Association of endometriosis and breast cancer: mini review of the literature

Background Endometriosis is a common, estrogen-dependent, gynecological disease, which is defined as the presence of endometrial tissue outside the uterine cavity. Current data have associated endometriosis with specific malignancies, including ovarian and breast cancer. Purpose The purpose of our study is to summarize and present published literature providing evidence regarding the possible relationship between endometriosis and breast cancer.

Pubmed and Scopus databases were searched systematically for studies that sought to identify a potential association of endometriosis and breast cancer. 15 relevant articles were retrieved and included in the present review.

A small number of observational studies have shown a correlation of endometriosis and breast cancer. Other studies found that the risk of breast cancer increases with age. The scenario of an early interruption of the inflammatory process, derived from endometriosis, by oophorectomy and a possible consequent decrease in the risk of breast cancer has also been proposed. The hypothesis that both conditions could be related through common mutations on BRAC1 and BRAC2 genes has also been investigated.

The available published evidence is inconclusive. Further studies are needed to evaluate the association of endometriosis and breast cancer and the possible pathogenetic pathways that relate the two disorders. Similar content being viewed by others

Panidis DK, Matalliotakis IM (1998) Subfertility associated with minimal to mild endometriosis. Main mechanisms. J Reprod Med 43:1034–1042 Ozkan S, Murk W, Arici A (2008) Endometriosis and infertility, epidemiology and evidence-based treatments. Ann N Y Acad Sci 1127:92–100 Somigliana E, Vigano P, Parazzini F, Stoppelli S, Giambattista E, Vercellini P (2006) Association between endometriosis and cancer: a comprehensive review and a critical analysis of clinical and epidemiological evidence. Gynecol Oncol 101:331–341 Genc M, Genc B, Karaarslan S, Solak A, Saracoglu M (2014) Endometriosis localized to urinary bladder wall mimicking urinary bladder carcinoma. Arch Ital Urol Androl 86:233–234 Ceccaroni M, Clarizia R, Placci A (2010) Pericardial, pleural, and diaphragmatic endometriosis. J Thorac Cardiovasc Surg 140:1189–1190 Zorbas KA, Economopoulos KP, Vlahos NF (2015) Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review. Arch Gynecol Obstet 292(1):37–43 Garry R (2006) Diagnosis of endometriosis and pelvic pain. Fertil Steril 86:1307–1309 Kokcu A (2011) Relationship between endometriosis and cancer from current perspective. Arch Gynecol Obstet 284:1473–1479 Brinton LA, Gridley G, Persson I, Baron J, Bergqvist A (1997) Cancer risk after a hospital discharge diagnosis of endometriosis. Am J Obstet Gynecol 176:572–579 Wiegand KC, Shah SP, Al-Agha OM, Zhao Y, Tse K, Zeng T, Senz J, McConechy MK, Anglesio MS, Kalloger SE et al (2010) ARID1A mutations in endometriosis-associated ovarian carcinomas. N Engl J Med 363:1532–1543 Worley MJ, Welch WR, Berkowitz RS, Ng SW (2013) Endometriosis-associated ovarian cancer: a review of pathogenesis. Int J Mol Sci 14:5367–5379 Melin A, Sparen P, Persson I, Bergqvist A (2006) Endometriosis and the risk of cancer with special emphasis on ovarian cancer. Hum Reprod 21:1237–1242 Melin A, Sparen P, Bergqvist A (2007) The risk of cancer and the role of parity among women with endometriosis. Hum Reprod 22:3021–3026 Liede A, Pal T, Mitchell M, Narod SA (2000) Delineation of a new syndrome: clustering of pyloric stenosis, endometriosis, and breast cancer in two families. J Med Genet 37:794–796 Borgfeldt C, Andolf E (2004) Cancer risk after hospital discharge diagnosis of benign ovarian cysts and endometriosis. Acta Obstet Gynecol Scand 83:395–400 Baron JA, Weiderpass E, Newcomb PA, Stampfer M, Titus-Ernstoff L, Egan KM, Greenberg ER (2001) Metabolic disorders and breast cancer risk (United States). Cancer Causes Control 12:875–880 Morales L, Alvarez-Garriga C, Matta J, Ortiz C, Vergne Y, Vargas W, Acosta H, Ramirez J, Perez-Mayoral J, Bayona M (2013) Factors associated with breast cancer in Puerto Rican women. J Epidemiol Glob Health 3:205–215 Gemmill JA, Stratton P, Cleary SD, Ballweg ML, Sinaii N (2010) Cancers, infections, and endocrine diseases in women with endometriosis. Fertil Steril 94:1627–1631 Olson JE, Cerhan JR, Janney CA, Anderson KE, Vachon CM, Sellers TA (2002) Postmenopausal cancer risk after self-reported endometriosis diagnosis in the Iowa Women’s Health Study. Cancer 94:1612–1618 Bertelsen L, Mellemkjaer L, Frederiksen K, Kjaer SK, Brinton LA, Sakoda LC, van Valkengoed I, Olsen JH (2007) Risk for breast cancer among women with