Distribution of age at natural menopause, age at menarche, menstrual cycle length, height and BMI in BRCA1 and BRCA2 pathogenic variant carriers and non-carriers: results from EMBRACE

Abstract Background Carriers of germline pathogenic variants (PVs) in the BRCA1 and BRCA2 genes are at higher risk of developing breast and ovarian cancer than the general population. It is unclear if these PVs influence other breast or ovarian cancer risk factors, including age at menopause (ANM),...

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Main Authors: Nasim Mavaddat, Debra Frost, Emily Zhao, Daniel R. Barnes, Munaza Ahmed, Julian Barwell, Angela F. Brady, Paul Brennan, Hector Conti, Jackie Cook, Harriet Copeland, Rosemarie Davidson, Alan Donaldson, Emma Douglas, David Gallagher, Rachel Hart, Louise Izatt, Zoe Kemp, Fiona Lalloo, Zosia Miedzybrodzka, Patrick J. Morrison, Jennie E. Murray, Alex Murray, Hannah Musgrave, Claire Searle, Lucy Side, Katie Snape, Vishakha Tripathi, Lisa Walker, Stephanie Archer, D. Gareth Evans, Marc Tischkowitz, Antonis C. Antoniou, Douglas F. Easton
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Breast Cancer Research
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Online Access:https://doi.org/10.1186/s13058-025-02030-9
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author Nasim Mavaddat
Debra Frost
Emily Zhao
Daniel R. Barnes
Munaza Ahmed
Julian Barwell
Angela F. Brady
Paul Brennan
Hector Conti
Jackie Cook
Harriet Copeland
Rosemarie Davidson
Alan Donaldson
Emma Douglas
David Gallagher
Rachel Hart
Louise Izatt
Zoe Kemp
Fiona Lalloo
Zosia Miedzybrodzka
Patrick J. Morrison
Jennie E. Murray
Alex Murray
Hannah Musgrave
Claire Searle
Lucy Side
Katie Snape
Vishakha Tripathi
Lisa Walker
Stephanie Archer
D. Gareth Evans
Marc Tischkowitz
Antonis C. Antoniou
Douglas F. Easton
author_facet Nasim Mavaddat
Debra Frost
Emily Zhao
Daniel R. Barnes
Munaza Ahmed
Julian Barwell
Angela F. Brady
Paul Brennan
Hector Conti
Jackie Cook
Harriet Copeland
Rosemarie Davidson
Alan Donaldson
Emma Douglas
David Gallagher
Rachel Hart
Louise Izatt
Zoe Kemp
Fiona Lalloo
Zosia Miedzybrodzka
Patrick J. Morrison
Jennie E. Murray
Alex Murray
Hannah Musgrave
Claire Searle
Lucy Side
Katie Snape
Vishakha Tripathi
Lisa Walker
Stephanie Archer
D. Gareth Evans
Marc Tischkowitz
Antonis C. Antoniou
Douglas F. Easton
author_sort Nasim Mavaddat
collection DOAJ
description Abstract Background Carriers of germline pathogenic variants (PVs) in the BRCA1 and BRCA2 genes are at higher risk of developing breast and ovarian cancer than the general population. It is unclear if these PVs influence other breast or ovarian cancer risk factors, including age at menopause (ANM), age at menarche (AAM), menstrual cycle length, BMI or height. There is a biological rationale for associations between BRCA1 and BRCA2 PVs and reproductive traits, for example involving DNA damage and repair mechanisms. The evidence for or against such associations is limited. Methods We used data on 3,046 BRCA1 and 3,264 BRCA2 PV carriers, and 2,857 non-carrier female relatives of PV carriers from the Epidemiological Study of Familial Breast Cancer (EMBRACE). Associations between ANM and PV carrier status was evaluated using linear regression models allowing for censoring. AAM, menstrual cycle length, BMI, and height in carriers and non-carriers were compared using linear and multinomial logistic regression. Analyses were adjusted for potential confounders, and weighted analyses carried out to account for non-random sampling with respect to cancer status. Results No statistically significant difference in ANM between carriers and non-carriers was observed in analyses accounting for censoring. Linear regression effect sizes for ANM were -0.002 (95%CI: -0.401, 0.397) and -0.172 (95%CI: -0.531, 0.188), for BRCA1 and BRCA2 PV carriers respectively, compared with non-carrier women. The distributions of AAM, menstrual cycle length and BMI were similar between PV carriers and non-carriers, but BRCA1 PV carriers were slightly taller on average than non-carriers (0.5 cm difference, p = 0.003). Conclusion Information on the distribution of cancer risk factors in PV carriers is needed for incorporating these factors into multifactorial cancer risk prediction algorithms. Contrary to previous reports, we found no evidence that BRCA1 or BRCA2 PV are associated with hormonal or anthropometric factors, except for a weak association with height. We highlight methodological considerations and data limitations inherent in studies aiming to address this question.
