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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)
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.
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.
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).
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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