Associations of breast cancer risk factors with tumor subtypes

A pooled analysis from the breast cancer association consortium studies

Xiaohong R. Yang, Jenny Chang-Claude, Ellen L. Goode, Fergus J. Couch, Heli Nevanlinna, Roger L. Milne, Mia Gaudet, Marjanka K. Schmidt, Annegien Broeks, Angela Cox, Peter A. Fasching, Rebecca Hein, Amanda B. Spurdle, Fiona Blows, Kristy Driver, Dieter Flesch-Janys, Judith Heinz, Peter Sinn, Alina Vrieling, Tuomas Heikkinen & 154 others Kristiina Aittomäki, Päivi Heikkilä, Carl Blomqvist, Jolanta Lissowska, Beata Peplonska, Stephen Chanock, Jonine Figueroa, Louise Brinton, Per Hall, Kamila Czene, Keith Humphreys, Hatef Darabi, Jianjun Liu, Laura J. Van 'T Veer, Flora E. Van Leeuwen, Irene L. Andrulis, Gord Glendon, Julia A. Knight, Anna Marie Mulligan, Frances P. O'Malley, Nayana Weerasooriya, Esther M. John, Matthias W. Beckmann, Arndt Hartmann, Sebastian B. Weihbrecht, David L. Wachter, Sebastian M. Jud, Christian R. Loehberg, Laura Baglietto, Dallas R. English, Graham G. Giles, Catriona A. McLean, Gianluca Severi, Diether Lambrechts, Thijs Vandorpe, Caroline Weltens, Robert Paridaens, Ann Smeets, Patrick Neven, Hans Wildiers, Xianshu Wang, Janet E. Olson, Victoria Cafourek, Zachary Fredericksen, Matthew Kosel, Celine Vachon, Helen E. Cramp, Daniel Connley, Simon S. Cross, Sabapathy P. Balasubramanian, Malcolm W R Reed, Thilo Dörk, Michael Bremer, Andreas Meyer, Johann H. Karstens, Aysun Ay, Tjoung Won Park-Simon, Peter Hillemanns, Jose Ignacio Arias Pérez, Primitiva Menéndez Rodríguez, Pilar Zamora, Javier Benítez, Yon Dschun Ko, Hans Peter Fischer, Ute Hamann, Beate Pesch, Thomas Brüning, Christina Justenhoven, Hiltrud Brauch, Diana M. Eccles, William J. Tapper, Sue M. Gerty, Elinor J. Sawyer, Ian P. Tomlinson, Angela Jones, Michael Kerin, Nicola Miller, Niall McInerney, Hoda Anton-Culver, Argyrios Ziogas, Chen Yang Shen, Chia Ni Hsiung, Pei Ei Wu, Show Lin Yang, Jyh Cherng Yu, Shou Tung Chen, Giu Cheng Hsu, Christopher A. Haiman, Brian E. Henderson, Loic Le Marchand, Laurence N. Kolonel, Annika Lindblom, Sara Margolin, Anna Jakubowska, Jan Lubiński, Tomasz Huzarski, Tomasz Byrski, Bohdan Górski, Jacek Gronwald, Maartje J. Hooning, Antoinette Hollestelle, Ans M W Van Den Ouweland, Agnes Jager, Mieke Kriege, Madeleine M A Tilanus-Linthorst, Margriet Collée, Shan Wang-Gohrke, Katri Pylkäs, Arja Jukkola-Vuorinen, Kari Mononen, Mervi Grip, Pasi Hirvikoski, Robert Winqvist, Arto Mannermaa, Veli Matti Kosma, Jaana Kauppinen, Vesa Kataja, Päivi Auvinen, Ylermi Soini, Reijo Sironen, Stig E. Bojesen, David Dynnes Ørsted, Diljit Kaur-Knudsen, Henrik Flyger, Børge G. Nordestgaard, Helene Holland, Georgia Chenevix-Trench, Siranoush Manoukian, Monica Barile, Paolo Radice, Susan E. Hankinson, David J. Hunter, Rulla Tamimi, Suleeporn Sangrajrang, Paul Brennan, James McKay, Fabrice Odefrey, Valerie Gaborieau, Peter Devilee, P. E A Huijts, Raem Tollenaar, C. Seynaeve, Gillian S. Dite, Carmel Apicella, John L. Hopper, Fleur Hammet, Helen Tsimiklis, Letitia D. Smith, Melissa C. Southey, Manjeet K. Humphreys, Douglas Easton, Paul Pharoah, Mark E. Sherman, Montserrat Garcia-Closas

