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Severe acne and risk of breast cancer.

ABSTRACT: PURPOSE:Hormonal imbalance early in life is thought to be associated with breast cancer risk. Severe acne may arise from hormonal imbalance and could serve as an indicator of increased breast cancer risk. We explored whether severe acne was associated with incident breast cancer. METHODS:We used data from the Sister Study, a large (n?=?50,884) prospective cohort of women who had a sister diagnosed with breast cancer, but who were free of breast cancer themselves at baseline. Participants completed a structured questionnaire that included demographics, lifestyle factors, and medical history, including any diagnosis of severe acne. Adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association of severe acne and breast cancer (invasive disease or ductal carcinoma in situ). RESULTS:During an average of 8.4 years of follow-up, 3049 breast cancer cases were diagnosed. Ever being diagnosed with severe acne was associated with a higher risk of breast cancer (HR 1.23; 95% CI 0.98, 1.54), particularly in women who were diagnosed prior to age 18 years (HR 1.40; 95% CI 1.04, 1.90). Results were similar when limited to invasive cancers. CONCLUSIONS:Our study supports a non-significant positive association between severe acne-a potential marker of hormonal imbalance-and breast cancer risk. These findings suggest that severe acne, when considered along with other risk factors, could help to identify women who may be at a higher risk of breast cancer.

SUBMITTER: Murphy JD

PROVIDER: S-EPMC6771926 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Severe acne and risk of breast cancer.

Murphy John D JD Sandler Dale D White Alexandra J AJ O'Brien Katie M KM

Breast cancer research and treatment 20190605 2

<h4>Purpose</h4>Hormonal imbalance early in life is thought to be associated with breast cancer risk. Severe acne may arise from hormonal imbalance and could serve as an indicator of increased breast cancer risk. We explored whether severe acne was associated with incident breast cancer.<h4>Methods</h4>We used data from the Sister Study, a large (n = 50,884) prospective cohort of women who had a sister diagnosed with breast cancer, but who were free of breast cancer themselves at baseline. Parti ...[more]

PMID: 31165375

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Project description:Study questionIs there a relationship between severe teenage acne and endometriosis?Summary answerEndometriosis is positively associated with severe teenage acne.What is known alreadyNo studies have specifically explored a possible association between severe acne in adolescence and risk of endometriosis.Study design, size, durationThis prospective cohort study used data collected from 88 623 female nurses from September 1989 to June 2009 as part of the Nurses' Health Study II (NHS II) cohort.Participants/materials, setting, methodsRegression models were used to calculate hazard ratios (HRs) and confidence intervals (CIs) for endometriosis among women with and without severe teenage acne. Multivariate models were adjusted for established risk factors of endometriosis.Main results and the role of chanceA total of 4 382 laparoscopically confirmed endometriosis cases were documented during 1 132 272 woman-years of follow-up. Compared with women without a history of severe teenage acne, women who had severe teenage acne had a 20% increased risk of endometriosis (HR = 1.20, 95% CI: 1.08-1.32). The association was not affected by adjusting for use of tetracycline or isotretinoin.Limitations and reasons for cautionThe HR is likely to be underestimated since we only included endometriosis cases confirmed by laparoscopy. Although geographically diverse, the NHS II cohort is primarily Caucasian, which may limit generalization to more ethnically diverse populations.Wider implications of the studyThe results of this study suggest that severe teenage acne is associated with an increased risk of endometriosis. As a visible and non-invasive clinical indicator, severe teenage acne may be useful for early detection of endometriosis. We bring this counter-intuitive association to the attention of clinicians for the benefit of the patient and an early diagnosis of endometriosis.Study funding/competing interestThis study was funded by research grant CA176726 from the National Institute of Health. M.K. is supported by a Marie Curie International Outgoing Fellowship within the 7th European Community Framework Programme (#PIOF-GA-2011-302078). The funding agencies had no role in the design of the study, in the analysis and interpretation of the data, in the writing of the report or in the decision to submit the paper for publication.