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spelling doaj-art-915836c9e2fe45f6a1dfbc638128e99c2025-08-20T03:47:45ZengBMCBreast Cancer Research1465-542X2025-05-0127111210.1186/s13058-025-02030-9Distribution of age at natural menopause, age at menarche, menstrual cycle length, height and BMI in BRCA1 and BRCA2 pathogenic variant carriers and non-carriers: results from EMBRACENasim Mavaddat0Debra Frost1Emily Zhao2Daniel R. Barnes3Munaza Ahmed4Julian Barwell5Angela F. Brady6Paul Brennan7Hector Conti8Jackie Cook9Harriet Copeland10Rosemarie Davidson11Alan Donaldson12Emma Douglas13David Gallagher14Rachel Hart15Louise Izatt16Zoe Kemp17Fiona Lalloo18Zosia Miedzybrodzka19Patrick J. Morrison20Jennie E. Murray21Alex Murray22Hannah Musgrave23Claire Searle24Lucy Side25Katie Snape26Vishakha Tripathi27Lisa Walker28Stephanie Archer29D. Gareth Evans30Marc Tischkowitz31Antonis C. Antoniou32Douglas F. Easton33Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of CambridgeDepartment of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of CambridgeDepartment of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of CambridgeDepartment of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of CambridgeNorth East Thames Regional Clinical Genetics Service, Great Ormond Street HospitalLeicestershire, Northamptonshire and Rutland Clinical Genetics Service, University Hospitals of Leicester NHS TrustNorth West Thames Regional Genetics Service, London North West University Healthcare NHS TrustNorthern Genetics Service, Newcastle Upon Tyne NHS Foundation TrustAll Wales Medical Genomics Services, Wrexham Maelor HospitalSheffield Clinical Genetics Service, Sheffield Children’s HospitalDepartment Clinical Genetics, Royal Devon University Healthcare NHS Foundation TrustDepartment of Clinical Genetics, South Glasgow University HospitalsClinical Genetics Department, St Michael’s HospitalWest Midlands Regional Clinical Genetics Service, Birmingham Women’s HospitalTrinity St Jame’s Cancer Institute, Cancer Genetics ServiceLiverpool Women’s Hospital Cheshire and Merseyside Genetics, Liverpool Women’s NHS Foundation TrustClinical Genetics, Guy’s and St. Thomas’ NHS Foundation TrustRoyal Marsden Hospital, NHS TrustClinical Genetics Service, Manchester Centre for Genomic Medicine, Manchester University Hospitals Foundation TrustNHS Grampian, North of Scotland Regional Genetics ServiceBelfast Health and Social Care Trust, Clinical Genetics ServiceSouth East Scotland Clinical Genetics Service, Western General HospitalAll Wales Medical Genomics Service, Wales Genomic Health CentreLeeds Genomic Medicine Service, Leeds Teaching Hospitals NHS TrustDepartment of Clinical Genetics, Nottingham University Hospitals NHS TrustUniversity Hospital Southampton NHS Trust and Princess Anne HospitalMedical Genetics Unit, St George’s, University of LondonClinical Genetics, Guy’s and St. Thomas’ NHS Foundation TrustOxford Centre for Genomic Medicine, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation TrustDepartment of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of CambridgeGenomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution, Infection and Genomic Science, University of Manchester, Manchester University Hospitals NHS Foundation TrustDepartment of Genomic Medicine, Cambridge Biomedical Research Centre, National Institute for Health Research, University of CambridgeDepartment of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of CambridgeDepartment of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of CambridgeAbstract Background Carriers of germline pathogenic variants (PVs) in the BRCA1 and BRCA2 genes are at higher risk of developing breast and ovarian cancer than the general population. It is unclear if these PVs influence other breast or ovarian cancer risk factors, including age at menopause (ANM), age at menarche (AAM), menstrual cycle length, BMI or height. There is a biological rationale for associations