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The Effects of Breastfeeding on Retinoblastoma Development: Results from an International Multicenter Retinoblastoma Survey

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The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
2
USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
3
Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Sheba Medical Center, Goldschleger Eye Institute, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel
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The Operation Eyesight Universal Institute for Eye Cancer, Hyderabad 500034, India
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Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA
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Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka 1215, Bangladesh
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Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa 3614, Ethiopia
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Institut Curie, Université de Paris, 75248 Paris, France
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Clinica Angloamericana, Lima 15073, Peru
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Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru
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N.N. Blokhin National Medical Research Center, Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, Oncology of Russian Federation, 115478 Moscow, Russia
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Medical Academy of Postgraduate Education, 125445 Moscow, Russia
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Chittagong Eye Infirmary & Training Complex, Chittagong 4202, Bangladesh
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The Children’s Hospital and the Institute of Child Health, Lahore 54000, Pakistan
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The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK
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Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
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UCL Institute of Ophthalmology, London EC1V 2PD, UK
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Ophthalmology Department, Great Ormond Street Children’s Hospital, London WC1N 3JH, UK
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Tel Aviv Sourasky Medical Center, Division of Ophthalmology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 39040, Israel
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Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Jaume Mora
Cancers 2021, 13(19), 4773; https://doi.org/10.3390/cancers13194773
Received: 11 August 2021 / Revised: 16 September 2021 / Accepted: 18 September 2021 / Published: 24 September 2021
(This article belongs to the Special Issue Detection and Treatment of Retinoblastoma)
Breastfeeding has been shown to lower the risk of oncogenesis in many pediatric cancers, with longer periods of breastfeeding having the most protective effect. However, an association has not yet been determined for the consequence or benefit of breastfeeding in retinoblastoma (RB), the most common intraocular malignancy of childhood affecting 8000 children worldwide each year. Herein, we aimed to understand the role of breastfeeding in the severity of development of nonhereditary RB, specifically its relationship to age at diagnosis, ocular prognosis, and extraocular involvement. Our analysis of 344 patients indicated that neither breastfeeding nor formula feeding was associated with differences in age at diagnosis, ocular prognosis, or extraocular involvement. More research elucidating the factors affecting the development of RB is warranted both to understand the pathophysiology of tumor development and to develop clinical recommendations for preventive care.
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 severity of nonhereditary RB development, assessing relationship to (1) age at diagnosis, (2) ocular prognosis, measured by International Intraocular RB Classification (IIRC) or Intraocular Classification of RB (ICRB) group and success of eye salvage, and (3) extraocular involvement. Analyses were performed on a global dataset subgroup of 344 RB patients whose legal guardian(s) consented to answer a neonatal questionnaire. Patients with undetermined or mixed feeding history, family history of RB, or sporadic bilateral RB were excluded. There was no statistically significant difference between breastfed and formula-fed groups in (1) age at diagnosis (p = 0.20), (2) ocular prognosis measures of IIRC/ICRB group (p = 0.62) and success of eye salvage (p = 0.16), or (3) extraocular involvement shown by International Retinoblastoma Staging System (IRSS) at presentation (p = 0.74), lymph node involvement (p = 0.20), and distant metastases (p = 0.37). This study suggests that breastfeeding neither impacts the sporadic development nor is associated with a decrease in the severity of nonhereditary RB as measured by age at diagnosis, stage of disease, ocular prognosis, and extraocular spread. A further exploration into the impact of diet on children who develop RB is warranted. View Full-Text
Keywords: eye; tumor; pediatric cancer; retinoblastoma; breastfeeding eye; tumor; pediatric cancer; retinoblastoma; breastfeeding
MDPI and ACS Style

Randhawa, J.K.; Kim, M.E.; Polski, A.; Reid, M.W.; Mascarenhas, K.; Brown, B.; Fabian, I.D.; Kaliki, S.; Stacey, A.W.; Burner, E.; Sayegh, C.S.; Poblete, R.A.; Ji, X.; Zou, Y.; Sultana, S.; Rashid, R.; Sherief, S.T.; Cassoux, N.; Garcia, J.; Coronado, R.D.; López, A.M.Z.; Ushakova, T.; Polyakov, V.G.; Roy, S.R.; Ahmad, A.; Reddy, M.A.; Sagoo, M.S.; Al Harby, L.; Astbury, N.J.; Bascaran, C.; Blum, S.; Bowman, R.; Burton, M.J.; Gomel, N.; Keren-Froim, N.; Madgar, S.; Zondervan, M.; Berry, J.L. The Effects of Breastfeeding on Retinoblastoma Development: Results from an International Multicenter Retinoblastoma Survey. Cancers 2021, 13, 4773. https://doi.org/10.3390/cancers13194773

AMA Style

Randhawa JK, Kim ME, Polski A, Reid MW, Mascarenhas K, Brown B, Fabian ID, Kaliki S, Stacey AW, Burner E, Sayegh CS, Poblete RA, Ji X, Zou Y, Sultana S, Rashid R, Sherief ST, Cassoux N, Garcia J, Coronado RD, López AMZ, Ushakova T, Polyakov VG, Roy SR, Ahmad A, Reddy MA, Sagoo MS, Al Harby L, Astbury NJ, Bascaran C, Blum S, Bowman R, Burton MJ, Gomel N, Keren-Froim N, Madgar S, Zondervan M, Berry JL. The Effects of Breastfeeding on Retinoblastoma Development: Results from an International Multicenter Retinoblastoma Survey. Cancers. 2021; 13(19):4773. https://doi.org/10.3390/cancers13194773

Chicago/Turabian Style

Randhawa, Jasmeen K., Mary E. Kim, Ashley Polski, Mark W. Reid, Kristen Mascarenhas, Brianne Brown, Ido D. Fabian, Swathi Kaliki, Andrew W. Stacey, Elizabeth Burner, Caitlin S. Sayegh, Roy A. Poblete, Xunda Ji, Yihua Zou, Sadia Sultana, Riffat Rashid, Sadik T. Sherief, Nathalie Cassoux, Juan Garcia, Rosdali D. Coronado, Arturo M.Z. López, Tatiana Ushakova, Vladimir G. Polyakov, Soma R. Roy, Alia Ahmad, M. A. Reddy, Mandeep S. Sagoo, Lamis Al Harby, Nicholas J. Astbury, Covadonga Bascaran, Sharon Blum, Richard Bowman, Matthew J. Burton, Nir Gomel, Naama Keren-Froim, Shiran Madgar, Marcia Zondervan, and Jesse L. Berry. 2021. "The Effects of Breastfeeding on Retinoblastoma Development: Results from an International Multicenter Retinoblastoma Survey" Cancers 13, no. 19: 4773. https://doi.org/10.3390/cancers13194773

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