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Interactions of hormone replacement therapy, body weight, and bilateral oophorectomy in breast cancer risk.

Abstract

PURPOSE

To examine potential modifying effects of body weight and bilateral oophorectomy on the association of hormone replacement therapy (HRT) with risk of breast cancer, overall and by subtypes according to status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (Her2) among postmenopausal women.

EXPERIMENTAL DESIGN

This analysis included 2,510 postmenopausal white women recruited in the Nashville Breast Health Study, a population-based case-control study of breast cancer. Multivariable logistic regression was used to estimate ORs and 95% confidence intervals (CI) for associations between HRT use and risk of breast cancer overall and by subtypes, adjusted for age and education.

RESULTS

Among women with natural menopause and body mass index (BMI) < 25 kg/m(2), ever-use of HRT was associated with increased breast cancer risk (OR, 1.95; 95% CI, 1.32-2.88). Risk was elevated with duration of HRT use (P for trend = 0.002). Similar association patterns were found for ER(+), ER(+)PR(+), and luminal A cancer subtypes but not ER(-), ER(-)PR(-), and triple-negative cancer. In contrast, ever-HRT use in overweight women (BMI ≥ 25 kg/m(2)) showed no association with risk of breast cancer overall or by subtypes; interaction tests for modifying effect of BMI were statistically significant. Ever-HRT use was associated with decreased breast cancer risk (OR, 0.70; 95% CI, 0.38-1.31) among women with prior bilateral oophorectomy but elevated risk (OR, 1.45; 95% CI, 0.92-2.29) among those with hysterectomy without bilateral oophorectomy (P for interaction = 0.057). Similar associations were seen for virtually all breast cancer subtypes, although interaction tests were statistically significant for ER(+) and luminal A only.

CONCLUSION

Body weight and bilateral oophorectomy modify associations between HRT use and breast cancer risk, especially the risk of hormone receptor-positive tumors.

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  • Authors+Show Affiliations

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    Authors' Affiliations: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center and Vanderbilt Institute of Clinical Translational Research, Vanderbilt University School of Medicine, Nashville, Tennessee.

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    Source

    MeSH

    Aged
    Body Mass Index
    Body Weight
    Breast Neoplasms
    Case-Control Studies
    Female
    Hormone Replacement Therapy
    Humans
    Middle Aged
    Ovariectomy
    Postmenopause
    Public Health Surveillance
    Receptor, ErbB-2
    Receptors, Estrogen
    Receptors, Progesterone
    Registries
    Risk
    Tennessee

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    24423614

    Citation

    Cui, Yong, et al. "Interactions of Hormone Replacement Therapy, Body Weight, and Bilateral Oophorectomy in Breast Cancer Risk." Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, vol. 20, no. 5, 2014, pp. 1169-78.
    Cui Y, Deming-Halverson SL, Beeghly-Fadiel A, et al. Interactions of hormone replacement therapy, body weight, and bilateral oophorectomy in breast cancer risk. Clin Cancer Res. 2014;20(5):1169-78.
    Cui, Y., Deming-Halverson, S. L., Beeghly-Fadiel, A., Lipworth, L., Shrubsole, M. J., Fair, A. M., ... Zheng, W. (2014). Interactions of hormone replacement therapy, body weight, and bilateral oophorectomy in breast cancer risk. Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, 20(5), pp. 1169-78. doi:10.1158/1078-0432.CCR-13-2094.
    Cui Y, et al. Interactions of Hormone Replacement Therapy, Body Weight, and Bilateral Oophorectomy in Breast Cancer Risk. Clin Cancer Res. 2014 Mar 1;20(5):1169-78. PubMed PMID: 24423614.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Interactions of hormone replacement therapy, body weight, and bilateral oophorectomy in breast cancer risk. AU - Cui,Yong, AU - Deming-Halverson,Sandra L, AU - Beeghly-Fadiel,Alicia, AU - Lipworth,Loren, AU - Shrubsole,Martha J, AU - Fair,Alecia M, AU - Shu,Xiao-Ou, AU - Zheng,Wei, Y1 - 2014/01/14/ PY - 2014/1/16/entrez PY - 2014/1/16/pubmed PY - 2014/10/29/medline SP - 1169 EP - 78 JF - Clinical cancer research : an official journal of the American Association for Cancer Research JO - Clin. Cancer Res. VL - 20 IS - 5 N2 - PURPOSE: To examine potential modifying effects of body weight and bilateral oophorectomy on the association of hormone replacement therapy (HRT) with risk of breast cancer, overall and by subtypes according to status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (Her2) among postmenopausal women. EXPERIMENTAL DESIGN: This analysis included 2,510 postmenopausal white women recruited in the Nashville Breast Health Study, a population-based case-control study of breast cancer. Multivariable logistic regression was used to estimate ORs and 95% confidence intervals (CI) for associations between HRT use and risk of breast cancer overall and by subtypes, adjusted for age and education. RESULTS: Among women with natural menopause and body mass index (BMI) < 25 kg/m(2), ever-use of HRT was associated with increased breast cancer risk (OR, 1.95; 95% CI, 1.32-2.88). Risk was elevated with duration of HRT use (P for trend = 0.002). Similar association patterns were found for ER(+), ER(+)PR(+), and luminal A cancer subtypes but not ER(-), ER(-)PR(-), and triple-negative cancer. In contrast, ever-HRT use in overweight women (BMI ≥ 25 kg/m(2)) showed no association with risk of breast cancer overall or by subtypes; interaction tests for modifying effect of BMI were statistically significant. Ever-HRT use was associated with decreased breast cancer risk (OR, 0.70; 95% CI, 0.38-1.31) among women with prior bilateral oophorectomy but elevated risk (OR, 1.45; 95% CI, 0.92-2.29) among those with hysterectomy without bilateral oophorectomy (P for interaction = 0.057). Similar associations were seen for virtually all breast cancer subtypes, although interaction tests were statistically significant for ER(+) and luminal A only. CONCLUSION: Body weight and bilateral oophorectomy modify associations between HRT use and breast cancer risk, especially the risk of hormone receptor-positive tumors. SN - 1078-0432 UR - https://www.unboundmedicine.com/medline/citation/24423614/Interactions_of_hormone_replacement_therapy_body_weight_and_bilateral_oophorectomy_in_breast_cancer_risk_ L2 - http://clincancerres.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=24423614 DB - PRIME DP - Unbound Medicine ER -