Postmenopausal Female Hormone Use and Estrogen Receptor–Positive and –Negative Breast Cancer in African American Women
Year: 2015
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Use of estrogen with progestin (combination therapy) is associated with increased incidence of estrogen receptor-positive (ER+) breast cancer in observational studies and randomized trials among postmenopausal white women. Whether this is also the case among African American women is not established. METHODS: Using data from the AMBER consortium collected from 1993 to 2013, we assessed use of estrogen alone and of combination therapy in relation to ER+ and ER-negative (ER-) breast cancer risk in postmenopausal African American women, based on 1132 ER+ case patients, 512 ER- case patients, and 6693 control patients. Odds ratios (ORs) and confidence intervals (CIs) were estimated using multinomial logistic regression with control for breast cancer risk factors. RESULTS: Forty-seven percent of control patients had used estrogen alone, combination therapy, or both. The odds ratio for ER+ breast cancer associated with combination use, relative to never use of either estrogen alone or combination therapy, was 1.50 (95% CI = 1.25 to 1.79). The increase was greater for recent (OR = 1.55, 95% CI = 1.21 to 1.99) and long-term use (OR = 1.75, 95% CI = 1.13 to 2.73) and among nonobese women (OR = 1.91, 95% CI = 1.29 to 2.83). Breast cancer risk was increased regardless of the interval between onset of menopause and initiation of combination use (OR = 1.43, 95% CI = 1.11 to 1.85, for <5 year interval; OR = 1.78, 95% CI = 1.34 to 2.37, for ≥5 year interval). Combination use was not associated with risk of ER- breast cancer, and use of estrogen alone was not associated with risk of either ER+ or ER- breast cancer. CONCLUSION: Use of estrogen with progestin increases risk of ER+ breast cancer in African American women. A decrease in use would be expected to reduce the number of ER+ cancers.
DOI: 10.1093/jnci/djv361
Institutions: Boston University, University of North Carolina at Chapel Hill, University of Southern California, University of Hawaiʻi at Mānoa, Roswell Park Comprehensive Cancer Center, University of Hawaii System, USC Norris Comprehensive Cancer Center, Rutgers Cancer Institute, UNC Lineberger Comprehensive Cancer Center
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1120543537, G1569999668, G2069482854, G299563851, A Follow-up Study for Causes of Illness in Black Women, MULTIETHNIC/MINORITY COHORT STUDY OF DIET AND CANCER, G4592503987, Race & Risk Factors for Early/Aggressive Breast Cancer, G7220299422, Carolina Population Center, Epidemiology of Breast Cancer Subtypes in African American Women: a Consortium, A Follow-up Study for Causes of Cancer in Black Women, G870117454, G884543044, Cancer Center Support Grant
OpenAlex ID: W2186952255