Project description:We present a 55-year-old male patient - a smoker, admitted to a Medical Institute of MVR (Ministry of the interior, Sofia, Bulgaria), on occasion of pain and swellings, located in the area of both axillae, accompanied by purulent discharge, with bloody admixtures. Bilateral localised cystic rose above the skin surface, hyperpigmented nodules interconnected with multiple fistulas, was observed within the dermatological examination, resulting in a limitation of the possibility of movement of the hands in all directions. A subjective complaint of pain was obtained on palpation. Solid bilateral axillar cicatrices - formation was also established, which additional impeded the movements of the upper limbs. The disease was generalised affecting additional inguinal, femoral and perineal areas, while at this stage the patient refused categorically eventual photo documentation of them. The diagnosis of acne inversa was made based on the available clinical and para-clinical data, as dual antibiotic therapy with Clindamycin 300 mg, two times per day was initiated for two months, in combination with rifampicin 300 mg, two times per day also for two months. This led to a significant improvement in the clinic symptoms and the patient was hospitalised for radical surgery. A surgical management of the clinical findings was planned by an interdisciplinary team including surgeons and dermatologists. The procedure was performed under general anaesthesia. After a thorough cleaning of the operative field, a radical excision of the lesion in the left axillary and para axillar region was performed, comprising the skin and subcutaneous tissue forward the fascia pectoralis. Tissue was dissected in depth in the form of number 4, thereby creating the conditions for adaptation of the initially encountered communicating with each other skin defects. Two tubular drains were placed, followed by gradual suturing of skin and subcutaneous tissue with final applying of a sterile dressing. Effective medical treatment of patients (as in our case) with severe AI is limited. Adalimumab is the first biological approved for moderate to severe AI but does not result in stable CR (cure rate). Therefore its use in a neoadjuvant setting is under investigation. Wide local excision significantly reduces pain and improves the quality of life of AI patients. While local recurrences rate is low, the satisfaction with the cosmetic results is high. The recurrence rate is dependent on the region affected and the type of surgery. While in the axillary region primary closure may be used to reduce the time to healing, anogenital AI has the lowest recurrence rate of healing by secondary intention.

Project description:BackgroundAcne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and severity of lesions. While many epidemiology studies have investigated the risk factors for acne presentation, fewer studies have specifically studied the risk factors for acne severity and scarring. Therefore, this study investigated the prevalence of acne, acne severity and scarring grades, and their associated non-modifiable and modifiable epidemiological risk factors among Malaysian Chinese.MethodsA total of 1840 subjects (1117 cases/723 controls) completed an investigator-administered questionnaire as part of a cross-sectional study, which include socio-demographics, familial history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 1051) and scarring (n = 1052) grades by a trained personnel.ResultsMajority of the acne cases (up to 69%) had mild acne or Grade 1/2 scarring, while 21.6% had moderate/severe acne and 5.5% had Grade 3/4 scarring. Males had significantly higher risk of presenting with higher grades of acne scarring. Those who had acne, regardless of severity and scarring grades, had strong positive familial history (either in parents and/or sibling). Frequent consumption (most or all days) of foods that are commonly consumed during breakfast (butter, probiotic drinks, cereals and milk) decreased the risk for acne presentation and higher acne scarring, while periodic consumption (once/twice per week) of nuts and burgers/fast food decreased the risk for higher acne severity. Alcohol drinking was significantly associated with increased risk for acne presentation, while paternal, parental and household smoking were associated with reduced risk of more severe acne.ConclusionsIn conclusion, positive familial history is a strong predisposing factor in influencing acne presentation, severity and scarring. Frequent consumption of foods that are commonly consumed during breakfast is protective against acne presentation.

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Severe acne and risk of breast cancer.

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Severe acne and risk of breast cancer.

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