Zentralbl Gynakol 2003; 125(2): 48-52
DOI: 10.1055/s-2003-40365
Übersicht

© Georg Thieme Verlag Stuttgart · New York

Stillen als Brustkrebsprävention - eine Übersicht

Does breast-feeding prevent breast cancer?M. Abou-Dakn1 , M. Scheele2 , J. R. Strecker1
  • 1 Vivantes Humboldt-Klinikum · Klinik für Gynäkologie und Geburtsmedizin, Berlin
  • 2 Klinikum Nord Heidberg, Hamburg
Further Information

Publication History

Publication Date:
01 July 2003 (online)

Zusammenfassung

Viele epidemiologischen Studien zeigen deutlich den hemmenden Effekt des Stillens auf die Brustkrebsentwicklung. So konnte gezeigt werden, dass das Stillen für ein Jahr das individuelle Risiko für ein prämenopausales Mammakarzinom bis 45 % reduziert. Bei einer Verlängerung der „ Lebensstillzeit” nach entsprechend vielen Schwangerschaften und langer Stillzeit, könnte für Industrieländer mit einer 42 %igen Reduktion auch des postmenopausalen Karzinoms gerechnet werden. Die meisten Autoren vermuten, dass der protektive Wert des Stillens hormonbedingt sei. Weitere theoretische Ansätze ergeben sich aus den zunehmend bekannten immunologischen Eigenschaften der Muttermilch. Neben den bekannten positiven Effekten des Stillens auf die kindliche Gesundheit, sollte also auch aus Sicht der Gesundheitsprävention der Frau das Stillen weiter gefördert werden.

Abstract

Many epidemiological studies show clearly the restraining effect of breast-feeding on breast cancer. So it could be shown that breast-feeding for one year reduces the individual risk for premenopausal breast cancer by 45 %. The risk of postmenopausal breast cancer in the developed countries could be decreased by 42 % by increasing the breast feeding time in life. Most authors assume that the protective value of breast feeding is hormone-conditioned. Further theoretical implications result from the increasing knowledge of the immunologic characteristics of theÂ’mother’s milk. Beside well-known positive effects of breast- feeding on children’s health, breast-feeding should also be further promoted from the view of women’s health.

