Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Ritte R

PROVIDER: S-EPMC3866571 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

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Publications

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

Ritte Rebecca R Tikk Kaja K Lukanova Annekatrin A Tjønneland Anne A Olsen Anja A Overvad Kim K Dossus Laure L Fournier Agnès A Clavel-Chapelon Françoise F Grote Verena V Boeing Heiner H Aleksandrova Krasimira K Trichopoulou Antonia A Lagiou Pagona P Trichopoulos Dimitrios D Palli Domenico D Berrino Franco F Mattiello Amalia A Tumino Rosario R Sacerdote Carlotta C Quirós José Ramón JR Buckland Genevieve G Molina-Montes Esther E Chirlaque María-Dolores MD Ardanaz Eva E Amiano Pilar P Bueno-de-Mesquita H Bas HB van Gils Carla H CH Peeters Petra Hm PH Wareham Nick N Khaw Kay-Tee KT Key Timothy J TJ Travis Ruth C RC Weiderpass Elisabete E Dumeaux Vanessa V Lund Eliv E Sund Malin M Andersson Anne A Romieu Isabelle I Rinaldi Sabina S Vineis Paulo P Merritt Melissa A MA Riboli Elio E Kaaks Rudolf R

BMC cancer 20131209

<h4>Background</h4>The association of reproductive factors with hormone receptor (HR)-negative breast tumors remains uncertain.<h4>Methods</h4>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 con ...[more]

PMID: 24321460

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Project description:PurposeAdvanced breast cancer is a heterogeneous disease with several well-defined subtypes, among which, hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) is most prevalent. Determination of HR and HER2 status influences prognosis and, thus, disease management. Although literature on these prognostic factors exist, especially in the early breast cancer setting, it remains unclear to what extent these factors can guide clinical decision-making in the advanced disease setting. Therefore, we sought to identify the strength and consistency of evidence for prognostic factors in patients with HR+/HER2- advanced breast cancer.MethodsA systematic literature review (SLR) of the major electronic databases was conducted in November 2018 for primary research studies published since 2010. Endpoints of interest were tumor response, progression-free survival (PFS), overall survival (OS), and breast cancer-specific survival (BCSS).ResultsSeventy-nine studies were included wherein all patients were diagnosed with advanced breast cancer and ≥50% of the population were HR+/HER2-. OS was the most commonly assessed endpoint (n=67) followed by PFS (n=33), BCSS (n=5) and tumor response (n=3). The prognostic factors with strongest evidence of association with worse OS were negative progesterone receptor status, higher tumor grade, higher circulating tumor cell (CTC) count and higher Ki67 level, number of metastatic sites (eg multiple vs single) and sites of metastases (eg presence of liver metastases vs absence), shorter time to recurrence or progression to advanced breast cancer, poor performance status, prior therapy attributes in the early or metastatic setting (type of therapy, treatment line, response of prior therapy), and race (black vs white). The prognostic factors that had strongest evidence of association with PFS included CTC count, number and sites of metastases, and absence of prior therapy or higher lines of therapy in the early or metastatic setting. The directionality of association was consistent for all prognostic factors except between lymph node and OS, and de novo metastatic breast cancer and PFS.ConclusionMultiple disease, treatment, and patient-related prognostic factors impact survival, particularly OS, in patients with HR+/HER2- advanced breast cancer. Treatment outcomes can vary considerably due to these factors. Understanding poorer prognostic factors for patients can result in improved clinical decision-making.

Dataset Information

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

Background

Methods

Results

Conclusion

Publications

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

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