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Epidemiologic risk factors for in situ and invasive breast cancer among postmenopausal women in the NIH-AARP Diet and Health Study

Menée aux Etats-Unis à partir des données de la cohorte "NIH-AARP Diet and Health Study" incluant 190 325 participantes, cette étude analyse les différents facteurs associés au risque de cancer du sein invasif ou in situ chez des femmes après la ménopause (1 453 cas de carcinome canalaire in situ, 7 525 cas de carcinome canalaire invasif, 186 cas de carcinome lobulaire in situ, 1 191 cas de carcinome lobulaire invasif)

Comparing risk factor associations between invasive breast cancers and possible precursors may further understanding of factors related to initiation versus progression. Accordingly, among 190,325 postmenopausal participants in the National Institutes of Health-AARP Diet and Health Study (1995-2011), we compared risk factor associations between incident ductal carcinoma in situ (DCIS: n = 1,453) and invasive ductal carcinomas (n = 7,525) and lobular carcinoma in situ (LCIS: n = 186) and invasive lobular carcinomas (n = 1,191). Hazard ratios and 95% confidence intervals were estimated from multivariable Cox proportional hazards regression models. Case-only multivariable logistic regression was used to test for heterogeneity in associations (Phet). Younger age at menopause was associated with increased risk of DCIS but reduced risks of LCIS and invasive ductal carcinomas (Phet < 0.01). Prior breast biopsy was more strongly associated with risk of LCIS vs. DCIS (Phet = 0.04). Increased risks associated with menopausal hormone therapy were stronger for LCIS than DCIS (Phet = 0.03) and invasive lobular carcinomas (Phet < 0.01). Associations were similar for race, ages at menarche or first birth, family history, alcohol consumption and smoking, suggesting that most risk factor associations are similar for in situ and invasive cancers, and may influence early stages of tumorigenesis. Differential associations observed for factors may provide important clues for understanding breast etiology.

American Journal of Epidemiology

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