ArticleJournal of mammary gland biology and neoplasia2026
Differential effects of oral contraceptives on lymph node metastasis in breast cancer: role of tumor size as an effect modifier.
Article in Journal of mammary gland biology and neoplasia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
objectiveLymph node metastasis (LNM) is a critical determinant of breast cancer prognosis. While oral contraceptives (OC) are associated with breast cancer risk, their relationship with LNM-particularly in understudied populations like Morocco-remains unclear. This study investigates whether tumor size modifies OC-LNM associations in Moroccan patients.
methodsWe analyzed 356 breast cancer cases from Morocco's National Institute of Oncology(2009). Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for OC-LNM associations were estimated using multivariable logistic regression, stratified by tumor size (≤ 2 cm vs. > 2 cm). Multiplicative and additive interactions between OC use and tumor size were assessed.
resultsAfter full adjustment for clinicopathological factors, OCs use was associated with reduced LNM risk in tumors ≤ 2 cm (OR = 0.08, 95% CI: 0.02-0.47, P = 0.005) but increased risk in tumors > 2 cm (OR = 1.97, 95%CI: 1.04-3.76, P = 0.039). Significant multiplicative interaction (P = 0.047) and evidence of additive interaction (RERI = 1.72, AP = 0.69) suggest tumor size acts as an effect modifier, though the precision of the additive interaction estimate is limited (AP 95% CI: 0.30-1.07).
conclusionTumor size critically modifies OC-LNM relationships, with protective effects in small tumors and risk-promoting effects in large tumors. This heterogeneity underscores the need for size-stratified assessments in breast cancer management.
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