Literatur

  • 1 Unbekannt . Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50 302 women with breast cancer and 96 973 women without the disease.  Lancet. 2002;  360 (9328) 187-195
  • 2 Unbekannt . Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Collaborative Group on Hormonal Factors in Breast Cancer.  Lancet. 1996;  347 (9017) 1713-127
  • 3 Unbekannt . Breast cancer and hormonal contraceptives: further results. Collaborative Group on Hormonal Factors in Breast Cancer.  Contraception. 1996;  54 (3 Suppl) 1S-106S
  • 4 Unbekannt . Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52 705 women with breast cancer and 108 411 women without breast cancer. Collaborative Group on Hormonal Factors in Breast Cancer.  Lancet. 1997;  350 (9084) 1047-1059
  • 5 Abou-Dakn M, Strecker J R. Einflussfaktoren der Entbindungsklinik auf den Stillbeginn. In: Springer S, ed. 3. Deutscher Still- und Laktationskongress. Leipziger Univ.-Verlag, Leipzig 2001; vol. 4: 9-29
  • 6 Abou-Daoud K T. Cancer of the breast and breast-feeding. Study of 279 parous women and matched controls.  Cancer. 1971;  28(3) 781-784
  • 7 Abramson J H. Breastfeeding and breast cancer. A study of cases and matched controls in Jerusalem.  Isr J Med Sci. 1966;  2(4) 457-464
  • 8 Adami H O, Adams G, Boyle P, Ewertz M, Lee N C, Lund E . et al . Breast-cancer etiology. Report of a working party for the Nordic Cancer Union.  Int J Cancer Suppl. 1990;  5 22-39
  • 9 al-Idrissi H Y. Pattern of breast cancer in Saudi females in eastern province of Saudi Arabia.  Indian J Med Sci. 1991;  45(4) 85-87
  • 10 Anonymus .Breastfeeding and complemetary infant feeding, and the postpartum effects of breastfeeding. Demographic and health surveys comprehensive studies, vol. 30. Maryland, USA: Macro International Inc 1999
  • 11 Brignone G, Cusimano R, Dardanoni G, Gugliuzza M, Lanzarone F, Scibilia V. et al . A case-control study on breast cancer risk factors in a southern European population.  Int J Epidemiol. 1987;  16(3) 356-361
  • 12 Brinton L A, Potischman N A, Swanson C A, Schoenberg J B, Coates R J, Gammon M D. et al . Breastfeeding and breast cancer risk.  Cancer Causes Control. 1995;  6(3) 199-208
  • 13 Byers T, Graham S, Rzepka T, Marshall J. Lactation and breast cancer. Evidence for a negative association in premenopausal women.  Am J Epidemiol. 1985;  121(5) 664-674
  • 14 Chang-Claude J, Eby N, Kiechle M, Bastert G, Becher H. Breastfeeding and breast cancer risk by age 50 among women in Germany.  Cancer Causes Control. 2000;  11(8) 687-695
  • 15 Daniels J L, Olshan A F, Pollock B H, Shah N R, Stram D O. Breast- feeding and neuroblastoma, USA and Canada.  Cancer Causes Control. 2002;  13(5) 401-405
  • 16 Donegan W L. Epidemiology of mammary cancer.  Major Probl Clin Surg. 1967;  5 12-33
  • 17 Dulon M, Kersting M, Schach S. Duration of breastfeeding and associated factors in Western and Eastern Germany.  Acta Paediatr. 2001;  90(8) 931-935
  • 18 Egan K M, Stampfer M J, Rosner B A, Trichopoulos D, Newcomb P A, Trentham-Dietz A. et al . Risk factors for breast cancer in women with a breast cancer family history.  Cancer Epidemiol Biomarkers Prev. 1998;  7(5) 359-364
  • 19 Enger S M, Ross R K, Paganini-Hill A, Bernstein L. Breastfeeding experience and breast cancer risk among postmenopausal women.  Cancer Epidemiol Biomarkers Prev. 1998;  7(5) 365-369
  • 20 Glasier A, McNeilly A S. Physiology of lactation.  Baillieres Clin Endocrinol Metab. 1990;  4(2) 379-395
  • 21 Gwinn M L, Lee N C, Rhodes P H, Layde P M, Rubin G L. Pregnancy, breast feeding, and oral contraceptives and the risk of epithelial ovarian cancer.  J Clin Epidemiol. 1990;  43(6) 559-568
  • 22 Hardell L, Dreifaldt A C. Breast-feeding duration and the risk of malignant diseases in childhood in Sweden.  Eur J Clin Nutr. 2001;  55(3) 179-185
  • 23 Ing R, Petrakis N L, Ho J H. Unilateral breast-feeding and breast cancer.  Lancet. 1977;  2(8029) 124-127
  • 24 Kennedy K I. Effects of breastfeeding on women’s health.  Int J Gynaecol Obstet. 1994;  47 Suppl S11-20; discussion S20 - 21
  • 25 Kramer M S, Chalmers B, Hodnett E D, Sevkovskaya Z, Dzikovich I, Shapiro S. et al . Promotion of breastfeeding intervention trial (PROBIT): a cluster-randomized trial in the Republic of Belarus. Design, follow-up, and data validation.  Adv Exp Med Biol. 2000;  478 327-345