between BRCA1 and BRCA2 PVs and reproductive traits, for example involving DNA damage and repair mechanisms. The evidence for or against such associations is limited. Methods We used data on 3,046 BRCA1 and 3,264 BRCA2 PV carriers, and 2,857 non-carrier female relatives of PV carriers from the Epidemiological Study of Familial Breast Cancer (EMBRACE). Associations between ANM and PV carrier status was evaluated using linear regression models allowing for censoring. AAM, menstrual cycle length, BMI, and height in carriers and non-carriers were compared using linear and multinomial logistic regression. Analyses were adjusted for potential confounders, and weighted analyses carried out to account for non-random sampling with respect to cancer status. Results No statistically significant difference in ANM between carriers and non-carriers was observed in analyses accounting for censoring. Linear regression effect sizes for ANM were -0.002 (95%CI: -0.401, 0.397) and -0.172 (95%CI: -0.531, 0.188), for BRCA1 and BRCA2 PV carriers respectively, compared with non-carrier women. The distributions of AAM, menstrual cycle length and BMI were similar between PV carriers and non-carriers, but BRCA1 PV carriers were slightly taller on average than non-carriers (0.5 cm difference, p = 0.003). Conclusion Information on the distribution of cancer risk factors in PV carriers is needed for incorporating these factors into multifactorial cancer risk prediction algorithms. Contrary to previous reports, we found no evidence that BRCA1 or BRCA2 PV are associated with hormonal or anthropometric factors, except for a weak association with height. We highlight methodological considerations and data limitations inherent in studies aiming to address this question.https://doi.org/10.1186/s13058-025-02030-9BRCA1BRCA2MenopauseMenarcheHeightBody mass index
spellingShingle Nasim Mavaddat
Debra Frost
Emily Zhao
Daniel R. Barnes
Munaza Ahmed
Julian Barwell
Angela F. Brady
Paul Brennan
Hector Conti
Jackie Cook
Harriet Copeland
Rosemarie Davidson
Alan Donaldson
Emma Douglas
David Gallagher
Rachel Hart
Louise Izatt
Zoe Kemp
Fiona Lalloo
Zosia Miedzybrodzka
Patrick J. Morrison
Jennie E. Murray
Alex Murray
Hannah Musgrave
Claire Searle
Lucy Side
Katie Snape
Vishakha Tripathi
Lisa Walker
Stephanie Archer
D. Gareth Evans
Marc Tischkowitz
Antonis C. Antoniou
Douglas F. Easton
Distribution of age at natural menopause, age at menarche, menstrual cycle length, height and BMI in BRCA1 and BRCA2 pathogenic variant carriers and non-carriers: results from EMBRACE
Breast Cancer Research
BRCA1
BRCA2
Menopause
Menarche
Height
Body mass index
title Distribution of age at natural menopause, age at menarche, menstrual cycle length, height and BMI in BRCA1 and BRCA2 pathogenic variant carriers and non-carriers: results from EMBRACE
title_full Distribution of age at natural menopause, age at menarche, menstrual cycle length, height and BMI in BRCA1 and BRCA2 pathogenic variant carriers and non-carriers: results from EMBRACE
title_fullStr Distribution of age at natural menopause, age at menarche, menstrual cycle length, height and BMI in BRCA1 and BRCA2 pathogenic variant carriers and non-carriers: results from EMBRACE
title_full_unstemmed Distribution of age at natural menopause, age at menarche, menstrual cycle length, height and BMI in BRCA1 and BRCA2 pathogenic variant carriers and non-carriers: results from EMBRACE
title_short Distribution of age at natural menopause, age at menarche, menstrual cycle length, height and BMI in BRCA1 and BRCA2 pathogenic variant carriers and non-carriers: results from EMBRACE
title_sort distribution of age at natural menopause age at menarche menstrual cycle length height and bmi in brca1 and brca2 pathogenic variant carriers and non carriers results from embrace
topic BRCA1
BRCA2
Menopause
Menarche
Height
Body mass index
url https://doi.org/10.1186/s13058-025-02030-9
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