Distinct reproductive risk profiles for intrinsic-like breast cancer subtypes: pooled analysis of population-based studies.
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Authors
Jung, Audrey Y
Ahearn, Thomas U
Behrens, Sabine
Middha, Pooja
Bolla, Manjeet K
Wang, Qin
Arndt, Volker
Aronson, Kristan J
Augustinsson, Annelie
Beane Freeman, Laura E
Becher, Heiko
Brenner, Hermann
Canzian, Federico
Carey, Lisa A
CTS Consortium
Czene, Kamila
Eliassen, A Heather
Eriksson, Mikael
Evans, D Gareth
Figueroa, Jonine D
Fritschi, Lin
Gabrielson, Marike
Giles, Graham G
Guénel, Pascal
Hadjisavvas, Andreas
Haiman, Christopher A
Håkansson, Niclas
Hall, Per
Hamann, Ute
Hoppe, Reiner
Hopper, John L
Howell, Anthony
Hunter, David J
Hüsing, Anika
Kaaks, Rudolf
Kosma, Veli-Matti
Koutros, Stella
Kraft, Peter
Lacey, James V
Le Marchand, Loic
Lissowska, Jolanta
Loizidou, Maria A
Mannermaa, Arto
Maurer, Tabea
Murphy, Rachel A
Olshan, Andrew F
Olsson, Håkan
Patel, Alpa V
Perou, Charles M
Rennert, Gad
Shibli, Rana
Shu, Xiao-Ou
Southey, Melissa C
Stone, Jennifer
Tamimi, Rulla M
Teras, Lauren R
Troester, Melissa A
Truong, Thérèse
Vachon, Celine M
Wang, Sophia S
Wolk, Alicja
Wu, Anna H
Yang, Xiaohong R
Zheng, Wei
Dunning, Alison M
Milne, Roger L
Chatterjee, Nilanjan
Schmidt, Marjanka K
García-Closas, Montserrat
Chang-Claude, Jenny
Publication Date
2022-06-20Journal Title
J Natl Cancer Inst
ISSN
0027-8874
Publisher
Oxford University Press (OUP)
Pages
djac117
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Jung, A. Y., Ahearn, T. U., Behrens, S., Middha, P., Bolla, M. K., Wang, Q., Arndt, V., et al. (2022). Distinct reproductive risk profiles for intrinsic-like breast cancer subtypes: pooled analysis of population-based studies.. J Natl Cancer Inst, djac117. https://doi.org/10.1093/jnci/djac117
Abstract
BACKGROUND: Reproductive factors have been shown to be differentially associated with risk of estrogen receptor (ER) positive and ER-negative breast cancer. However, their associations with intrinsic-like subtypes are less clear. METHODS: Analyses included up to 23,353 cases, and 71,072 controls pooled from 31 population-based case-control or cohort studies in the Breast Cancer Association Consortium across 16 countries on 4 continents. Polytomous logistic regression was used to estimate the association between reproductive factors and risk of breast cancer by intrinsic-like subtypes (luminal A-like, luminal B-like, luminal B-HER2-like, HER2-enriched-like, and triple-negative) and by invasiveness. All statistical tests were 2-sided. RESULTS: Compared to nulliparous women, parous women had a lower risk of luminal A-like, luminal B-like, luminal B-HER2-like and HER2-enriched-like disease. This association was apparent only after approximately 10 years since last birth and became stronger with increasing time (odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.49 to 0.71; and OR = 0.36, 95% CI = 0.28 to 0.46; for multiparous women with luminal A-like tumors 20-<25 years after last birth and 45-<50 years after last birth, respectively). In contrast, parous women had a higher risk of triple-negative breast cancer right after their last birth (for multiparous women: OR = 3.12, 95%CI = 2.02 to 4.83) that was attenuated with time but persisted for decades (OR = 1.03, 95%CI = 0.79 to 1.34, for multiparous women 25 to < 30 years after last birth). Older age at first birth (P-heterogeneity<.001 for triple-negative compared to luminal-A like) and breastfeeding (P-heterogeneity<.001 for triple-negative compared to luminal-A like) were associated with lower risk of triple-negative but not with other disease subtypes. Younger age at menarche was associated with higher risk of all subtypes; older age at menopause was associated with higher risk of luminal A-like but not triple-negative breast cancer. Associations for in situ tumors were similar to luminal A-like. CONCLUSION: This large and comprehensive study demonstrates a distinct reproductive risk factor profile for triple-negative breast cancer compared to other subtypes, with implications for the understanding of disease etiology and risk prediction.
Keywords
breast cancer, intrinsic-like subtypes, reproductive risk factors, triple-negative
Sponsorship
Cancer Research Uk (None)
Cancer Research UK (20861)
Embargo Lift Date
2023-06-20
Identifiers
External DOI: https://doi.org/10.1093/jnci/djac117
This record's URL: https://www.repository.cam.ac.uk/handle/1810/338682
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