Puerperal mastitis a reproductive event of import

Authors: Daniel W Cramer Kristina Williams Allison F Vitonis Hidemi S Yamamoto Alison Stuebe William R Welch Linda Titus Raina N Fichorova

Publish Date: 2013/08/08

Volume: 24, Issue: 11, Pages: 1911-1923

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Abstract

In two case–control studies conducted in New England between 1998 and 2008 we examined the association between selfreported mastitis and ovarian cancer in 1483 women with epithelial ovarian cancer and 1578 controls IgG1 antibodies against MUC1 CA153 and MUC16 CA125 were measured using electrochemiluminescence assays in a subset of controls n = 200 Preoperative CA125 was recorded in 649 cases The association between ovarian cancer and mastitis was assessed using unconditional logistic regression to calculate adjusted odds ratios OR and 95  confidence intervals CI Associations between mastitis and antiCA153 and antiCA125 antibodies and preoperative CA125 levels were evaluated using adjusted linear regression modelsPrior mastitis was associated with a significantly lower risk of ovarian cancer OR and 95  CI of 067 048 094 adjusted for parity breastfeeding and other potential confounders The association was strongest with 2 or more episodes of mastitis and risk declined progressively with increasing number of children and episodes of mastitis Among controls prior mastitis was associated with significantly higher antiCA153 and antiCA125 antibody levels and among cases with significantly lower preoperative CA125 levelsPuerperal mastitis may produce longlasting antimucin antibodies that may lower the risk of ovarian cancer plausibly through enhanced immune surveillance Studying immune reactions related to MUC1 and MUC16 in the 10–20  of breastfeeding women who develop mastitis may suggest ways to duplicate its effects through vaccines based on both antigensWe acknowledge Professor Olivera J Finn for her support of our prior studies of mucin immunity and ovarian cancer and her thoughtful input on this manuscript We thank John R McKolanis for his technical advice on the antimucin assays and Hassan Y Dawood BS for performing the antiCA125 and anti CA153 immunoassays in Dr Fichorova’s laboratory This work is dedicated to the memory of Katherine Astrove in recognition of her husband’s longterm support of research on ovarian cancer at the Brigham and Women’s Hospital This research was supported by the National Institutes of Health Grant numbers R01CA123170 R01CA54419 and P50CA105009 to DWC and donations from Mr Edgar Astrove

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