Associations of Breast Cancer Risk Factors With Tumor Subtypes: A Pooled Analysis From the Breast Cancer Association Consortium Studies
Year: 2010
Type: article
Abstract: BACKGROUND: Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors. METHODS: We pooled tumor marker and epidemiological risk factor data from 35,568 invasive breast cancer case patients from 34 studies participating in the Breast Cancer Association Consortium. Logistic regression models were used in case-case analyses to estimate associations between epidemiological risk factors and tumor subtypes, and case-control analyses to estimate associations between epidemiological risk factors and the risk of developing specific tumor subtypes in 12 population-based studies. All statistical tests were two-sided. RESULTS: In case-case analyses, of the epidemiological risk factors examined, early age at menarche (≤12 years) was less frequent in case patients with PR(-) than PR(+) tumors (P = .001). Nulliparity (P = 3 × 10(-6)) and increasing age at first birth (P = 2 × 10(-9)) were less frequent in ER(-) than in ER(+) tumors. Obesity (body mass index [BMI] ≥ 30 kg/m(2)) in younger women (≤50 years) was more frequent in ER(-)/PR(-) than in ER(+)/PR(+) tumors (P = 1 × 10(-7)), whereas obesity in older women (>50 years) was less frequent in PR(-) than in PR(+) tumors (P = 6 × 10(-4)). The triple-negative (ER(-)/PR(-)/HER2(-)) or core basal phenotype (CBP; triple-negative and cytokeratins [CK]5/6(+) and/or epidermal growth factor receptor [EGFR](+)) accounted for much of the heterogeneity in parity-related variables and BMI in younger women. Case-control analyses showed that nulliparity, increasing age at first birth, and obesity in younger women showed the expected associations with the risk of ER(+) or PR(+) tumors but not triple-negative (nulliparity vs parity, odds ratio [OR] = 0.94, 95% confidence interval [CI] = 0.75 to 1.19, P = .61; 5-year increase in age at first full-term birth, OR = 0.95, 95% CI = 0.86 to 1.05, P = .34; obesity in younger women, OR = 1.36, 95% CI = 0.95 to 1.94, P = .09) or CBP tumors. CONCLUSIONS: This study shows that reproductive factors and BMI are most clearly associated with hormone receptor-positive tumors and suggest that triple-negative or CBP tumors may have distinct etiology.
DOI: 10.1093/jnci/djq526
Authors: Xiaohong R. Yang, Jenny Chang-Claude, Ellen L. Goode, Fergus J. Couch, Heli Nevanlinna, Roger L. Milne, Mia Gaudet, Marjanka K. Schmidt, Annegien Broeks, Angela Cox, Peter A. Fasching, Rebecca Hein, Amanda B. Spurdle, Fiona Blows, Kristy Driver, Dieter Flesch-Janys, Judith Heinz, Peter Sinn, Alina Vrieling, Tuomas Heikkinen, Kristiina Aittomäki, Päivi Heikkilä, Carl Blomqvist, Jolanta Lissowska, Beata Peplonska, Stephen Chanock, Jonine Figueroa, Louise Brinton, Per Hall, Kamila Czene, Keith Humphreys, Hatef Darabi, Jianjun Liu, Laura J. Van ‘t Veer, Flora E. van Leeuwen, Irene L. Andrulis, Gord Glendon, Julia A. Knight, Anna Marie Mulligan, Frances P. O’Malley, Nayana Weerasooriya, Esther M. John, Matthias W. Beckmann, Arndt Hartmann, Sebastian B. Weihbrecht, David L. Wachter, Sebastian M. Jud, Christian R. Loehberg, Laura Baglietto, Dallas R. English, Graham G. Giles, Catriona A. McLean, Gianluca Severi, Diether Lambrechts, Thijs Vandorpe, Caroline Weltens, Robert Paridaens, Ann Smeets, Patrick Neven, Hans Wildiers, Xianshu Wang, Janet E. Olson, Victoria Cafourek, Zachary Fredericksen, Matthew Kosel, Celine Vachon, Helen E. Cramp, Daniel Connley, Simon S. Cross, Sabapathy P. Balasubramanian, Malcolm W. R. Reed, Thilo Dörk, Michael Bremer, Andreas Meyer, Johann H. Karstens, Aysun Ay, Tjoung-Won