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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)

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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.

Schlüsselwörter

das Stillen - Brusttumore/Epidemiologie/Vorbeugung & Kontrolle - Alter der Mutter - Statistiken

Key words

Breast-feeding - breast neoplasms/epidemiology/prevention & control - maternal age - statistics

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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 3 Unbekannt . Breast cancer and hormonal contraceptives: further results. Collaborative Group on Hormonal Factors in Breast Cancer.  Contraception. 1996;  54 (3 Suppl) 1S-106S
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 16 Donegan W L. Epidemiology of mammary cancer.  Major Probl Clin Surg. 1967;  5 12-33
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 20 Glasier A, McNeilly A S. Physiology of lactation.  Baillieres Clin Endocrinol Metab. 1990;  4(2) 379-395
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 23 Ing R, Petrakis N L, Ho J H. Unilateral breast-feeding and breast cancer.  Lancet. 1977;  2(8029) 124-127
    PubMedGoogle Scholar
  • 24 Kennedy K I. Effects of breastfeeding on women’s health.  Int J Gynaecol Obstet. 1994;  47 Suppl S11-20; discussion S20 - 21
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 26 Labbok M H. Effects of breastfeeding on the mother.  Pediatr Clin North Am. 2001;  48(1) 143-158
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 28 Lane-Claypon J. A further report on cancer with special reference to its associate antecendent conditions. Vol. 32. London: HMSO, 1926
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 30 Lipworth L. Epidemiology of brest cancer.  Eur J Cancer Prev.. 1995;  4 7-30
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 32 MacMahon B. Lactation and cancer of the breast: A summery of an international study.  bull WHO. 1970;  42 185-94
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 36 Newcomb P A. Lactation and breast cancer risk.  J Mammary Gland Biol Neoplasia. 1997;  2(3) 311-8
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 40 Riordan J. Anatomy and psychophysiology of lactation. In: Auerback JRaK, ed. Breastfeeding and human lactation Boston: Jones and Bartlett, 1993: 81-104
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 43 Sauer H, Hölzel D, Keßler M, Untch M. Nachsorge. In: München T, ed. Mammakarzinom. Tumorzentrum München, Mü nchen 2001; vol. 8: 83 - 96
    Google Scholar
  • 44 Schaefer O. Cancer of the breast and lactation.  Can Med Assoc J. 1969;  100(13) 625-626
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 46 Sikorski J, Renfrew M J, Pindoria S, Wade A. Support for breastfeeding mothers. Cochrane Database Syst Rev 2002(1); CD001141
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 48 Stillkommission N. Empfehlungen der Nationalen Stillkommission Deutschland. In: Przyrembel H, ed. Stillen und Muttermilchernährung. BZgA, Köln 2001; vol. 3: 279 - 284
    Google Scholar
  • 49 UNICEF W. On the protection, promotion and support of breastfeeding. UNICEF W, ed. A globel initiative 1990
    Google Scholar
  • 50 UNICEF W. The State of the worlds children New York. unicef 2003
    Google Scholar
  • 51 Vorherr H. Breast cancer. Urban und Schwarzer, Baltimore, München 1980
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar

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

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