endometriosis. Int J Cancer 120:1372–1375 Aviel-Ronen S, Soriano D, Shmuel E, Schonman R, Rosenblatt K, Zadok O, Vituri A, Seidman D, Barshack I, Cohen Y (2014) Surgically treated ovarian endometriosis association with BRCA1 and BRCA2 mutations. Pathol Res Pract 210:250–255 Schairer C, Persson I, Falkeborn M, Naessen T, Troisi R, Brinton LA (1997) Breast cancer risk associated with gynecologic surgery and indications for such surgery. Int J Cancer 70:150–154 Weiss HA, Brinton LA, Potischman NA, Brogan D, Coates RJ, Gammon MD, Malone KE, Schoenberg JB (1999) Breast cancer risk in young women and history of selected medical conditions. Int J Epidemiol 28:816–823 Nichols HB, Visvanathan K, Newcomb PA, Hampton JM, Egan KM, Titus-Ernstoff L, Trentham-Dietz A (2011) Bilateral oophorectomy in relation to risk of postmenopausal breast cancer: confounding by nonmalignant indications for surgery? Am J Epidemiol 173:1111–1120 Govindan S, Ahmad SN, Vedicherla B, Kodati V, Jahan P, Rao KP, Ahuja YR, Hasan Q (2007) Association of progesterone receptor gene polymorphism (PROGINS) with endometriosis, uterine fibroids and breast cancer. Cancer Biomark 3:73–78 Matalliotakis IM, Cakmak H, Mahutte N, Goumenou AG, Koumantakis G, Arici A (2008) The familial risk of breast cancer in women with endometriosis from Yale series. Surg Oncol 17:289–293 Melin A, Lundholm C, Malki N, Swahn ML, Sparen P, Bergqvist A (2011) Endometriosis as a prognostic factor for cancer survival. Int J Cancer 129:948–955 Ness RB, Modugno F (2006) Endometriosis as a model for inflammation-hormone interactions in ovarian and breast cancers. Eur J Cancer 42:691–703 Lebovic DI, Mueller MD, Taylor RN (2001) Immunobiology of endometriosis. Fertil Steril 75:1–10 Gazvani R, Templeton A (2002) New considerations for the pathogenesis of endometriosis. Int J Gynaecol Obstet 76:117–126 Reed MJ, Purohit A (1997) Breast cancer and the role of cytokines in regulating estrogen synthesis: an emerging hypothesis. Endocr Rev 18:701–715 Singer CF, Kronsteiner N, Hudelist G, Marton E, Walter I, Kubista M, Czerwenka K, Schreiber M, Seifert M, Kubista E (2003) Interleukin 1 system and sex steroid receptor expression in human breast cancer: interleukin 1alpha protein secretion is correlated with malignant phenotype. Clin Cancer Res 9:4877–4883 Zeitoun KM, Bulun SE (1999) Aromatase: a key molecule in the pathophysiology of endometriosis and a therapeutic target. Fertil Steril 72:961–969 Collins JA, Blake JM, Crosignani PG (2005) Breast cancer risk with postmenopausal hormonal treatment. Hum Reprod Update 11:545–560 Prentice RL, Chlebowski RT, Stefanick ML, Manson JE, Langer RD, Pettinger M, Hendrix SL, Hubbell FA, Kooperberg C, Kuller LH et al (2008) Conjugated equine estrogens and breast cancer risk in the Women’s Health Initiative clinical trial and observational study. Am J Epidemiol 167:1407–1415 Ron E, Lunenfeld B, Menczer J, Blumstein T, Katz L, Oelsner G, Serr D (1987) Cancer incidence in a cohort of infertile women. Am J Epidemiol 125:780–790 Orgeas CC, Sanner K, Hall P, Conner P, Holte J, Nilsson SJ, Sundfeldt K, Persson I, Chia KS, Wedren S et al (2009) Breast cancer incidence after hormonal infertility treatment in Sweden: a cohort study. Am J Obstet Gynecol 200(72):e71–e77 Doyle P, Maconochie N, Beral V, Swerdlow AJ, Tan SL (2002) Cancer incidence following treatment for infertility at a clinic in the UK. Hum Reprod 17:2209–2213 Kitawaki J, Obayashi H, Ishihara H, Koshiba H, Kusuki I, Kado N, Tsukamoto K, Hasegawa G, Nakamura N, Honjo H (2001) Oestrogen receptor-alpha gene polymorphism is associated with endometriosis, adenomyosis and leiomyomata. Hum Reprod 16:51–55 Massart F, Becherini L, Marini F, Noci I, Piciocchi L, Del Monte F, Masi L, Falchetti A, Tanini A, Scarselli G, Brandi L (2003) Analysis of estrogen receptor (ERalpha and ERbeta) and progesterone receptor (PR) polymorphisms in uterine leiomyomas. Med Sci Monit 9:BR25–BR30 Conneely OM, Mulac-Jericevic B, DeMayo F, Lydon JP, O’Malley BW (2002) Reproductive functions of progesterone receptors. Recent Prog Horm Res 57:339–355 Lattuada D, Somigliana E, Vigano P, Candiani M, Pardi G, Di Blasio AM (2004) Genetics of endometriosis: a role for the progesterone receptor gene polymorphism PROGINS? Clin Endocrinol (Oxf) 61:190–194 Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest We declare that we have no conflict of interest. Rights and permissions About this article Cite this article Anifantaki, F., Boutas, I., Kalampokas, T. et al. Association of endometriosis and breast cancer: mini review of the literature. Arch Gynecol Obstet 293, 5–10 (2016). https://doi.org/10.1007/s00404-015-3809-8 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-015-3809-8