Park-Simon, Peter Hillemanns, Jose Ignacio Arias Pérez, Primitiva Menéndez Rodríguez, Pilar Zamora, Javier Benítez, Yon-Dschun Ko, Hans-Peter Fischer, Ute Hamann, Beate Pesch, Thomas Brüning, Christina Justenhoven, Hiltrud Brauch, Diana M. Eccles, William J. Tapper, Sue M. Gerty, Elinor J. Sawyer, Ian P. Tomlinson, Angela Jones, Michael Kerin, Nicola Miller, Niall McInerney, Hoda Anton-Culver, Argyrios Ziogas, Chen-Yang Shen, Chia-Ni Hsiung, Pei-Ei Wu, Show-Lin Yang, Jyh-Cherng Yu, Shou-Tung Chen, Giu-Cheng Hsu, Christopher A. Haiman, Brian E. Henderson, Loic Le Marchand, Laurence N. Kolonel, Annika Lindblom, Sara Margolin, Anna Jakubowska, Jan Lubiński, Tomasz Huzarski, Tomasz Byrski, Bohdan Górski, Jacek Gronwald, Maartje J. Hooning, Antoinette Hollestelle, Ans M. W. van den Ouweland, Agnes Jager, Mieke Kriege, Madeleine M. A. Tilanus-Linthorst, Margriet Collée, Shan Wang-Gohrke, Katri Pylkäs, Arja Jukkola-Vuorinen, Kari Mononen, Mervi Grip, Pasi Hirvikoski, Robert Winqvist, Arto Mannermaa, Veli-Matti Kosma, Jaana Kauppinen, Vesa Kataja, Päivi Auvinen, Ylermi Soini, Reijo Sironen, Stig E. Bojesen, David Dynnes Ørsted, Diljit Kaur-Knudsen, Henrik Flyger, Børge G. Nordestgaard, Helene Holland, Georgia Chenevix-Trench, Siranoush Manoukian, Monica Barile, Paolo Radice, Susan E. Hankinson, David J. Hunter, Rulla Tamimi, Suleeporn Sangrajrang, Paul Brennan, James McKay, Fabrice Odefrey, Valerie Gaborieau, Peter Devilee, P.E.A. Huijts, RAEM. Tollenaar, C. Seynaeve, Gillian S. Dite, Carmel Apicella, John L. Hopper, Fleur Hammet, Helen Tsimiklis, Letitia D. Smith, Melissa C. Southey, Manjeet K. Humphreys, Douglas Easton, Paul Pharoah, Mark E. Sherman, Montserrat Garcia-Closas
Language: English
Topic: Cancer Risks and Factors
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Brigham and Women's Hospital, University of Southern California, Taiwan Biobank, Itä-Suomen Yliopisto, Helsingin ja Uudenmaan Sairaanhoitopiiri, Sundhed og Sygdom, Det Frie Forskningsråd, Deutsches Krebsforschungszentrum, Cancer Care Ontario, Wellcome Trust, Lon V. Smith Foundation, Cancer Research UK, National Institute for Health and Care Research, Breast Cancer Campaign, University of Southampton, King's College London, University of Oxford, European Commission, National Breast Cancer Foundation, Robert Bosch Stiftung, Universiteit Leiden, University of Melbourne, Academia Sinica, Eberhard Karls Universität Tübingen, Bundesministerium für Bildung und Forschung, Cancerfonden, Gentofte Hospital, Ministerio de Economía y Competitividad, Deutsche Gesetzliche Unfallversicherung, Herlev Hospital, University of Toronto, KU Leuven, Karolinska Institutet, Kuopion Yliopistollinen Sairaala, Peter MacCallum Cancer Centre, KWF Kankerbestrijding, Leids Universitair Medisch Centrum, Genome Institute of Singapore, Deutsche Krebshilfe, Oulun Yliopisto, Cancerföreningen i Stockholm, China Medical University, Changhua Christian Hospital, Rheinische Friedrich-Wilhelms-Universität Bonn, Pomorski Uniwersytet Medyczny W Szczecinie, Universität Ulm, Vaasan Keskussairaala, Tri-Service General Hospital, National Institutes of Health, School of Medicine, Stanford University, University of California, Irvine, Medical Research Council, National Health and Medical Research Council, Cancer Council Victoria, Erasmus Universitair Medisch Centrum Rotterdam, Institute of Biomedical Sciences, Academia Sinica, National Cancer Institute, David Geffen School of Medicine, University of California, Los Angeles, Division of Cancer Epidemiology and Genetics, National Cancer Institute
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OpenAlex ID: W2155533563