  • 26 Labbok M H. Effects of breastfeeding on the mother.  Pediatr Clin North Am. 2001;  48(1) 143-158
  • 27 Land C E, Hayakawa N, Machado S G, Yamada Y, Pike M C, Akiba S. et al . A case-control interview study of breast cancer among Japanese A-bomb survivors. I. Main effects.  Cancer Causes Control. 1994;  5(2) 157-65
  • 28 Lane-Claypon J. A further report on cancer with special reference to its associate antecendent conditions. Vol. 32. London: HMSO, 1926
  • 29 Layde P M, Webster L A, Baughman A L, Wingo P A, Rubin G L, Ory H W. The independent associations of parity, age at first full term pregnancy, and duration of breastfeeding with the risk of breast cancer. Cancer and Steroid Hormone Study Group.  J Clin Epidemiol. 1989;  42(10) 963-73
  • 30 Lipworth L. Epidemiology of brest cancer.  Eur J Cancer Prev.. 1995;  4 7-30
  • 31 Lipworth L, Bailey L R, Trichopoulos D. History of breast-feeding in relation to breast cancer risk: a review of the epidemiologic literature.  J Natl Cancer Inst. 2000;  92(4) 302-12
  • 32 MacMahon B. Lactation and cancer of the breast: A summery of an international study.  bull WHO. 1970;  42 185-94
  • 33 McCredie M, Paul C, Skegg D C, Williams S. Family history and risk of breast cancer in New Zealand.  Int J Cancer. 1997;  73(4) 503-7
  • 34 Michels K B, Willett W C, Rosner B A, Manson J E, Hunter D J, Colditz G A,. et al . Prospective assessment of breastfeeding and breast cancer incidence among 89,887 women.  Lancet. 1996;  347(8999) 431-6
  • 35 Murrell T G. Epidemiological and biochemical support for a theory on the cause and prevention of breast cancer.  Med Hypotheses. 1991;  36(4) 389-96
  • 36 Newcomb P A. Lactation and breast cancer risk.  J Mammary Gland Biol Neoplasia. 1997;  2(3) 311-8
  • 37 Parkin D M, Pisani P, Ferlay J. Estimates of the worldwide incidence of 25 major cancers in 1990.  Int J Cancer. 1999;  80(6) 827-41
  • 38 Petrakis N L, Wrensch M R, Ernster V L, Miike R, Murai J, Simberg N. et al . Influence of pregnancy and lactation on serum and breast fluid estrogen levels: implications for breast cancer risk.  Int J Cancer. 1987;  40(5) 587-91
  • 39 Rabe T, Rabe D, Runnebaum B. New aromatase assay and its application for inhibitory studies of aminoglutethimide on microsomes of human term placenta.  J Steroid Biochem. 1982;  17(3) 305-309
  • 40 Riordan J. Anatomy and psychophysiology of lactation. In: Auerback JRaK, ed. Breastfeeding and human lactation Boston: Jones and Bartlett, 1993: 81-104
  • 41 Romieu I, Hernandez-Avila M, Lazcano E, Lopez L, Romero-Jaime R. Breast cancer and lactation history in Mexican women.  Am J Epidemiol. 1996;  143(6) 543-552
  • 42 Rosero-Bixby L, Oberle M W, Lee N C. Reproductive history and breast cancer in a population of high fertility, Costa Rica, 1984-85.  Int J Cancer. 1987;  40(6) 747-754
  • 43 Sauer H, Hölzel D, Keßler M, Untch M. Nachsorge. In: München T, ed. Mammakarzinom. Tumorzentrum München, Mü nchen 2001; vol. 8: 83 - 96
  • 44 Schaefer O. Cancer of the breast and lactation.  Can Med Assoc J. 1969;  100(13) 625-626
  • 45 Siiteri P K, Murai J T, Hammond G L, Nisker J A, Raymoure W J, Kuhn R W. The serum transport of steroid hormones.  Recent Prog Horm Res. 1982;  38 457-510
  • 46 Sikorski J, Renfrew M J, Pindoria S, Wade A. Support for breastfeeding mothers. Cochrane Database Syst Rev 2002(1); CD001141
  • 47 Siskind V, Schofield F, Rice D, Bain C. Breast cancer and breastfeeding: results from an Australian case-control study.  Am J Epidemiol. 1989;  130(2) 229-236
  • 48 Stillkommission N. Empfehlungen der Nationalen Stillkommission Deutschland. In: Przyrembel H, ed. Stillen und Muttermilchernährung. BZgA, Köln 2001; vol. 3: 279 - 284
  • 49 UNICEF W. On the protection, promotion and support of breastfeeding. UNICEF W, ed. A globel initiative 1990
  • 50 UNICEF W. The State of the worlds children New York. unicef 2003
  • 51 Vorherr H. Breast cancer. Urban und Schwarzer, Baltimore, München 1980
  • 52 Zheng T, Duan L, Liu Y, Zhang B, Wang Y, Chen Y. et al . Lactation reduces breast cancer risk in Shandong Province, China.  Am J Epidemiol. 2000;  152(12) 1129-1135

Dr. Michael Abou-Dakn

Ltd. Oberarzt der Klinik für Gynäkologie und Geburtsmedizin

Am Nordgraben 2

13503 Berlin

Phone: +49/30/41 94 12 52

Fax: +49/30/41 94 12 62

Email: MAbou-Dakn@khr-berlin.de