Reproductive profiles and risk of breast cancer subtypes: a multi-center case-only study

Brouckaert O, Rudolph A, Laenen A, Keeman R, Bolla MK, Wang Q, Soubry A, Wildiers H, Andrulis IL, Arndt V, Beckmann M, Benitez J, Blomqvist C, Bojesen SE, Brauch H, Brennan P, Brenner H, Chenevix-Trench G, Choi JY, Cornelissen S, Couch FJ, Cox A, Cross SS, Czene K, Eriksson M, Fasching P, Figueroa J, Flyger H, Giles GG, Gonzalez-Neira A, Guenel P, Hall P, Hollestelle A, Hopper JL, Ito H, Jones M, Kang D, Knight JA, Kosma VM, Li J, Lindblom A, Lilyquist J, Lophatananon A, Mannermaa A, Manoukian S, Margolin S, Matsuo K, Muir K, Nevanlinna H, Peterlongo P, Pylkas K, Saajrang S, Seynaeve C, Shen CY, Shu XO, Southey MC, Swerdlow A, Teo SH, Tollenaar RAEM, Truong T, Tseng CC, Van Den Broek AJ, Van Deurzen CHM, Winqvist R, Wu AH, Yip CH, Yu JC, Zheng W, Milne RL, Pharoah PDP, Easton DF, Schmidt MK, Garcia-Closas M, Chang-Claude J, Lambrechts D, Neven P (2017)


Publication Type: Journal article

Publication year: 2017

Journal

Book Volume: 19

Journal Issue: 1

DOI: 10.1186/s13058-017-0909-3

Abstract

BACKGROUND: Previous studies have shown that reproductive factors are differentially associated with breast cancer (BC) risk by subtypes. The aim of this study was to investigate associations between reproductive factors and BC subtypes, and whether these vary by age at diagnosis. METHODS: We used pooled data on tumor markers (estrogen and progesterone receptor, human epidermal growth factor receptor-2 (HER2)) and reproductive risk factors (parity, age at first full-time pregnancy (FFTP) and age at menarche) from 28,095 patients with invasive BC from 34 studies participating in the Breast Cancer Association Consortium (BCAC). In a case-only analysis, we used logistic regression to assess associations between reproductive factors and BC subtype compared to luminal A tumors as a reference. The interaction between age and parity in BC subtype risk was also tested, across all ages and, because age was modeled non-linearly, specifically at ages 35, 55 and 75 years. RESULTS: Parous women were more likely to be diagnosed with triple negative BC (TNBC) than with luminal A BC, irrespective of age (OR for parity = 1.38, 95% CI 1.16-1.65, p = 0.0004; p for interaction with age = 0.076). Parous women were also more likely to be diagnosed with luminal and non-luminal HER2-like BCs and this effect was slightly more pronounced at an early age (p for interaction with age = 0.037 and 0.030, respectively). For instance, women diagnosed at age 35 were 1.48 (CI 1.01-2.16) more likely to have luminal HER2-like BC than luminal A BC, while this association was not significant at age 75 (OR = 0.72, CI 0.45-1.14). While age at menarche was not significantly associated with BC subtype, increasing age at FFTP was non-linearly associated with TNBC relative to luminal A BC. An age at FFTP of 25 versus 20 years lowered the risk for TNBC (OR = 0.78, CI 0.70-0.88, p < 0.0001), but this effect was not apparent at a later FFTP. CONCLUSIONS: Our main findings suggest that parity is associated with TNBC across all ages at BC diagnosis, whereas the association with luminal HER2-like BC was present only for early onset BC.

Authors with CRIS profile

Involved external institutions

Deutsches Krebsforschungszentrum (DKFZ) DE Germany (DE) Karolinska Institute SE Sweden (SE) QIMR Berghofer Medical Research Institute (früher: the Queensland Institute of Medical Research) AU Australia (AU) Spanish National Cancer Research Centre / Centro Nacional de Investigaciones Oncológicas (CNIO) ES Spain (ES) Mount Sinai Hospital (MSH) CA Canada (CA) Helsingin yliopisto / University of Helsinki FI Finland (FI) University of Edinburgh GB United Kingdom (GB) University of Eastern Finland FI Finland (FI) Seoul National University (SNU) / 서울대학교 KR Korea, Republic of (KR) Oulun Yliopisto / University of Oulo FI Finland (FI) National Cancer Institute (NCI) US United States (USA) (US) University of Southern California (USC) US United States (USA) (US) Cancer Council Victoria AU Australia (AU) The Institute of Cancer Research (ICR) GB United Kingdom (GB) Cancer Research Initiatives Foundation (CARIF) / Cancer Research Malaysia (CRM) MY Malaysia (MY) Fondazione IRCCS: Istituto Nazionale dei Tumori IT Italy (IT) The University of Melbourne AU Australia (AU) University of Cambridge GB United Kingdom (GB) Vanderbilt University US United States (USA) (US) Erasmus University Medical Center (MC) NL Netherlands (NL) China Medical University (CMU) / 中國醫藥大學 TW Taiwan (TW) Aichi Cancer Center Research Institute JP Japan (JP) IFOM - FIRC Institute of Molecular Oncology IT Italy (IT) University of Warwick GB United Kingdom (GB) University of Sheffield GB United Kingdom (GB) Jan Yperman Ziekenhuis BE Belgium (BE) Antoni van Leeuwenhoek NL Netherlands (NL) Netherlands Cancer Institute (NKI) NL Netherlands (NL) Katholieke Universiteit Leuven (KUL) / Catholic University of Leuven BE Belgium (BE) Leiden University NL Netherlands (NL) National Taiwan University Hospital (NTUH) / 國立台灣大學醫學院附設醫院 TW Taiwan (TW) Flanders Institute for Biotechnology / Vlaams Instituut voor Biotechnologie (VIB) BE Belgium (BE) Erasmus University Rotterdam (EUR) / Erasmus Universiteit Rotterdam NL Netherlands (NL) University of Paris 11 - Paris-Sud / Université Paris XI Paris-Sud FR France (FR) Copenhagen University Hospital DK Denmark (DK) Mayo Clinic US United States (USA) (US) Robert-Bosch-Krankenhaus DE Germany (DE) University Hospital Leuven (UZ) / Universitaire ziekenhuizen Leuven BE Belgium (BE) International Agency for Research on Cancer (IARC) FR France (FR) University of Malaya (UM) / Universiti Malaya MY Malaysia (MY)

How to cite

APA:

Brouckaert, O., Rudolph, A., Laenen, A., Keeman, R., Bolla, M.K., Wang, Q.,... Neven, P. (2017). Reproductive profiles and risk of breast cancer subtypes: a multi-center case-only study. Breast Cancer Research, 19(1). https://dx.doi.org/10.1186/s13058-017-0909-3

MLA:

Brouckaert, Olivier, et al. "Reproductive profiles and risk of breast cancer subtypes: a multi-center case-only study." Breast Cancer Research 19.1 (2017).

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