Alternating Reducing and Enhancing Effect of Pregnancy on Breast Cancer Risk May Reveal Periodic Phenomena which Mask Circannual Rhythms

Abstract

Although a relationship between reproductive factors and breast cancer risk has been known for long, there are many contradictions between different studies, and a connection with a biological mechanism has not yet been found. Recently, new details have been revealed about different effects of pregnancy on breast cancer risk. During pregnancy breast cancer risk is strongly reduced, while inversely,some years after giving birth the risk is increased. Furthermore, risk is strongly reduced in women whose consecutive births of four or more children occur after short intervals and are terminated before the age of 30. Recently, we have postulated rhythmicity in the occurrence of breast cancer in a subgroup of young women. By analogy with circadian rhythms it may be assumed that circannual rhythms too are influenced by synchronizers and masking effects. In circadian rhythms masking may be by external or internal periodic factors, such as the sleep/wake cycle, meal timing and activity. Over the year pregnancy may be such a periodic factor, with alternation of an empty uterus and one wich gradually enlarges as a consequence of a developing fetus. A masking factor is active only as long as present. Therefore the circannual rhythmicity of breast cancer is attenuated or nullified only during pregnancy. After giving birth, the temporal deficit of the rhythmic increase of tumor growth may be restored, leading to a rebound effect expressed as an increased clinical detection of malignancy some years later. When several consecutive pregnancies occur after short intervals the masking effect continues uninterruptedly, accompanied by a strong reduced breast cancer risk. The same biological mechanism may underly the remission during pregnancy in autoimmune disorders such as rheumatoid arthritis and Graves’ disease. The immune system, crucial in autoimmune disorders, is build up of several constituents which are clearly rhythmic, e.g the lymphocytes. Masking of one or more of these rhythmicities may lead to disease attenuation, followed by relapses as soon as the masking factor has been eliminated.