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

BMC Cancer

Rebecca Ritte¹⁵  Kaja Tikk¹⁵  Annekatrin Lukanova¹⁵  Anne Tjønneland²³  Anja Olsen²³  Kim Overvad¹⁰  Laure Dossus²⁰  Agnès Fournier²⁰  Françoise Clavel-Chapelon²⁰  Verena Grote¹⁵  Heiner Boeing³⁰  Krasimira Aleksandrova³⁰  Antonia Trichopoulou²²  Pagona Lagiou⁶  Dimitrios Trichopoulos⁶  Domenico Palli⁹  Franco Berrino²⁹  Amalia Mattiello²  Rosario Tumino¹²  Carlotta Sacerdote²¹  José Ramón Quirós³²  Genevieve Buckland¹¹  Esther Molina-Montes¹⁸  María-Dolores Chirlaque⁸  Eva Ardanaz²⁵  Pilar Amiano²⁷  H Bas Bueno-de-Mesquita²⁶  Carla H van Gils³¹  Petra HM Peeters¹⁶  Nick Wareham²⁴  Kay-Tee Khaw²⁸  Timothy J Key¹³  Ruth C Travis¹³  Elisabete Weiderpass¹⁴  Vanessa Dumeaux¹⁷  Eliv Lund³  Malin Sund¹⁹  Anne Andersson⁴  Isabelle Romieu⁷  Sabina Rinaldi⁵  Paulo Vineis¹  Melissa A Merritt¹  Elio Riboli¹  Rudolf Kaaks¹⁵ 

[1] Imperial College School of Public Health, London, UK

[2] Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy

[3] Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway

[4] Department of Oncology and Radiation Sciences, Oncology, Umeå University Hospital, Umeå, Sweden

[5] Biomarkers Group, Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France

[6] Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA

[7] Nutritional Epidemiology Group, Section of Nutrition and Metabolism, IARC, Lyon, France

[8] Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain

[9] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy

[10] Section of Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark

[11] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Granada, Spain

[12] Cancer Registry and Histopathology Unit, “Civile M. P. Arezzo” Hospital, ASP 7 Ragusa, Italy

[13] Cancer Epidemiology Unit, University of Oxford, Oxford, UK

[14] Samfundet Folkhälsan, Helsinki, Finland

[15] Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany

[16] Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College, London, UK

[17] McGill university, Montreal, Canada

[18] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Granada, Spain

[19] Department of Surgery and Perioperative Sciences, Umea University, Umea, Sweden

[20] Paris South University, UMRS 1018, F-94805 Villejuif, France

[21] HuGeF Foundation, Torino, Italy

[22] Hellenic Health Foundation, 10-12 Tetrapoleos Street, GR-115 27 Athens, Greece

[23] Institute of Cancer Epidemiology, Danish Cancer Society, 2100 Copenhagen, Denmark

[24] MRC epidemiology Unit, Cambridge, UK

[25] Navarre Public Health Institute, Pamplona, Spain

[26] Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands

[27] Public Health division of Gipuzkoa, Institute BIODonostai, Health Department, Gipuzkoa, Basque Region, France

[28] University of Cambridge, Cambridge, UK

[29] Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Tumori, Via Venezian, 1, Milan, Italy

[30] German Institute of Human Nutrition Potsdam-Rehbruecke Department of Epidemiology Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany

[31] Julius Center for Health Sciences and Primary Care, University Medical Center, 3508, GA, Utrecht, The Netherlands

[32] Public Health and Health Planning Directorate, Asturias, Spain

关键词: Breast cancer;    Oral contraceptive;    Parity;    Menopause;    Risk factors;    Reproductive factors;    PR-receptor;    ER-receptor;   

Others  :  859210
DOI  :  10.1186/1471-2407-13-584

 received in 2013-09-20, accepted in 2013-10-15,  发布年份 2013

【 摘 要 】

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.

【 授权许可】

   
2013 Ritte et al.; licensee BioMed Central Ltd.

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