Distinct Reproductive Risk Profiles for Intrinsic-Like Breast Cancer Subtypes: Pooled Analysis of Population-Based Studies.
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Authors
Bolla, Manjeet K
Augustinsson, Annelie
Beane Freeman, Laura E
Carey, Lisa A
CTS Consortium
Eriksson, Mikael
Evans, D Gareth
Haiman, Christopher A
Hamann, Ute
Hoppe, Reiner
Hopper, John L
Howell, Anthony
Hunter, David J
Kaaks, Rudolf
Kosma, Veli-Matti
Lacey, James V
Maurer, Tabea
Olshan, Andrew F
Rennert, Gad
Shibli, Rana
Teras, Lauren R
Troester, Melissa A
Truong, Thérèse
Wang, Sophia S
Wu, Anna H
Yang, Xiaohong R
Zheng, Wei
Chatterjee, Nilanjan
Publication Date
2022-12-08Journal 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 breast cancer) and by invasiveness. All statistical tests were 2-sided. RESULTS: Compared with 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 to less than 25 years after last birth and 45 to less than 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 less than 30 years after last birth). Older age at first birth (Pheterogeneity < .001 for triple-negative compared with luminal A-like breast cancer) and breastfeeding (Pheterogeneity < .001 for triple-negative compared with luminal A-like breast cancer) were associated with lower risk of triple-negative breast cancer 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. CONCLUSIONS: This large and comprehensive study demonstrates a distinct reproductive risk factor profile for triple-negative breast cancer compared with other subtypes, with implications for the understanding of disease etiology and risk prediction.
Keywords
Female, Humans, Breast Neoplasms, Receptor, ErbB-2, Receptors, Progesterone, Receptors, Estrogen, Triple Negative Breast Neoplasms, Case-Control Studies, Risk Factors, Biomarkers, Tumor
Sponsorship
Cancer Research Uk (None)
Cancer Research UK (20861)
European Commission Horizon 2020 (H2020) Societal Challenges (634935)
European Commission Horizon 2020 (H2020) Societal Challenges (633784)
Medical Research Council (G1000143)
National Cancer Institute (U19CA148065)
National Cancer Institute (P30CA023100)
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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