June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
The Effects of Breastfeeding on Retinoblastoma Development
Author Affiliations & Notes
  • Jasmeen Kaur Randhawa
    Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, United States
    The Vision Center, Children's Hospital of Los Angeles, Los Angeles, California, United States
  • Mary E Kim
    The Vision Center, Children's Hospital of Los Angeles, Los Angeles, California, United States
    Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Ashley Polski
    The Vision Center, Children's Hospital of Los Angeles, Los Angeles, California, United States
    Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Mark Reid
    The Vision Center, Children's Hospital of Los Angeles, Los Angeles, California, United States
  • Brianne Brown
    The Vision Center, Children's Hospital of Los Angeles, Los Angeles, California, United States
  • Ido Didi Fabian
    Sheba Medical Center The Goldschleger Eye Institute, Tel Hashomer, Tel Aviv, Israel
    International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
  • Swathi Kaliki
    The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India
  • Andrew Stacey
    University of Washington Department of Ophthalmology, Seattle, Washington, United States
  • Jesse L Berry
    The Vision Center, Children's Hospital of Los Angeles, Los Angeles, California, United States
    Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Jasmeen Randhawa, None; Mary Kim, The Wright Foundation (F); Ashley Polski, None; Mark Reid, None; Brianne Brown, None; Ido Fabian, None; Swathi Kaliki, None; Andrew Stacey, None; Jesse Berry, None
  • Footnotes
    Support  Dr. Berry holds grants not directly related to the support of this work from the Wright Foundation, National Cancer Institute of the National Institute of Health Award K08CA232344, National Institute of Health P30EY029220, National Cancer Institute P30CA014089, Hyundai Hope on Wheels RGA012351, American Cancer Society IRG-16-181-57, Knights Templar Eye Foundation Institute for Families, Inc., Children’s Hospital Los Angeles Larry and Celia Moh Foundation, Nautica Foundation Research to Prevent Blindness, an unrestricted departmental grant USC Dornsife College of Letters, Arts and Sciences, Vicky Joseph Research Fund, Carol Vassiliadis Research Fund
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2842. doi:
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      Jasmeen Kaur Randhawa, Mary E Kim, Ashley Polski, Mark Reid, Brianne Brown, Ido Didi Fabian, Swathi Kaliki, Andrew Stacey, Jesse L Berry; The Effects of Breastfeeding on Retinoblastoma Development. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2842.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The protective effects of breastfeeding on various childhood malignancies have been established, but an association has not yet been determined for retinoblastoma (RB). We aimed to further investigate the role of breastfeeding in the development or severity of non-hereditary RB, specifically assessing its relationship to (1) age at presentation (2) ocular prognosis, and (3) extraocular involvement. We also assessed the role of socio-economic status (SES) in these outcomes.

Methods : A subgroup analysis was performed on a global dataset of 651 patients who received RB treatment and answered a neonatal questionnaire. 532 patients reported “breastfed” or “formula fed” feeding history and were included in the analyses. Patients noted to have a family history of RB (n=25) or sporadic bilateral RB (n=218) were excluded. Multiple regression was used to examine the predictive nature of breastfeeding status on age at presentation. Logistic regression was used to examine effects on enucleation status and lymph node involvement. Ordered logistic regression was used to examine the effects of breastfeeding on International Intraocular Retinoblastoma Classification System (IIRC) group, International Retinoblastoma Staging System (IRSS) stage, and distant metastases. Each model controlled for age, sex, SES and immunizations.

Results : Neither breastfeeding nor formula feeding was associated with differences in age (B = 0.66, 95% CI = -4.96, 6.27) or IIRC group (OR =0.83, 95% CI = 0.41, 1.68) at presentation. In terms of clinical outcomes, neither breastfeeding nor formula feeding was associated with differences in enucleation (OR = 1.54, 95% CI = 0.80, 3.00), IRSS stage (OR = 1.37, 95% CI = 0.72, 2.60), lymph node involvement (OR = 0.51, 95% CI =.04, 6.73), or distant metastases (OR = 3.20, 95% CI = .40, 25.51). Consistent with previous studies, patients were significantly more likely to be diagnosed at a younger age if they reported higher SES (B=-5.62, 95%CI=-8.22, -3.01). Patients treated in high-income countries were more likely to present with a lower IRSS stage (OR = 9.67, 95% CI= 2.48, 37.69) and were less likely to necessitate enucleation (OR = 0.24, 95% CI= 0.06, 0.96).

Conclusions : This study suggests that breastfeeding neither impacts the sporadic development nor the severity of non-hereditary RB. As expected, children from higher SES countries have lower IRSS stage at presentation and lower overall risk of enucleation.

This is a 2021 ARVO Annual Meeting abstract.

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