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 35568 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/m2) 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. Conclusion sThis 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.
Original language | English |
---|---|
Pages (from-to) | 250-263 |
Number of pages | 14 |
Journal | Journal of the National Cancer Institute |
Volume | 103 |
Issue number | 3 |
DOIs | |
Publication status | Published - 2 Feb 2011 |
Externally published | Yes |
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In: Journal of the National Cancer Institute, Vol. 103, No. 3, 02.02.2011, p. 250-263.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Associations of breast cancer risk factors with tumor subtypes
T2 - A pooled analysis from the breast cancer association consortium studies
AU - Yang, Xiaohong R.
AU - Chang-Claude, Jenny
AU - Goode, Ellen L.
AU - Couch, Fergus J.
AU - Nevanlinna, Heli
AU - Milne, Roger L.
AU - Gaudet, Mia
AU - Schmidt, Marjanka K.
AU - Broeks, Annegien
AU - Cox, Angela
AU - Fasching, Peter A.
AU - Hein, Rebecca
AU - Spurdle, Amanda B.
AU - Blows, Fiona
AU - Driver, Kristy
AU - Flesch-Janys, Dieter
AU - Heinz, Judith
AU - Sinn, Peter
AU - Vrieling, Alina
AU - Heikkinen, Tuomas
AU - Aittomäki, Kristiina
AU - Heikkilä, Päivi
AU - Blomqvist, Carl
AU - Lissowska, Jolanta
AU - Peplonska, Beata
AU - Chanock, Stephen
AU - Figueroa, Jonine
AU - Brinton, Louise
AU - Hall, Per
AU - Czene, Kamila
AU - Humphreys, Keith
AU - Darabi, Hatef
AU - Liu, Jianjun
AU - Van 'T Veer, Laura J.
AU - Van Leeuwen, Flora E.
AU - Andrulis, Irene L.
AU - Glendon, Gord
AU - Knight, Julia A.
AU - Mulligan, Anna Marie
AU - O'Malley, Frances P.
AU - Weerasooriya, Nayana
AU - John, Esther M.
AU - Beckmann, Matthias W.
AU - Hartmann, Arndt
AU - Weihbrecht, Sebastian B.
AU - Wachter, David L.
AU - Jud, Sebastian M.
AU - Loehberg, Christian R.
AU - Baglietto, Laura
AU - English, Dallas R.
AU - Giles, Graham G.
AU - McLean, Catriona A.
AU - Severi, Gianluca
AU - Lambrechts, Diether
AU - Vandorpe, Thijs
AU - Weltens, Caroline
AU - Paridaens, Robert
AU - Smeets, Ann
AU - Neven, Patrick
AU - Wildiers, Hans
AU - Wang, Xianshu
AU - Olson, Janet E.
AU - Cafourek, Victoria
AU - Fredericksen, Zachary
AU - Kosel, Matthew
AU - Vachon, Celine
AU - Cramp, Helen E.
AU - Connley, Daniel
AU - Cross, Simon S.
AU - Balasubramanian, Sabapathy P.
AU - Reed, Malcolm W.R.
AU - Dörk, Thilo
AU - Bremer, Michael
AU - Meyer, Andreas
AU - Karstens, Johann H.
AU - Ay, Aysun
AU - Park-Simon, Tjoung Won
AU - Hillemanns, Peter
AU - Arias Pérez, Jose Ignacio
AU - Rodríguez, Primitiva Menéndez
AU - Zamora, Pilar
AU - Benítez, Javier
AU - Ko, Yon Dschun
AU - Fischer, Hans Peter
AU - Hamann, Ute
AU - Pesch, Beate
AU - Brüning, Thomas
AU - Justenhoven, Christina
AU - Brauch, Hiltrud
AU - Eccles, Diana M.
AU - Tapper, William J.
AU - Gerty, Sue M.
AU - Sawyer, Elinor J.
AU - Tomlinson, Ian P.
AU - Jones, Angela
AU - Kerin, Michael
AU - Miller, Nicola
AU - McInerney, Niall
AU - Anton-Culver, Hoda
AU - Ziogas, Argyrios
AU - Shen, Chen Yang
AU - Hsiung, Chia Ni
AU - Wu, Pei Ei
AU - Yang, Show Lin
AU - Yu, Jyh Cherng
AU - Chen, Shou Tung
AU - Hsu, Giu Cheng
AU - Haiman, Christopher A.
AU - Henderson, Brian E.
AU - Le Marchand, Loic
AU - Kolonel, Laurence N.
AU - Lindblom, Annika
AU - Margolin, Sara
AU - Jakubowska, Anna
AU - Lubiński, Jan
AU - Huzarski, Tomasz
AU - Byrski, Tomasz
AU - Górski, Bohdan
AU - Gronwald, Jacek
AU - Hooning, Maartje J.
AU - Hollestelle, Antoinette
AU - Van Den Ouweland, Ans M.W.
AU - Jager, Agnes
AU - Kriege, Mieke
AU - Tilanus-Linthorst, Madeleine M.A.
AU - Collée, Margriet
AU - Wang-Gohrke, Shan
AU - Pylkäs, Katri
AU - Jukkola-Vuorinen, Arja
AU - Mononen, Kari
AU - Grip, Mervi
AU - Hirvikoski, Pasi
AU - Winqvist, Robert
AU - Mannermaa, Arto
AU - Kosma, Veli Matti
AU - Kauppinen, Jaana
AU - Kataja, Vesa
AU - Auvinen, Päivi
AU - Soini, Ylermi
AU - Sironen, Reijo
AU - Bojesen, Stig E.
AU - Dynnes Ørsted, David
AU - Kaur-Knudsen, Diljit
AU - Flyger, Henrik
AU - Nordestgaard, Børge G.
AU - Holland, Helene
AU - Chenevix-Trench, Georgia
AU - Manoukian, Siranoush
AU - Barile, Monica
AU - Radice, Paolo
AU - Hankinson, Susan E.
AU - Hunter, David J.
AU - Tamimi, Rulla
AU - Sangrajrang, Suleeporn
AU - Brennan, Paul
AU - McKay, James
AU - Odefrey, Fabrice
AU - Gaborieau, Valerie
AU - Devilee, Peter
AU - Huijts, P. E.A.
AU - Tollenaar, Raem
AU - Seynaeve, C.
AU - Dite, Gillian S.
AU - Apicella, Carmel
AU - Hopper, John L.
AU - Hammet, Fleur
AU - Tsimiklis, Helen
AU - Smith, Letitia D.
AU - Southey, Melissa C.
AU - Humphreys, Manjeet K.
AU - Easton, Douglas
AU - Pharoah, Paul
AU - Sherman, Mark E.
AU - Garcia-Closas, Montserrat
PY - 2011/2/2
Y1 - 2011/2/2
N2 - 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 35568 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/m2) 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. Conclusion sThis 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.
AB - 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 35568 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/m2) 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. Conclusion sThis 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.
UR - http://www.scopus.com/inward/record.url?scp=79551694006&partnerID=8YFLogxK
U2 - 10.1093/jnci/djq526
DO - 10.1093/jnci/djq526
M3 - Article
C2 - 21191117
AN - SCOPUS:79551694006
SN - 0027-8874
VL - 103
SP - 250
EP - 263
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 3
ER -