Reproductive factors and risk of luminal, HER2-overexpressing and triple negative breast cancer among multiethnic women
Menée aux Etats-Unis à partir de données portant sur 2 710 patientes âgées de 20 à 69 ans, cette étude évalue les disparités ethniques dans l'association entre des facteurs reproductifs et le risque de cancer du sein par sous-type (luminal, triple négatif, HER2+)
Background:Reproductive factors are among the most well-established risk factors for breast cancer. However, their associations with different breast cancer subtypes defined by joint estrogen receptor (ER)/progesterone receptor (PR)/HER2 status remain unclear. Methods:We assessed relationships between reproductive factors and risks of luminal A (ER+/HER2-), luminal B (ER+/HER2+), triple negative (TN, ER-/PR-/HER2-), and HER2-overexpressing (H2E, ER-/HER2+) breast cancers in a population-based case-case study consisting of 2,710 women aged 20-69 years diagnosed between 2004-2012. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated with luminal A cases serving as the reference group using polytomous logistic regression. Results:Earlier age at first full-term pregnancy and age at menopause were positively associated with odds of TN breast cancer (p-values for trend: 0.003 and 0.024, respectively). Parity was associated with a 43% (95% CI: 1.08-1.89) elevated odds of H2E breast cancer, and women who had {greater than or equal to}3 full-term pregnancies had a 63% (95% CI: 1.16-2.29, p-trend: 0.013) increased odds of this subtype compared to nulliparous women. Breastfeeding for {greater than or equal to}36 months was associated with a 49% (OR: 0.51, 95% CI: 0.27-0.99) lower odds of TN breast cancer. Conclusions:Our results suggest that reproductive factors contribute differently to risks of the major molecular subtypes of breast cancer. Impact: African American and Hispanic women have higher incidence rates of the more aggressive TN and H2E breast cancers and their younger average age at first pregnancy, higher parity, and less frequent breast feeding could in part contribute to this disparity.