A diagnosis of ovarian cysts is likely an indicator of hormonal milieu and thus may be related to breast cancer risk. Recent
studies have reported an inverse relationship between prior ovarian cyst diagnosis and breast cancer risk. We evaluated this
relationship in the Women’s Contraceptive and Reproductive Experiences (CARE) Study, a population-based case–control study
conducted in Atlanta, Detroit, Philadelphia, Los Angeles, and Seattle. Cases had first primary invasive breast cancer diagnosed
between 1994 and 1998 at ages 35–64 years. African American women were over-sampled. Controls were identified through random
digit dialling and were frequency matched to cases on centre, race, and five-year age group. A total of 4575 cases and 4682
controls were interviewed. We used unconditional logistic regression adjusted for age and study centre within racial groups
to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship between prior ovarian cysts and breast
cancer. Ovarian cyst diagnosis was associated with a significantly reduced risk among Caucasians (OR = 0.85, 95% CI 0.76–0.96)
and among African Americans (OR = 0.68, 95% CI 0.57–0.81). The association in Caucasians was not significant within subgroups
defined by menopausal status, hormone use, or gynecological surgery while the OR estimates in African Americans were consistently
lower and frequently significant. These data are consistent with the previously reported inverse association between ovarian
cysts and breast cancer, but the evidence for a relationship was stronger in African Americans than Caucasians. Additional
studies are required to determine the specific cyst type(s) responsible for the observed relationship.
Keywords Breast cancer - Ovarian cysts - Case–control study - Race - Hormone receptor status