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

被引:65
作者
Ritte, Rebecca [1 ]
Tikk, Kaja [1 ]
Lukanova, Annekatrin [1 ]
Tjonneland, Anne [2 ]
Olsen, Anja [2 ]
Overvad, Kim [3 ]
Dossus, Laure [4 ,5 ]
Fournier, Agnes [4 ,5 ]
Clavel-Chapelon, Francoise [4 ,5 ]
Grote, Verena [1 ]
Boeing, Heiner [6 ]
Aleksandrova, Krasimira [6 ]
Trichopoulou, Antonia [7 ,8 ]
Lagiou, Pagona [7 ,9 ,10 ]
Trichopoulos, Dimitrios [9 ,10 ]
Palli, Domenico [11 ]
Berrino, Franco [12 ]
Mattiello, Amalia [13 ]
Tumino, Rosario
Sacerdote, Carlotta [14 ,15 ]
Ramon Quiros, Jose [16 ]
Buckland, Genevieve [17 ]
Molina-Montes, Esther [18 ,19 ]
Chirlaque, Maria-Dolores [19 ,20 ]
Ardanaz, Eva [19 ,21 ]
Amiano, Pilar [19 ,22 ]
Bueno-de-Mesquita, H. Bas [23 ,24 ]
van Gils, Carla H. [25 ]
Peeters, Petra H. M. [25 ,26 ]
Wareham, Nick [27 ]
Khaw, Kay-Tee [28 ]
Key, Timothy J. [29 ]
Travis, Ruth C. [29 ]
Weiderpass, Elisabete [30 ,31 ,32 ,33 ]
Dumeaux, Vanessa [30 ,34 ]
Lund, Eliv [30 ]
Sund, Malin [35 ]
Andersson, Anne [36 ]
Romieu, Isabelle [37 ]
Rinaldi, Sabina [38 ]
Vineis, Paulo [15 ,39 ]
Merritt, Melissa A. [39 ]
Riboli, Elio [39 ]
Kaaks, Rudolf [1 ]
机构
[1] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany
[2] Danish Canc Soc, Inst Canc Epidemiol, DK-2100 Copenhagen, Denmark
[3] Aarhus Univ, Dept Publ Hlth, Epidemiol Sect, Aarhus, Denmark
[4] Inst Gustave Roussy, INSERM, U1018, Ctr Res Epidemiol & Populat Hlth, F-94805 Villejuif, France
[5] Paris South Univ, UMRS 1018, F-94805 Villejuif, France
[6] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, D-14558 Nuthetal, Germany
[7] Univ Athens, Sch Med, WHO Collaborating Ctr Food & Nutr Policies, Dept Hyg Epidemiol & Med Stat, GR-11527 Athens, Greece
[8] Hellen Hlth Fdn, GR-11527 Athens, Greece
[9] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA
[10] Acad Athens, Bur Epidemiol Res, GR-10679 Athens, Greece
[11] Canc Res & Prevent Inst ISPO, Mol & Nutr Epidemiol Unit, Florence, Italy
[12] Fdn IRCCS Ist Nazl Tumori, Epidemiol & Prevent Unit, Milan, Italy
[13] Univ Naples Federico II, Dept Clin & Expt Med, Naples, Italy
[14] Ctr Canc Prevent CPO Piemonte, Turin, Italy
[15] HuGeF Fdn, Turin, Italy
[16] Publ Hlth & Hlth Planning Directorate, Asturias, Spain
[17] Catalan Inst Oncol ICO IDIBELL, Unit Nutr Environm & Canc, Canc Epidemiol Res Programme, Granada, Spain
[18] Andalusian Sch Publ Hlth, Granada, Spain
[19] CIBERESP, Consortium Biomed Res Epidemiol & Publ Hlth, Granada, Spain
[20] Murcia Reg Hlth Author, Dept Epidemiol, Murcia, Spain
[21] Navarre Publ Hlth Inst, Pamplona, Spain
[22] Inst BIODonostai, Dept Hlth, Publ Hlth Div Gipuzkoa, Gipuzkoa, Basque Region, France
[23] Natl Inst Publ Hlth & Environm RIVM, Bilthoven, Netherlands
[24] Univ Med Ctr, Dept Gastroenterol & Hepatol, NL-3508 GA Utrecht, Netherlands
[25] Univ Med Ctr, Julius Ctr Hlth Sci & Primary Care, NL-3508 GA Utrecht, Netherlands
[26] Univ London Imperial Coll Sci Technol & Med, Fac Med, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England
[27] MRC Epidemiol Unit, Cambridge, England
[28] Univ Cambridge, Cambridge, England
[29] Univ Oxford, Canc Epidemiol Unit, Oxford, England
[30] Univ Tromso, Fac Hlth Sci, Dept Community Med, Tromso, Norway
[31] Canc Registry Norway, Dept Res, Oslo, Norway
[32] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden
[33] Samfundet Folkhalsan, Helsinki, Finland
[34] McGill Univ, Montreal, PQ, Canada
[35] Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden
[36] Umea Univ Hosp, Dept Oncol & Radiat Sci, S-90185 Umea, Sweden
[37] IARC, Nutr Epidemiol Grp, Sect Nutr & Metab, Lyon, France
[38] IARC, Sect Nutr & Metab, Biomarkers Grp, Lyon, France
[39] Imperial Coll Sch Publ Hlth, London, England
基金
英国医学研究理事会;
关键词
ER-receptor; PR-receptor; Reproductive factors; Risk factors; Menopause; Parity; Oral contraceptive; Breast cancer; ORAL-CONTRACEPTIVE USE; ESTROGEN-RECEPTOR; REPLACEMENT THERAPY; AGE; WOMEN; MENARCHE; ASSOCIATIONS;
D O I
10.1186/1471-2407-13-584
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
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页数:12
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