Associations of Hormone-Related Factors With Breast Cancer Risk According to Hormone Receptor Status Among White and African American Women

作者：Cui Yong; Deming Halverson Sandra L; Shrubsole Martha J; Beeghly Fadiel Alicia; Fair Alecia M; Sanderson Maureen; Shu Xiao Ou; Kelley Mark C; Zheng Wei^*

来源：Clinical Breast Cancer, 2014, 14(6): 417-425.

DOI：10.1016/j.clbc.2014.04.003

• Epidemiology
• Estrogen receptor
• Hormone receptor status
• Race
• Risk factors

This study examined racial differences in the distribution of breast cancer by receptor status and evaluated the associations of menstrual and reproductive factors with risk of breast cancer by race and subtypes defined by estrogen receptor status in a case-control study including 1866 breast cancer cases and 2306 controls. The study suggests that certain hormone-related factors are differentially associated with breast cancer subtypes, and these associations also differ by race.
Background: Causes of racial disparities in breast cancer incidence and mortality between white and African American women remain unclear. This study evaluated associations of menstrual and reproductive factors with breast cancer risk by race and cancer subtypes. Patients and Methods: Included in the study were 1866 breast cancer cases and 2306 controls recruited in the Nashville Breast Health Study, a population-based case-control study. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (Cis). Results: African American women were more likely to have estrogen receptor-negative (ER-), progesterone receptor-negative (PR-), and triple-negative (ER(-)PR(-)HER2(-)) breast cancer than white women. Age at menarche (>= 14 years) and multiparity (>= 3 live births) were inversely associated with ER+ tumors only, whereas late age at first live birth (> 30 years) and nulliparity were associated with elevated risk; such associations were predominantly seen in white women (OR = 0.70, 95% Cl = 0.55-0.88; OR = 0.72, 95% Cl = 0.56-0.92; OR = 1.42, 95% Cl = 1.13-1.79; OR = 1.32, 95% Cl = 1.06-1.63, respectively). Age at menopause between 47 and 51 years was associated with elevated risk of ER- tumors in both white and African American women. Among women who had natural menopause, positive association between ever-use of hormone replacement therapy and breast cancer risk was seen in white women only (OR = 1.39, 95% Cl = 1.03-1.87). Conclusion: This study suggests that certain hormone-related factors are differentially associated with risk of breast cancer subtypes, and these associations also differ by race.

• 出版日期2014-12