Research output: Contribution to journalArticle

Abstract

Background Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors. Methods We pooled tumor marker and epidemiological risk factor data from 35568 invasive breast cancer case patients from 34 studies participating in the Breast Cancer Association Consortium. Logistic regression models were used in case-case analyses to estimate associations between epidemiological risk factors and tumor subtypes, and case-control analyses to estimate associations between epidemiological risk factors and the risk of developing specific tumor subtypes in 12 population-based studies. All statistical tests were two-sided. Results In case-case analyses, of the epidemiological risk factors examined, early age at menarche (≤12 years) was less frequent in case patients with PR- than PR+ tumors (P =. 001). Nulliparity (P = 3 × 10 -6) and increasing age at first birth (P = 2 × 10-9) were less frequent in ER- than in ER+ tumors. Obesity (body mass index [BMI] ≥ 30 kg/m2) in younger women (≤50 years) was more frequent in ER-/PR- than in ER +/PR+ tumors (P = 1 × 10-7), whereas obesity in older women (>50 years) was less frequent in PR- than in PR+ tumors (P = 6 × 10-4). The triple-negative (ER-/PR-/HER2-) or core basal phenotype (CBP; triple-negative and cytokeratins [CK]5/6+ and/or epidermal growth factor receptor [EGFR]+) accounted for much of the heterogeneity in parity-related variables and BMI in younger women. Case-control analyses showed that nulliparity, increasing age at first birth, and obesity in younger women showed the expected associations with the risk of ER+ or PR + tumors but not triple-negative (nulliparity vs parity, odds ratio [OR] = 0.94, 95% confidence interval [CI] = 0.75 to 1.19, P =. 61; 5-year increase in age at first full-term birth, OR = 0.95, 95% CI = 0.86 to 1.05, P =. 34; obesity in younger women, OR = 1.36, 95% CI = 0.95 to 1.94, P =. 09) or CBP tumors. Conclusion sThis study shows that reproductive factors and BMI are most clearly associated with hormone receptor-positive tumors and suggest that triple-negative or CBP tumors may have distinct etiology.

Original languageEnglish (US)
Pages (from-to)250-263
Number of pages14
JournalJournal of the National Cancer Institute
Volume103
Issue number3
DOIs
StatePublished - Feb 2 2011
Externally publishedYes

Fingerprint

Progesterone Receptors
Breast Neoplasms
Estrogen Receptors
Parity
Neoplasms
Obesity
Birth Order
Body Mass Index
Odds Ratio
Confidence Intervals
Logistic Models
Keratin-6
Keratin-5
Term Birth
Menarche
Tumor Biomarkers
Epidermal Growth Factor Receptor
Hormones
Phenotype

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Yang, X. R., Chang-Claude, J., Goode, E. L., Couch, F. J., Nevanlinna, H., Milne, R. L., ... Garcia-Closas, M. (2011). Associations of breast cancer risk factors with tumor subtypes: A pooled analysis from the breast cancer association consortium studies. Journal of the National Cancer Institute, 103(3), 250-263. https://doi.org/10.1093/jnci/djq526

