title: Gestational diabetes mellitus may be associated with increased risk of breast cancer.
abstract: BACKGROUND
  Although a positive association between type 2 diabetes and breast cancer has been reported, an association with gestational diabetes mellitus (GDM) is less clear.
  
  
  METHODS
  The Sister Study enroled 50 884 women aged 35-74 years, from 2003 through 2009. Cox proportional hazards models were used to estimate breast cancer risk in relation to GDM.
  
  
  RESULTS
  Ever having GDM was not associated with breast cancer overall (hazards ratio (HR)=1.10, 95% confidence interval (CI)=0.88-1.36), but there was a suggestive association between ever having a GDM pregnancy and oestrogen receptor (ER) -negative breast cancer (HR=1.73, 95% CI=0.98-3.06). However, having 2 or more GDM pregnancies was associated with overall breast cancer risk 1.68 (95% CI=1.15-2.44) and with ER-positive breast cancer (HR=1.81, 95% CI=1.10-2.98), which was supported by sensitivity analyses. Results were similar when analyses were stratified by whether or not type 2 diabetes had developed after GDM.
  
  
  CONCLUSIONS
  Women with multiple GDM pregnancies had a higher incidence of breast cancer, suggesting that such women could benefit from increased surveillance for breast cancer.
authors.affiliation: Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
authors.forename: Yong-Moon Mark
authors.initials: YM
authors.lastname: Park
authors.affiliation: Biostatistics & Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
authors.forename: Katie M
authors.initials: KM
authors.lastname: O'Brien
authors.affiliation: Biostatistics & Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Biostatistics & Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
authors.forename: Clarice R
authors.initials: CR
authors.lastname: Weinberg
authors.affiliation: Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
authors.forename: Donna D
authors.initials: DD
authors.lastname: Baird
authors.affiliation: Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA.
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009367:Neoplasm Staging; D011247:Pregnancy; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult