Distinct reproductive risk profiles for intrinsic-like breast cancer subtypes: pooled analysis of population-based studies
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Distinct reproductive risk profiles for intrinsic-like breast cancer subtypes: pooled analysis of population-based studies. / Jung, Audrey Y; Ahearn, Thomas U; Behrens, Sabine; Middha, Pooja; Bolla, Manjeet K; Wang, Qin; Arndt, Volker; Aronson, Kristan J; Augustinsson, Annelie; Beane Freeman, Laura E; Becher, Heiko; Brenner, Hermann; Canzian, Federico; Carey, Lisa A; Czene, Kamila; Eliassen, A Heather; Eriksson, Mikael; Evans, D Gareth; Figueroa, Jonine D; Fritschi, Lin; Gabrielson, Marike; Giles, Graham G; Guénel, Pascal; Hadjisavvas, Andreas; Haiman, Christopher A; Håkansson, Niclas; Hall, Per; Hamann, Ute; Hoppe, Reiner; Hopper, John L; Howell, Anthony; Hunter, David J; Hüsing, Anika; Kaaks, Rudolf; Kosma, Veli-Matti; Koutros, Stella; Kraft, Peter; Lacey, James V; Le Marchand, Loic; Lissowska, Jolanta; Loizidou, Maria A; Mannermaa, Arto; Maurer, Tabea; Murphy, Rachel A; Olshan, Andrew F; Olsson, Håkan; Patel, Alpa V; Perou, Charles M; Rennert, Gad; Shibli, Rana; Shu, Xiao-Ou; Southey, Melissa C; Stone, Jennifer; Tamimi, Rulla M; Teras, Lauren R; Troester, Melissa A; Truong, Thérèse; Vachon, Celine M; Wang, Sophia S; Wolk, Alicja; Wu, Anna H; Yang, Xiaohong R; Zheng, Wei; Dunning, Alison M; Pharoah, Paul D P; Easton, Douglas F; Milne, Roger L; Chatterjee, Nilanjan; Schmidt, Marjanka K; García-Closas, Montserrat; Chang-Claude, Jenny; CTS Consortium.
In: JNCI-J NATL CANCER I, Vol. 114, No. 12, 08.12.2022, p. 1706-1719.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Distinct reproductive risk profiles for intrinsic-like breast cancer subtypes: pooled analysis of population-based studies
AU - Jung, Audrey Y
AU - Ahearn, Thomas U
AU - Behrens, Sabine
AU - Middha, Pooja
AU - Bolla, Manjeet K
AU - Wang, Qin
AU - Arndt, Volker
AU - Aronson, Kristan J
AU - Augustinsson, Annelie
AU - Beane Freeman, Laura E
AU - Becher, Heiko
AU - Brenner, Hermann
AU - Canzian, Federico
AU - Carey, Lisa A
AU - Czene, Kamila
AU - Eliassen, A Heather
AU - Eriksson, Mikael
AU - Evans, D Gareth
AU - Figueroa, Jonine D
AU - Fritschi, Lin
AU - Gabrielson, Marike
AU - Giles, Graham G
AU - Guénel, Pascal
AU - Hadjisavvas, Andreas
AU - Haiman, Christopher A
AU - Håkansson, Niclas
AU - Hall, Per
AU - Hamann, Ute
AU - Hoppe, Reiner
AU - Hopper, John L
AU - Howell, Anthony
AU - Hunter, David J
AU - Hüsing, Anika
AU - Kaaks, Rudolf
AU - Kosma, Veli-Matti
AU - Koutros, Stella
AU - Kraft, Peter
AU - Lacey, James V
AU - Le Marchand, Loic
AU - Lissowska, Jolanta
AU - Loizidou, Maria A
AU - Mannermaa, Arto
AU - Maurer, Tabea
AU - Murphy, Rachel A
AU - Olshan, Andrew F
AU - Olsson, Håkan
AU - Patel, Alpa V
AU - Perou, Charles M
AU - Rennert, Gad
AU - Shibli, Rana
AU - Shu, Xiao-Ou
AU - Southey, Melissa C
AU - Stone, Jennifer
AU - Tamimi, Rulla M
AU - Teras, Lauren R
AU - Troester, Melissa A
AU - Truong, Thérèse
AU - Vachon, Celine M
AU - Wang, Sophia S
AU - Wolk, Alicja
AU - Wu, Anna H
AU - Yang, Xiaohong R
AU - Zheng, Wei
AU - Dunning, Alison M
AU - Pharoah, Paul D P
AU - Easton, Douglas F
AU - Milne, Roger L
AU - Chatterjee, Nilanjan
AU - Schmidt, Marjanka K
AU - García-Closas, Montserrat
AU - Chang-Claude, Jenny
AU - CTS Consortium
N1 - © The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2022/12/8
Y1 - 2022/12/8
N2 - BACKGROUND: Reproductive factors have been shown to be differentially associated with risk of estrogen receptor (ER)-positive and ER-negative breast cancer. However, their associations with intrinsic-like subtypes are less clear.METHODS: Analyses included up to 23 353 cases and 71 072 controls pooled from 31 population-based case-control or cohort studies in the Breast Cancer Association Consortium across 16 countries on 4 continents. Polytomous logistic regression was used to estimate the association between reproductive factors and risk of breast cancer by intrinsic-like subtypes (luminal A-like, luminal B-like, luminal B-HER2-like, HER2-enriched-like, and triple-negative breast cancer) and by invasiveness. All statistical tests were 2-sided.RESULTS: Compared with nulliparous women, parous women had a lower risk