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Solar Ultraviolet Radiation and Breast Cancer Risk: A Systematic Review and Meta-Analysis.

ABSTRACT: BACKGROUND:A protective relationship has been hypothesized between exposure to solar ultraviolet radiation (UVR) and the development of breast cancer. OBJECTIVE:The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the association of exposure to solar UVR and breast cancer risk. METHODS:We searched Medline, EMBASE, and Web of Science for all studies investigating exposure to solar UVR and breast cancer risk. Separate analyses were performed using estimates of time spent in the sun, and ambient UVR. Associations were estimated using DerSimonian and Laird random-effect models. Heterogeneity was investigated through subgroup analyses and I2 statistics. RESULTS:Fourteen studies were included in the review and 13 in the meta-analysis, with the majority (n=8) conducted in North America. We observed a decreased risk of breast cancer for individuals spending ?1h/d in the sun during summer months over a lifetime or usual adulthood compared with <1h/d [pooled?relative?risk?(RR)=0.84; 95% CI: 0.77, 0.91]. Spending ?2h/d in the sun had a similar protective effect as 1 to <2h/d when compared with <1h/d (RR=0.83; 95% CI: 0.75, 0.93 vs. 0.83; 95% CI: 0.78, 0.89). Exposure during adolescence was suggestive of a lower risk of breast cancer than exposure later in life (?45?years of age) (RR=0.83; 95% CI: 0.71, 0.98 vs. 0.97; 95% CI: 0.85, 1.11). Ambient UVR was not associated with the risk of breast cancer (RR=1.00; 95% CI: 0.93, 1.09). DISCUSSION:To our knowledge, this was the first meta-analysis to estimate the risk of developing breast cancer associated with time spent in the sun. The results suggest that obtaining greater than an hour a day in the sun during the summer months could decrease the risk of developing breast cancer. https://doi.org/10.1289/EHP4861.

SUBMITTER: Hiller TWR

PROVIDER: S-EPMC7015554 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Solar Ultraviolet Radiation and Breast Cancer Risk: A Systematic Review and Meta-Analysis.

Hiller Troy W R TWR O'Sullivan Dylan E DE Brenner Darren R DR Peters Cheryl E CE King Will D WD

Environmental health perspectives 20200106 1

<h4>Background</h4>A protective relationship has been hypothesized between exposure to solar ultraviolet radiation (UVR) and the development of breast cancer.<h4>Objective</h4>The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the association of exposure to solar UVR and breast cancer risk.<h4>Methods</h4>We searched Medline, EMBASE, and Web of Science for all studies investigating exposure to solar UVR and breast cancer risk. Separat ...[more]

PMID: 31903801

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Project description:BackgroundAcute radiation dermatitis (ARD) is the most common acute response after adjuvant radiotherapy in breast cancer patients and negatively affects patients' quality of life. Some studies have reported several risk factors that can predict breast cancer patients who are at a high risk of ARD. This study aimed to identify patient- and treatment-related risk factors associated with ARD.MethodsPubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and WanFang literature databases were searched for studies exploring the risk factors in breast cancer patients. The pooled effect sizes, relative risks (RRs), and 95% CIs were calculated using the random-effects model. Potential heterogeneity and sensitivity analyses by study design, ARD evaluation scale, and regions were also performed.ResultsA total of 38 studies composed of 15,623 breast cancer patients were included in the analysis. Of the seven available patient-related risk factors, four factors were significantly associated with ARD: body mass index (BMI) ≥25 kg/m2 (RR = 1.11, 95% CI = 1.06-1.16, I 2 = 57.1%), large breast volume (RR = 1.02, 95% CI = 1.01-1.03, I 2 = 93.2%), smoking habits (RR = 1.70, 95% CI = 1.24-2.34, I 2 = 50.7%), and diabetes (RR = 2.24, 95% CI = 1.53-3.27, I 2 = 0%). Of the seven treatment-related risk factors, we found that hypofractionated radiotherapy reduced the risk of ARD in patients with breast cancer compared with that in conventional fractionated radiotherapy (RR = 0.28, 95% CI = 0.19-0.43, I 2 = 84.5%). Sequential boost and bolus use was significantly associated with ARD (boost, RR = 1.91, 95% CI = 1.34-2.72, I 2 = 92.5%; bolus, RR = 1.94, 95% CI = 1.82-4.76, I 2 = 23.8%). However, chemotherapy regimen (RR = 1.17, 95% CI = 0.95-1.45, I 2 = 57.2%), hormone therapy (RR = 1.35, 95% CI = 0.94-1.93, I 2 = 77.1%), trastuzumab therapy (RR = 1.56, 95% CI = 0.18-1.76, I 2 = 91.9%), and nodal irradiation (RR = 1.57, 95% CI = 0.98-2.53, I 2 = 72.5%) were not correlated with ARD. Sensitivity analysis results showed that BMI was consistently associated with ARD, while smoking, breast volume, and boost administration were associated with ARD depending on study design, country of study, and toxicity evaluation scale used. Hypofractionation was consistently shown as protective. The differences between study design, toxicity evaluation scale, and regions might explain a little of the sources of heterogeneity.ConclusionThe results of this systematic review and meta-analysis indicated that BMI ≥ 25 kg/m2 was a significant predictor of ARD and that hypofractionation was consistently protective. Depending on country of study, study design, and toxicity scale used, breast volume, smoking habit, diabetes, and sequential boost and bolus use were also predictive of ARD.

Project description:Objectives Mammographic density is a well-defined risk factor for breast cancer and having extremely dense breast tissue is associated with a one-to six-fold increased risk of breast cancer. However, it is questioned whether this increased risk estimate is applicable to current breast density classification methods. Therefore, the aim of this study was to further investigate and clarify the association between mammographic density and breast cancer risk based on current literature. Methods Medline, Embase and Web of Science were systematically searched for articles published since 2013, that used BI-RADS lexicon 5th edition and incorporated data on digital mammography. Crude and maximally confounder-adjusted data were pooled in odds ratios (ORs) using random-effects models. Heterogeneity regarding breast cancer risks were investigated using I2 statistic, stratified and sensitivity analyses. Results Nine observational studies were included. Having extremely dense breast tissue (BI-RADS density D) resulted in a 2.11-fold (95% CI 1.84–2.42) increased breast cancer risk compared to having scattered dense breast tissue (BI-RADS density B). Sensitivity analysis showed that when only using data that had adjusted for age and BMI, the breast cancer risk was 1.83-fold (95% CI 1.52–2.21) increased. Both results were statistically significant and homogenous. Conclusions Mammographic breast density BI-RADS D is associated with an approximately two-fold increased risk of breast cancer compared to having BI-RADS density B in general population women. This is a novel and lower risk estimate compared to previously reported and might be explained due to the use of digital mammography and BI-RADS lexicon 5th edition. Highlights • So far, breast density was linked to a one-to sixfold increased breast cancer risk.• Prior risk estimates were based on old BI-RADS lexicon and screen-film mammography.• We included only studies using digital mammography and BI-RADS lexicon 5th edition.• Breast density D is associated with a two-fold increased risk of breast cancer.• This is a lower risk estimate compared to previously reported studies.

Dataset Information

Solar Ultraviolet Radiation and Breast Cancer Risk: A Systematic Review and Meta-Analysis.

Publications

Solar Ultraviolet Radiation and Breast Cancer Risk: A Systematic Review and Meta-Analysis.

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