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Reproductive history and oral contraceptive use in relation to risk of triple-negative breast cancer.
J Natl Cancer Inst. 2011 Mar 16; 103(6):470-7.JNCI

Abstract

BACKGROUND

Triple-negative (ie, estrogen receptor [ER], progesterone receptor, and HER2 negative) breast cancer occurs disproportionately among African American women compared with white women and is associated with a worse prognosis than ER-positive (ER+) breast cancer. Hormonally mediated risk factors may be differentially related to risk of triple-negative and ER+ breast cancers.

METHODS

Using data from 155,723 women enrolled in the Women's Health Initiative, we assessed associations between reproductive and menstrual history, breastfeeding, oral contraceptive use, and subtype-specific breast cancer risk. We used Cox regression to evaluate associations with triple-negative (N = 307) and ER+ (N = 2610) breast cancers and used partial likelihood methods to test for differences in subtype-specific hazard ratios (HRs).

RESULTS

Reproductive history was differentially associated with risk of triple-negative and ER+ breast cancers. Nulliparity was associated with decreased risk of triple-negative breast cancer (HR = 0.61, 95% confidence interval [CI] = 0.37 to 0.97) but increased risk of ER+ breast cancer (HR = 1.35, 95% CI = 1.20 to 1.52). Age-adjusted absolute rates of triple-negative breast cancer were 2.71 and 1.54 per 10,000 person-years in parous and nulliparous women, respectively; by comparison, rates of ER+ breast cancer were 21.10 and 28.16 per 10,000 person-years in the same two groups. Among parous women, the number of births was positively associated with risk of triple-negative disease (HR for three births or more vs one birth = 1.46, 95% CI = 0.82 to 2.63) and inversely associated with risk of ER+ disease (HR = 0.88, 95% CI = 0.74 to 1.04). Ages at menarche and menopause were modestly associated with risk of ER+ but not triple-negative breast cancer; breastfeeding and oral contraceptive use were not associated with either subtype.

CONCLUSION

The association between parity and breast cancer risk differs appreciably for ER+ and triple-negative breast cancers. These findings require further confirmation because the biological mechanisms underlying these differences are uncertain.

Authors+Show Affiliations

Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA. aphipps@fhcrc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

21346227

Citation

Phipps, Amanda I., et al. "Reproductive History and Oral Contraceptive Use in Relation to Risk of Triple-negative Breast Cancer." Journal of the National Cancer Institute, vol. 103, no. 6, 2011, pp. 470-7.
Phipps AI, Chlebowski RT, Prentice R, et al. Reproductive history and oral contraceptive use in relation to risk of triple-negative breast cancer. J Natl Cancer Inst. 2011;103(6):470-7.
Phipps, A. I., Chlebowski, R. T., Prentice, R., McTiernan, A., Wactawski-Wende, J., Kuller, L. H., Adams-Campbell, L. L., Lane, D., Stefanick, M. L., Vitolins, M., Kabat, G. C., Rohan, T. E., & Li, C. I. (2011). Reproductive history and oral contraceptive use in relation to risk of triple-negative breast cancer. Journal of the National Cancer Institute, 103(6), 470-7. https://doi.org/10.1093/jnci/djr030
Phipps AI, et al. Reproductive History and Oral Contraceptive Use in Relation to Risk of Triple-negative Breast Cancer. J Natl Cancer Inst. 2011 Mar 16;103(6):470-7. PubMed PMID: 21346227.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reproductive history and oral contraceptive use in relation to risk of triple-negative breast cancer. AU - Phipps,Amanda I, AU - Chlebowski,Rowan T, AU - Prentice,Ross, AU - McTiernan,Anne, AU - Wactawski-Wende,Jean, AU - Kuller,Lewis H, AU - Adams-Campbell,Lucile L, AU - Lane,Dorothy, AU - Stefanick,Marcia L, AU - Vitolins,Mara, AU - Kabat,Geoffrey C, AU - Rohan,Thomas E, AU - Li,Christopher I, Y1 - 2011/02/23/ PY - 2011/2/25/entrez PY - 2011/2/25/pubmed PY - 2011/5/11/medline SP - 470 EP - 7 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 103 IS - 6 N2 - BACKGROUND: Triple-negative (ie, estrogen receptor [ER], progesterone receptor, and HER2 negative) breast cancer occurs disproportionately among African American women compared with white women and is associated with a worse prognosis than ER-positive (ER+) breast cancer. Hormonally mediated risk factors may be differentially related to risk of triple-negative and ER+ breast cancers. METHODS: Using data from 155,723 women enrolled in the Women's Health Initiative, we assessed associations between reproductive and menstrual history, breastfeeding, oral contraceptive use, and subtype-specific breast cancer risk. We used Cox regression to evaluate associations with triple-negative (N = 307) and ER+ (N = 2610) breast cancers and used partial likelihood methods to test for differences in subtype-specific hazard ratios (HRs). RESULTS: Reproductive history was differentially associated with risk of triple-negative and ER+ breast cancers. Nulliparity was associated with decreased risk of triple-negative breast cancer (HR = 0.61, 95% confidence interval [CI] = 0.37 to 0.97) but increased risk of ER+ breast cancer (HR = 1.35, 95% CI = 1.20 to 1.52). Age-adjusted absolute rates of triple-negative breast cancer were 2.71 and 1.54 per 10,000 person-years in parous and nulliparous women, respectively; by comparison, rates of ER+ breast cancer were 21.10 and 28.16 per 10,000 person-years in the same two groups. Among parous women, the number of births was positively associated with risk of triple-negative disease (HR for three births or more vs one birth = 1.46, 95% CI = 0.82 to 2.63) and inversely associated with risk of ER+ disease (HR = 0.88, 95% CI = 0.74 to 1.04). Ages at menarche and menopause were modestly associated with risk of ER+ but not triple-negative breast cancer; breastfeeding and oral contraceptive use were not associated with either subtype. CONCLUSION: The association between parity and breast cancer risk differs appreciably for ER+ and triple-negative breast cancers. These findings require further confirmation because the biological mechanisms underlying these differences are uncertain. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/21346227/Reproductive_history_and_oral_contraceptive_use_in_relation_to_risk_of_triple_negative_breast_cancer_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djr030 DB - PRIME DP - Unbound Medicine ER -