of luminal A-like, luminal B-like, luminal B-HER2-like, and HER2-enriched-like disease. This association was apparent only after approximately 10 years since last birth and became stronger with increasing time (odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.49 to 0.71; and OR = 0.36, 95% CI = 0.28 to 0.46 for multiparous women with luminal A-like tumors 20 to less than 25 years after last birth and 45 to less than 50 years after last birth, respectively). In contrast, parous women had a higher risk of triple-negative breast cancer right after their last birth (for multiparous women: OR = 3.12, 95% CI = 2.02 to 4.83) that was attenuated with time but persisted for decades (OR = 1.03, 95% CI = 0.79 to 1.34, for multiparous women 25 to less than 30 years after last birth). Older age at first birth (Pheterogeneity < .001 for triple-negative compared with luminal A-like breast cancer) and breastfeeding (Pheterogeneity < .001 for triple-negative compared with luminal A-like breast cancer) were associated with lower risk of triple-negative breast cancer but not with other disease subtypes. Younger age at menarche was associated with higher risk of all subtypes; older age at menopause was associated with higher risk of luminal A-like but not triple-negative breast cancer. Associations for in situ tumors were similar to luminal A-like.CONCLUSIONS: This large and comprehensive study demonstrates a distinct reproductive risk factor profile for triple-negative breast cancer compared with other subtypes, with implications for the understanding of disease etiology and risk prediction.
AB - BACKGROUND: Reproductive factors have been shown to be differentially associated with risk of estrogen receptor (ER)-positive and ER-negative breast cancer. However, their associations with intrinsic-like subtypes are less clear.METHODS: Analyses included up to 23 353 cases and 71 072 controls pooled from 31 population-based case-control or cohort studies in the Breast Cancer Association Consortium across 16 countries on 4 continents. Polytomous logistic regression was used to estimate the association between reproductive factors and risk of breast cancer by intrinsic-like subtypes (luminal A-like, luminal B-like, luminal B-HER2-like, HER2-enriched-like, and triple-negative breast cancer) and by invasiveness. All statistical tests were 2-sided.RESULTS: Compared with nulliparous women, parous women had a lower risk of luminal A-like, luminal B-like, luminal B-HER2-like, and HER2-enriched-like disease. This association was apparent only after approximately 10 years since last birth and became stronger with increasing time (odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.49 to 0.71; and OR = 0.36, 95% CI = 0.28 to 0.46 for multiparous women with luminal A-like tumors 20 to less than 25 years after last birth and 45 to less than 50 years after last birth, respectively). In contrast, parous women had a higher risk of triple-negative breast cancer right after their last birth (for multiparous women: OR = 3.12, 95% CI = 2.02 to 4.83) that was attenuated with time but persisted for decades (OR = 1.03, 95% CI = 0.79 to 1.34, for multiparous women 25 to less than 30 years after last birth). Older age at first birth (Pheterogeneity < .001 for triple-negative compared with luminal A-like breast cancer) and breastfeeding (Pheterogeneity < .001 for triple-negative compared with luminal A-like breast cancer) were associated with lower risk of triple-negative breast cancer but not with other disease subtypes. Younger age at menarche was associated with higher risk of all subtypes; older age at menopause was associated with higher risk of luminal A-like but not triple-negative breast cancer. Associations for in situ tumors were similar to luminal A-like.CONCLUSIONS: This large and comprehensive study demonstrates a distinct reproductive risk factor profile for triple-negative breast cancer compared with other subtypes, with implications for the understanding of disease etiology and risk prediction.
U2 - 10.1093/jnci/djac117
DO - 10.1093/jnci/djac117
M3 - SCORING: Journal article
C2 - 35723569
VL - 114
SP - 1706
EP - 1719
JO - JNCI-J NATL CANCER I
JF - JNCI-J NATL CANCER I
SN - 0027-8874
IS - 12
ER -