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The association between infectious agents and breast cancer: a review of the epidemiologic evidence

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Abstract

Purpose:

Several viruses have been casually linked to human cancers, including cervical, nasopharyngeal, liver, sarcoma, and Merkel cell carcinomas. However, the etiologic contribution of viral infections to breast cancer, the number one incident cancer among women worldwide, is not well established. Among studies exploring associations of viruses with breast cancer, potential linkages have been identified between breast cancer and five viruses: beta retrovirus, (i.e., mouse mammary tumor virus), human papillomavirus, Epstein Barr virus. bovine leukemia virus, and human cytomegalovirus.

Methods:

In this review, we provide a comprehensive evaluation of epidemiological ecologic, case–control, case-only, and cohort studies investigating these associations. We discuss results from several existing reviews and meta-analyses, evaluate epidemiological studies published in the past five years, and assess the relationship between these viruses and breast tumor clinicopathological factors.

Results:

The strongest epidemiological evidence for a viral role in breast cancer exists for MMTV and HPV, though limitations include lack of prospective studies for MMTV and potential detection bias in HPV studies. Viral detection challenges have limited studies of EBV and HCMV. Fewer studies have evaluated BLV, and though it has been associated with higher risk of breast cancer, sample sizes are quite small.  

Conclusion:

While epidemiologic evidence exists for an association between these five viruses and breast cancer, various methodological issues and lack of prospective studies preclude robust conclusions. Future research should prioritize establishing a temporal relationship between infection and disease, minimizing misclassification of detection assays, and further exploring the influence of co-infections.    

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Funding

This work was supported by T32 CA009001, awarded to A. Heather Eliassen (HSPH) by the National Cancer Institute.

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  1. Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MS, USA

    Kristen D. Brantley

  2. Department of Population Health Sciences, Weill Cornell Medicine, New York, USA

    Rulla M. Tamimi

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All authors contributed to the conception and design of this review. Kristen Brantley conducted literature review via PubMed to identify relevant articles. The first draft of the manuscript was written by Kristen Brantley and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Brantley, K.D., Tamimi, R.M. The association between infectious agents and breast cancer: a review of the epidemiologic evidence. Breast Cancer Res Treat (2024). https://doi.org/10.1007/s10549-024-07388-6

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