Evaluation of relationship between breast cancer and migraine

Authors
Abbas Ghorbani 1
Azam Moradi 1
Abbas Gookizadeh 2
Saman Jokar 3
Seyed Ali Sonbolestan 4
1 Department of Neurology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Radiotherapy, Omid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Oral and Maxillofacial Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
4 Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Frequency of migraine changes at different times of a woman's reproductive cycle because of fluctuation of estrogen levels. Breast cancer has also a link with hormonal changes. Given this fact that both migraine and breast cancer are affected by estrogen, the prevalence of migraine may be different in breast cancer patients compared to the normal population.
Materials and Methods: In this case-control study, two groups of women with and without breast cancer were compared regarding the prevalence of migraine. Each group consisted of 400 women. The diagnosis of different types of headache was made based on The International Headache Society (IHS) guidelines. Type of headache, type and receptor status of breast cancer, as well as history of taking hormonal medications was recorded. Independent t-test and Chi-square tests were used for data analysis.
Results: Relative frequency of migraine headache in the normal woman was 38% compared to 19% in the breast cancer group (P < 0.0001). Tension headache was also significantly more prevalent in the normal group (P < 0.001). The frequency of migraine was significantly lower in estrogen receptor (ER)+/progesterone receptor (PR)− women compared to ER−/PR+ (26 and 43 women, respectively; P = 0.04); however, this difference was not significant for tension headache (P = 0.68).
Conclusion: This study confirmed the lower frequency of migraine, as well as tension headache, in breast cancer sufferers. This could be contributed to several non-hormonal factors, such as a history of long term use of nonsteroidal anti-inflammatory drugs (NSAIDs), and hormonal factors, although only migraine showed a strong link with hormone status.

Keywords

1.
Stewart WF, Lipton RB, Celentano DD, Reed ML. Prevalence of migraine headache in the United States. Relation to age, income, race, and other sociodemographic factors. JAMA 1992;267:64-9.  Back to cited text no. 1
    
2.
Nomura M, Akama KT, Alves SE, Korach KS, Gustafsson JA, Pfaff DW, et al. Differential distribution of estrogen receptor (ER)-alpha and ER-beta in the midbrain raphe nuclei and periaqueductal gray in male mouse: Predominant role of ER-beta in midbrain serotonergic systems. Neuroscience 2005;130:445-56.  Back to cited text no. 2
    
3.
Scharff L, Turk DC, Marcus DA. The relationship of locus of control and psychosocial-behavioral response in chronic headache. Headache 1995;35:527-33.  Back to cited text no. 3
    
4.
Sulak PJ, Scow RD, Preece C, Riggs MW, Kuehl TJ. Hormone withdrawal symptoms in oral contraceptive users. Obstet Gynecol 2000;95:261-6.  Back to cited text no. 4
    
5.
Silberstein SD. Sex hormones and headache. Rev Neurol (Paris). 2000;156 Suppl 4:30-41.  Back to cited text no. 5
    
6.
HA Z. Hormonal changes throughout life in women. Headache 2006;46:S49-54.  Back to cited text no. 6
    
7.
Martin VT. Epidemiology and biology of menstrual migraine. Headache 2008;48:S124-30.  Back to cited text no. 7
    
8.
Melhado EM, Maciel JA, Guerreiro CA. Headache during gestation: Evaluation of 1101 women. Can J Neurol Sci 2007;34:187-92.  Back to cited text no. 8
    
9.
Dumitrescu RG, Cotarla I. Understanding breast cancer risk - where do we stand in 2005? J Cell Mol Med 2005;9:208-21.  Back to cited text no. 9
    
10.
Lampl C. [Migraine - diagnostic features, acute therapy and prophylactics]. 20110901 DCOM- 20111122 (0040-5930 (Print)).  Back to cited text no. 10
    
11.
Li CI, Mathes RW, Bluhm EC, Caan B, Cavanagh MF, Chlebowski RT, et al. Migraine history and breast cancer risk among postmenopausal women. J Clin Oncol 2010;28:1005-10.  Back to cited text no. 11
    
12.
Mathes RW, Malone KE, Daling JR, Davis S, Lucas SM, Porter PL, et al. Migraine in postmenopausal women and the risk of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 2008;17:3116-22.  Back to cited text no. 12
    
13.
Li CI, Mathes RW, Malone KE, Daling JR, Bernstein L, Marchbanks PA, et al. Relationship between migraine history and breast cancer risk among premenopausal and postmenopausal women. Cancer Epidemiol Biomarkers Prev 2009;18:2030-4.  Back to cited text no. 13
    
14.
Harris RE, Chlebowski RT, Jackson RD, Frid DJ, Ascenseo JL, Anderson G, et al. Breast cancer and nonsteroidal anti-inflammatory drugs: Prospective results from the Women's Health Initiative. Cancer Res 2003;63:6096-101.  Back to cited text no. 14
    
15.
Takkouche BR, Etminan M. Breast cancer and use of nonsteroidal antiinflammatory drugs: A meta-analysis. J Natl Cancer Inst 2008;100:1439-47.  Back to cited text no. 15
    
16.
Clemons M. Estrogen and the risk of breast cancer. N Engl J Med 2001:344:276.  Back to cited text no. 16
    
17.
Scharff LT, Marcus DA. Triggers of headache episodes and coping responses of headache diagnostic groups. Headache 1995;35:397.  Back to cited text no. 17
    
18.
Hamajima N, Hirose K, Tajima K, Rohan T, Calle EE, Heath CW Jr, et al. Alcohol, tobacco and breast cancer: Collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer 2002;87:1234-45.  Back to cited text no. 18