whether or not these results are generalizable to U.S. women (since reproductive and contraceptive patterns vary widely by country), and little is known about mechanisms through which DMPA promotes breast cancer. This study is worthwhile even if we find that there is no association between DMPA and breast cancer risk, since in this case women using DMPA will be reassured that using the same drug that has been implicated as a cause of breast cancer does not also increase their breast cancer risk when taken as an injectable contraceptive. Herein we propose a case-control study of 1,000 women aged 20-44 who have been diagnosed with breast cancer and 1,000 population-based controls who reside in the Seattle-Puget Sound area. The specific hypotheses to be tested are: (1) Is DMPA use associated with an increased risk of breast cancer in premenopausal women 20-44? Does the duration and/or recency of DMPA use influence the magnitude of this association?; (2) Do demographic, reproductive, or anthropometric characteristics, such as parity and body mass index, modify this association?; and (3) Does the association between DMPA and breast cancer risk vary by histologic type or by the expression of steroid receptors including ERq, ERft, and PR?

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Publications

Height, body mass index (BMI), BMI change, and the risk of estrogen receptor-positive, HER2-positive, and triple-negative breast cancer among women ages 20 to 44 years.
Authors: Kawai M, Malone KE, Tang MT, Li CI
Source: Cancer, 2014 Feb 5;null, p. null.
EPub date: 2014 Feb 5.
PMID: 24500704
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Use of antihypertensive medications and breast cancer risk among women aged 55 to 74 years.
Authors: Li CI, Daling JR, Tang MT, Haugen KL, Porter PL, Malone KE
Source: JAMA Intern Med, 2013 Sep 23;173(17), p. 1629-37.
PMID: 23921840
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Reproductive factors and risk of estrogen receptor positive, triple-negative, and HER2-neu overexpressing breast cancer among women 20-44 years of age.
Authors: Li CI, Beaber EF, Tang MT, Porter PL, Daling JR, Malone KE
Source: Breast Cancer Res Treat, 2013 Jan;137(2), p. 579-87.
EPub date: 2012 Dec 9.
PMID: 23224237
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Effect of depo-medroxyprogesterone acetate on breast cancer risk among women 20 to 44 years of age.
Authors: Li CI, Beaber EF, Tang MT, Porter PL, Daling JR, Malone KE
Source: Cancer Res, 2012 Apr 15;72(8), p. 2028-35.
EPub date: 2012 Feb 27.
PMID: 22369929
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Feasibility of including cellular telephone numbers in random digit dialing for epidemiologic case-control studies.
Authors: Voigt LF, Schwartz SM, Doody DR, Lee SC, Li CI
Source: Am J Epidemiol, 2011 Jan 1;173(1), p. 118-26.
EPub date: 2010 Nov 11.
PMID: 21071602
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