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Reproductive factors and risk of hormone receptor positive and negative breast cancer: a cohort study.

Abstract

BACKGROUND

The association of reproductive factors with hormone receptor (HR)-negative breast tumors remains uncertain.

METHODS

Within the EPIC cohort, Cox proportional hazards models were used to describe the relationships of reproductive factors (menarcheal age, time between menarche and first pregnancy, parity, number of children, age at first and last pregnancies, time since last full-term childbirth, breastfeeding, age at menopause, ever having an abortion and use of oral contraceptives [OC]) with risk of ER-PR- (n = 998) and ER+PR+ (n = 3,567) breast tumors.

RESULTS

A later first full-term childbirth was associated with increased risk of ER+PR+ tumors but not with risk of ER-PR- tumors (≥35 vs. ≤19 years HR: 1.47 [95% CI 1.15-1.88] p(trend) < 0.001 for ER+PR+ tumors; ≥35 vs. ≤19 years HR: 0.93 [95% CI 0.53-1.65] p(trend) = 0.96 for ER-PR- tumors; P(het) = 0.03). The risk associations of menarcheal age, and time period between menarche and first full-term childbirth with ER-PR-tumors were in the similar direction with risk of ER+PR+ tumors (p(het) = 0.50), although weaker in magnitude and statistically only borderline significant. Other parity related factors such as ever a full-term birth, number of births, age- and time since last birth were associated only with ER+PR+ malignancies, however no statistical heterogeneity between breast cancer subtypes was observed. Breastfeeding and OC use were generally not associated with breast cancer subtype risk.

CONCLUSION

Our study provides possible evidence that age at menarche, and time between menarche and first full-term childbirth may be associated with the etiology of both HR-negative and HR-positive malignancies, although the associations with HR-negative breast cancer were only borderline significant.

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  • Authors+Show Affiliations

    , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

    Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. r.kaaks@Dkfz-Heidelberg.de.

    Source

    BMC cancer 13: 2013 Dec 09 pg 584

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Breast Feeding
    Breast Neoplasms
    Contraceptives, Oral, Hormonal
    Female
    Gravidity
    Humans
    Maternal Age
    Menarche
    Menopause
    Middle Aged
    Parity
    Pregnancy
    Proportional Hazards Models
    Prospective Studies
    Receptors, Estrogen
    Receptors, Progesterone
    Risk Factors
    Young Adult

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    24321460

    Citation

    Ritte, Rebecca, et al. "Reproductive Factors and Risk of Hormone Receptor Positive and Negative Breast Cancer: a Cohort Study." BMC Cancer, vol. 13, 2013, p. 584.
    Ritte R, Tikk K, Lukanova A, et al. Reproductive factors and risk of hormone receptor positive and negative breast cancer: a cohort study. BMC Cancer. 2013;13:584.
    Ritte, R., Tikk, K., Lukanova, A., Tjønneland, A., Olsen, A., Overvad, K., ... Kaaks, R. (2013). Reproductive factors and risk of hormone receptor positive and negative breast cancer: a cohort study. BMC Cancer, 13, p. 584. doi:10.1186/1471-2407-13-584.
    Ritte R, et al. Reproductive Factors and Risk of Hormone Receptor Positive and Negative Breast Cancer: a Cohort Study. BMC Cancer. 2013 Dec 9;13:584. PubMed PMID: 24321460.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Reproductive factors and risk of hormone receptor positive and negative breast cancer: a cohort study. AU - Ritte,Rebecca, AU - Tikk,Kaja, AU - Lukanova,Annekatrin, AU - Tjønneland,Anne, AU - Olsen,Anja, AU - Overvad,Kim, AU - Dossus,Laure, AU - Fournier,Agnès, AU - Clavel-Chapelon,Françoise, AU - Grote,Verena, AU - Boeing,Heiner, AU - Aleksandrova,Krasimira, AU - Trichopoulou,Antonia, AU - Lagiou,Pagona, AU - Trichopoulos,Dimitrios, AU - Palli,Domenico, AU - Berrino,Franco, AU - Mattiello,Amalia, AU - Tumino,Rosario, AU - Sacerdote,Carlotta, AU - Quirós,José Ramón, AU - Buckland,Genevieve, AU - Molina-Montes,Esther, AU - Chirlaque,María-Dolores, AU - Ardanaz,Eva, AU - Amiano,Pilar, AU - Bueno-de-Mesquita,H Bas, AU - van Gils,Carla H, AU - Peeters,Petra Hm, AU - Wareham,Nick, AU - Khaw,Kay-Tee, AU - Key,Timothy J, AU - Travis,Ruth C, AU - Weiderpass,Elisabete, AU - Dumeaux,Vanessa, AU - Lund,Eliv, AU - Sund,Malin, AU - Andersson,Anne, AU - Romieu,Isabelle, AU - Rinaldi,Sabina, AU - Vineis,Paulo, AU - Merritt,Melissa A, AU - Riboli,Elio, AU - Kaaks,Rudolf, Y1 - 2013/12/09/ PY - 2013/09/20/received PY - 2013/10/15/accepted PY - 2013/12/11/entrez PY - 2013/12/11/pubmed PY - 2014/3/22/medline SP - 584 EP - 584 JF - BMC cancer JO - BMC Cancer VL - 13 N2 - BACKGROUND: The association of reproductive factors with hormone receptor (HR)-negative breast tumors remains uncertain. METHODS: Within the EPIC cohort, Cox proportional hazards models were used to describe the relationships of reproductive factors (menarcheal age, time between menarche and first pregnancy, parity, number of children, age at first and last pregnancies, time since last full-term childbirth, breastfeeding, age at menopause, ever having an abortion and use of oral contraceptives [OC]) with risk of ER-PR- (n = 998) and ER+PR+ (n = 3,567) breast tumors. RESULTS: A later first full-term childbirth was associated with increased risk of ER+PR+ tumors but not with risk of ER-PR- tumors (≥35 vs. ≤19 years HR: 1.47 [95% CI 1.15-1.88] p(trend) < 0.001 for ER+PR+ tumors; ≥35 vs. ≤19 years HR: 0.93 [95% CI 0.53-1.65] p(trend) = 0.96 for ER-PR- tumors; P(het) = 0.03). The risk associations of menarcheal age, and time period between menarche and first full-term childbirth with ER-PR-tumors were in the similar direction with risk of ER+PR+ tumors (p(het) = 0.50), although weaker in magnitude and statistically only borderline significant. Other parity related factors such as ever a full-term birth, number of births, age- and time since last birth were associated only with ER+PR+ malignancies, however no statistical heterogeneity between breast cancer subtypes was observed. Breastfeeding and OC use were generally not associated with breast cancer subtype risk. CONCLUSION: Our study provides possible evidence that age at menarche, and time between menarche and first full-term childbirth may be associated with the etiology of both HR-negative and HR-positive malignancies, although the associations with HR-negative breast cancer were only borderline significant. SN - 1471-2407 UR - https://www.unboundmedicine.com/medline/citation/24321460/Reproductive_factors_and_risk_of_hormone_receptor_positive_and_negative_breast_cancer:_a_cohort_study_ L2 - https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-13-584 DB - PRIME DP - Unbound Medicine ER -