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Total visual blindness is protective against breast cancer

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Abstract

Objective

Observational data, though sparse and based on small studies with limited ability to control for known breast cancer risk factors, support a lower risk of breast cancer in blind women compared to sighted women. Mechanisms influenced by ocular light perception, such as melatonin or circadian synchronization, are thought to account for this lower risk.

Methods

To evaluate whether blind women with no perception of light (NPL) have a lower prevalence of breast cancer compared to blind women with light perception (LP), we surveyed a cohort of 1,392 blind women living in North America (66 breast cancer cases).

Results

In multivariate-logistic regression models controlling for breast cancer risk factors, women with NPL had a significantly lower prevalence of breast cancer than women with LP (odds ratio, 0.43; 95% confidence interval, 0.21–0.85). We observed little difference in these associations when restricting to postmenopausal women, non-shift workers or when excluding women diagnosed with breast cancer within 2 or 4 years of onset of blindness. Blind women with NPL appear to have a lower risk of breast cancer, compared to blind women with LP. More research is needed to elucidate the impact of LP on circadian coordination and melatonin production in the blind and how these factors may relate to breast cancer risk.

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Acknowledgments

The authors thank Dr. Elizabeth Klerman, Professor Debra J. Skene, Dr. Benita Middleton, Emeritus Professor Josephine Arendt, Eve Silver, Amy Ruell, and Joseph Hull for assistance with this project. The authors also wish to thank the students who assisted with data collection, including Kathleen Maguire, Emily McCoy, Rebecca Steinberg, Jennifer Markham, Kai Romero, Yunxue Xu, Michael Steinhaus, Inés Pacheco, Grace Kim, Folasade Odenyi, Naila Ramji, Anna Rosenblum, Emma Prokic, Erica Bloom, Natasha Makengo, Ashley Pawlisz, Nicholas Moser, Alana Vivolo, Jessica Giordano, Marissa Sheldon, Tomoko Okada, Liwei Fan, Kristoff Nelson, Kevin Sun, and Jane Flynn. The authors also wish to thank several organizations who donated time and effort to assist with this project, including the American Council of the Blind, the Bay State Council for the Blind, the Massachusetts Commission for the Blind, the Canadian National Institute of the Blind, the National Braille Press, the National Federation of the Blind, the Perkins Braille and Talking Book Library, radio reading services nationwide, and Ripco. Finally, the authors would like to thank Velir Studios for development of the study website. This work was supported by a Department of Defense Breast Cancer Research Program Idea Award (BC030928, #W81XWH-04-1-0553 to SWL) and a predoctoral fellowship from the Harvard Medical School Division of Sleep Medicine Training Program in Sleep, Circadian, and Respiratory Neurobiology (Grant HL07901-11 to EEE).

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Authors and Affiliations

  1. Division of Sleep Medicine, Brigham and Women’s Hospital, 221 Longwood Avenue BLI 438, Boston, MA, 02115, USA

    Erin E. Flynn-Evans & Steven W. Lockley

  2. Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

    Erin E. Flynn-Evans

  3. Department of Community Medicine, University of Connecticut Health Center, Farmington, CT, USA

    Richard G. Stevens

  4. Retina-Vitreous Associates, Beverly Hills, CA, USA

    Homayoun Tabandeh

  5. Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Eva S. Schernhammer

  6. Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA

    Steven W. Lockley

Authors
  1. Erin E. Flynn-Evans
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  2. Richard G. Stevens
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  3. Homayoun Tabandeh
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  4. Eva S. Schernhammer
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  5. Steven W. Lockley
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Corresponding author

Correspondence to Erin E. Flynn-Evans.

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Flynn-Evans, E.E., Stevens, R.G., Tabandeh, H. et al. Total visual blindness is protective against breast cancer. Cancer Causes Control 20, 1753–1756 (2009). https://doi.org/10.1007/s10552-009-9405-0

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  • DOI: https://doi.org/10.1007/s10552-009-9405-0

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