Insufficient Milk Supply and Breast Cancer Risk: A Systematic Review
Open Access
- 14 December 2009
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 4 (12), e8237
- https://doi.org/10.1371/journal.pone.0008237
Abstract
An association between insufficient milk supply, the inability of a mother's breast milk to provide sufficiently for her infant, and breast cancer has been suggested by observations in animal models. To determine if an association has been reported in epidemiological studies of human breast cancer, a systematic review of the literature has been conducted. We also sought to identify the methodological limitations of existing studies to guide the design of any future prospective studies in this field. PubMed, EMBASE, Web of Science, BIOSIS, and CAB abstracts were searched. We selected any study that (1) assessed breast cancer in association with breastfeeding history and (2) examined the relationship between insufficient milk supply with breast cancer. Seven relevant studies were identified that met both criteria. There was statistically significant heterogeneity among the results which likely reflects clinically significant differences in definitions of insufficient milk supply and reference groups that were used. Among premenopausal women who had experienced insufficient milk supply, odds ratios (ORs) for breast cancer risk ranged from 0.9 to 16.3. Among postmenopausal women, ORs ranged from 0.6 to 6.7. Based on the range of odds ratios obtained in the studies reported in this review, it remains unclear if there is a true association between insufficient milk supply and breast cancer. Although some studies have shown a strong positive association, there is no consistent evidence for an effect of insufficient milk supply on breast cancer risk. Exposure definitions are in need of improvement in order to focus on primary insufficient milk supply. Reference groups consisting of women who have successfully breastfed may also introduce positive bias (inflation of the odds ratio) into study results because of the protective effect of prolonged breastfeeding in the control group.Keywords
This publication has 27 references indexed in Scilit:
- Relationship of Time Since Childbirth and Other Pregnancy Factors to Premenopausal Breast Cancer PrognosisObstetrics & Gynecology, 2008
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational StudiesPLoS Medicine, 2007
- The association between breastfeeding and breast cancer occurrence among Israeli Jewish women: a case control studyZeitschrift für Krebsforschung und Klinische Onkologie, 2007
- Dose-dependent protective effect of breast-feeding against breast cancer among ever-lactated women in KoreaEuropean Journal of Cancer Prevention, 2007
- An overview of prognostic factors for long-term survivors of breast cancerBreast Cancer Research and Treatment, 2007
- Measuring inconsistency in meta-analysesBMJ, 2003
- Does Breastfeeding Reduce Risk for Breast Cancer?MCN: The American Journal of Maternal/Child Nursing, 2001
- The Influence of Breast Surgery, Breast Appearance, and Pregnancy‐Induced Breast Changes on lactation Sufficiency as Measured by Infant Weight GainBirth, 1990
- Insufficient Milk SupplyImage: the Journal of Nursing Scholarship, 1989
- LACTATION AND BREAST CANCER: EVIDENCE FOR A NEGATIVE ASSOCIATION IN PREMENOPAUSAL WOMENAmerican Journal of Epidemiology, 1985