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Prolactin levels, breast-feeding and milk production in a cohort of young healthy women from high-risk breast cancer families: implications for breast cancer risk

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Abstract

High prolactin levels have been associated with increased breast cancer risk. Prolactin is essential for breast-feeding. Prolactin is lowered primarily by the first full-term pregnancy and not by subsequent pregnancies. The protection from breast cancer conferred by a long breast-feeding duration (>1 year) seems to be much greater for women with BRCA1 mutations (45%) than for women in the general population (4%). One study reported poor milk production to be more common in BRCA1 carriers (75%) than in non-carriers (36%). We aimed to explore the relationships between prolactin levels, breast-feeding duration, milk production and BRCA carrier status in young healthy women from high-risk breast cancer families. Questionnaires including information on reproductive factors and lifestyle were completed by 269 healthy women, aged 40 years or younger. Body measurements and plasma prolactin levels were obtained during cycle days 5–10 and 18–23. Prolactin was higher in nulliparous than in parous women (P < 0.0001). In parous women, post-lactational prolactin levels in both cycle phases were significantly negatively associated with breast-feeding duration of the first child (P ≤ 0.009), but not with additional breast-feeding of subsequent children (P ≥ 0.12). Prolactin was higher in women who reported insufficient versus sufficient milk production (P ≤ 0.01). Neither BRCA1/2 carrier status nor increasing parity was significantly associated with prolactin, breast-feeding duration of the first child or milk production. In conclusion, post-lactational prolactin levels were determined by breast-feeding duration of the first child and not simply by the first full-term pregnancy. Since prolactin modifies the risk for breast cancer, adequate counseling in favor of breast-feeding is essential.

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Abbreviations

BMI:

Body mass index

BRCA1 :

Breast cancer gene 1

BRCA2 :

Breast cancer gene 2

DHPLC:

Denaturing high-performance liquid chromatography

DNA:

Deoxyribonucleic acid

EDTA:

Ethylenediaminetetraacetic acid

MLPA:

Multiplex ligation-dependent probe amplification

MRI:

Magnetic resonance imaging

OR:

Odds ratio

WHR:

Waist-hip ratio

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Acknowledgments

This study was supported by grants from Grönbergska fonden, Vetenskapsrådet (The Swedish Research Council, K2001-27GX-14120-01A), the Medical Faculty in Lund, the Mrs. Berta Kamprad’s Foundation, The South Swedish Health Care Region (Region Skåne), Lund Hospital Fund and the Swedish Cancer Society. Helena Jernström’s position was funded by the Grönbergska foundation, the Swedish Research Council (K2002-27GP-14104-02B), the Medical Faculty of Lund University and the Faculty of Health and Society, Malmö University. We thank our research nurses Kerstin Nilsson, Monica Pehrsson, Karin Henriksson, and Anita Schmidt-Casslén for their assistance with body measurements and blood drawing, and Johanna Wagenius, Johanna Frenander, Helen Sundberg, Malin Sternby, Susanna Holmquist and Maria Henningson for their assistance with recruitment. We thank Eric T. Dryver for proofreading the manuscript.

Contribution of authors

Maria Hietala provided background information and prepared the manuscript. Drs. Helena Jernström and Håkan Olsson initiated this study. Håkan Olsson is medically responsible for the patients and provided background information. Helena Jernström performed the statistical analyses, provided background information and supervised the writing of the paper. All authors have read and approved the manuscript.

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Authors and Affiliations

  1. Department of Oncology, Clinical Sciences, Lund University, Barngatan 2:B, 221 85, Lund, Sweden

    Maria Hietala, Håkan Olsson & Helena Jernström

  2. Department of Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden

    Håkan Olsson

  3. Faculty of Health and Society, Malmö University, Malmo, Sweden

    Helena Jernström

Authors
  1. Maria Hietala
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  2. Håkan Olsson
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  3. Helena Jernström
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Correspondence to Helena Jernström.

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Hietala, M., Olsson, H. & Jernström, H. Prolactin levels, breast-feeding and milk production in a cohort of young healthy women from high-risk breast cancer families: implications for breast cancer risk. Familial Cancer 7, 221–228 (2008). https://doi.org/10.1007/s10689-007-9178-0

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