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Clin Breast Cancer. 2014 Dec;14(6):417-25. doi: 10.1016/j.clbc.2014.04.003. Epub 2014 Jun 2.

Associations of hormone-related factors with breast cancer risk according to hormone receptor status among white and African American women.

Author information

1
Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN.
2
Vanderbilt Institute of Clinical Translational Research, Vanderbilt University School of Medicine, Nashville, TN.
3
Meharry/Vanderbilt Cancer Partnership, Nashville General Hospital, Nashville, TN.
4
Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN.
5
Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN. Electronic address: wei.zheng@vanderbilt.edu.

Abstract

BACKGROUND:

Causes of racial disparities in breast cancer incidence and mortality between white and African American women remain unclear. This study evaluated associations of menstrual and reproductive factors with breast cancer risk by race and cancer subtypes.

PATIENTS AND METHODS:

Included in the study were 1866 breast cancer cases and 2306 controls recruited in the Nashville Breast Health Study, a population-based case-control study. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS:

African American women were more likely to have estrogen receptor-negative (ER(-)), progesterone receptor-negative (PR(-)), and triple-negative (ER(-)PR(-)HER2(-)) breast cancer than white women. Age at menarche (≥ 14 years) and multiparity (≥ 3 live births) were inversely associated with ER(+) tumors only, whereas late age at first live birth (> 30 years) and nulliparity were associated with elevated risk; such associations were predominantly seen in white women (OR = 0.70, 95% CI = 0.55-0.88; OR = 0.72, 95% CI = 0.56-0.92; OR = 1.42, 95% CI = 1.13-1.79; OR = 1.32, 95% CI = 1.06-1.63, respectively). Age at menopause between 47 and 51 years was associated with elevated risk of ER(-) tumors in both white and African American women. Among women who had natural menopause, positive association between ever-use of hormone replacement therapy and breast cancer risk was seen in white women only (OR = 1.39, 95% CI = 1.03-1.87).

CONCLUSION:

This study suggests that certain hormone-related factors are differentially associated with risk of breast cancer subtypes, and these associations also differ by race.

KEYWORDS:

Epidemiology; Estrogen receptor; Hormone receptor status; Race; Risk factors

PMID:
24970715
PMCID:
PMC4253543
DOI:
10.1016/j.clbc.2014.04.003
[Indexed for MEDLINE]
Free PMC Article

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