Associations of breast cancer risk factors with tumor subtypes : A pooled analysis from the breast cancer association consortium studies. / Yang, Xiaohong R.; Chang-Claude, Jenny; Goode, Ellen L.; Couch, Fergus J.; Nevanlinna, Heli; Milne, Roger L.; Gaudet, Mia; Schmidt, Marjanka K.; Broeks, Annegien; Cox, Angela; Fasching, Peter A.; Hein, Rebecca; Spurdle, Amanda B.; Blows, Fiona; Driver, Kristy; Flesch-Janys, Dieter; Heinz, Judith; Sinn, Peter; Vrieling, Alina; Heikkinen, Tuomas; Aittomäki, Kristiina; Heikkilä, Päivi; Blomqvist, Carl; Lissowska, Jolanta; Peplonska, Beata; Chanock, Stephen; Figueroa, Jonine; Brinton, Louise; Hall, Per; Czene, Kamila; Humphreys, Keith; Darabi, Hatef; Liu, Jianjun; Van 'T Veer, Laura J.; Van Leeuwen, Flora E.; Andrulis, Irene L.; Glendon, Gord; Knight, Julia A.; Mulligan, Anna Marie; O'Malley, Frances P.; Weerasooriya, Nayana; John, Esther M.; Beckmann, Matthias W.; Hartmann, Arndt; Weihbrecht, Sebastian B.; Wachter, David L.; Jud, Sebastian M.; Loehberg, Christian R.; Baglietto, Laura; English, Dallas R.; Giles, Graham G.; McLean, Catriona A.; Severi, Gianluca; Lambrechts, Diether; Vandorpe, Thijs; Weltens, Caroline; Paridaens, Robert; Smeets, Ann; Neven, Patrick; Wildiers, Hans; Wang, Xianshu; Olson, Janet E.; Cafourek, Victoria; Fredericksen, Zachary; Kosel, Matthew; Vachon, Celine; Cramp, Helen E.; Connley, Daniel; Cross, Simon S.; Balasubramanian, Sabapathy P.; Reed, Malcolm W R; Dörk, Thilo; Bremer, Michael; Meyer, Andreas; Karstens, Johann H.; Ay, Aysun; Park-Simon, Tjoung Won; Hillemanns, Peter; Arias Pérez, Jose Ignacio; Rodríguez, Primitiva Menéndez; Zamora, Pilar; Benítez, Javier; Ko, Yon Dschun; Fischer, Hans Peter; Hamann, Ute; Pesch, Beate; Brüning, Thomas; Justenhoven, Christina; Brauch, Hiltrud; Eccles, Diana M.; Tapper, William J.; Gerty, Sue M.; Sawyer, Elinor J.; Tomlinson, Ian P.; Jones, Angela; Kerin, Michael; Miller, Nicola; McInerney, Niall; Anton-Culver, Hoda; Ziogas, Argyrios; Shen, Chen Yang; Hsiung, Chia Ni; Wu, Pei Ei; Yang, Show Lin; Yu, Jyh Cherng; Chen, Shou Tung; Hsu, Giu Cheng; Haiman, Christopher A.; Henderson, Brian E.; Le Marchand, Loic; Kolonel, Laurence N.; Lindblom, Annika; Margolin, Sara; Jakubowska, Anna; Lubiński, Jan; Huzarski, Tomasz; Byrski, Tomasz; Górski, Bohdan; Gronwald, Jacek; Hooning, Maartje J.; Hollestelle, Antoinette; Van Den Ouweland, Ans M W; Jager, Agnes; Kriege, Mieke; Tilanus-Linthorst, Madeleine M A; Collée, Margriet; Wang-Gohrke, Shan; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Mononen, Kari; Grip, Mervi; Hirvikoski, Pasi; Winqvist, Robert; Mannermaa, Arto; Kosma, Veli Matti; Kauppinen, Jaana; Kataja, Vesa; Auvinen, Päivi; Soini, Ylermi; Sironen, Reijo; Bojesen, Stig E.; Dynnes Ørsted, David; Kaur-Knudsen, Diljit; Flyger, Henrik; Nordestgaard, Børge G.; Holland, Helene; Chenevix-Trench, Georgia; Manoukian, Siranoush; Barile, Monica; Radice, Paolo; Hankinson, Susan E.; Hunter, David J.; Tamimi, Rulla; Sangrajrang, Suleeporn; Brennan, Paul; McKay, James; Odefrey, Fabrice; Gaborieau, Valerie; Devilee, Peter; Huijts, P. E A; Tollenaar, Raem; Seynaeve, C.; Dite, Gillian S.; Apicella, Carmel; Hopper, John L.; Hammet, Fleur; Tsimiklis, Helen; Smith, Letitia D.; Southey, Melissa C.; Humphreys, Manjeet K.; Easton, Douglas; Pharoah, Paul; Sherman, Mark E.; Garcia-Closas, Montserrat.

In: Journal of the National Cancer Institute, Vol. 103, No. 3, 02.02.2011, p. 250-263.

Research output: Contribution to journalArticle

Yang, XR, Chang-Claude, J, Goode, EL, Couch, FJ, Nevanlinna, H, Milne, RL, Gaudet, M, Schmidt, MK, Broeks, A, Cox, A, Fasching, PA, Hein, R, Spurdle, AB, Blows, F, Driver, K, Flesch-Janys, D, Heinz, J, Sinn, P, Vrieling, A, Heikkinen, T, Aittomäki, K, Heikkilä, P, Blomqvist, C, Lissowska, J, Peplonska, B, Chanock, S, Figueroa, J, Brinton, L, Hall, P, Czene, K, Humphreys, K, Darabi, H, Liu, J, Van 'T Veer, LJ, Van Leeuwen, FE, Andrulis, IL, Glendon, G, Knight, JA, Mulligan, AM, O'Malley, FP, Weerasooriya, N, John, EM, Beckmann, MW, Hartmann, A, Weihbrecht, SB, Wachter, DL, Jud, SM, Loehberg, CR, Baglietto, L, English, DR, Giles, GG, McLean, CA, Severi, G, Lambrechts, D, Vandorpe, T, Weltens, C, Paridaens, R, Smeets, A, Neven, P, Wildiers, H, Wang, X, Olson, JE, Cafourek, V, Fredericksen, Z, Kosel, M, Vachon, C, Cramp, HE, Connley, D, Cross, SS, Balasubramanian, SP, Reed, MWR, Dörk, T, Bremer, M, Meyer, A, Karstens, JH, Ay, A, Park-Simon, TW, Hillemanns, P, Arias Pérez, JI, Rodríguez, PM, Zamora, P, Benítez, J, Ko, YD, Fischer, HP, Hamann, U, Pesch, B, Brüning, T, Justenhoven, C, Brauch, H, Eccles, DM, Tapper, WJ, Gerty, SM, Sawyer, EJ, Tomlinson, IP, Jones, A, Kerin, M, Miller, N, McInerney, N, Anton-Culver, H, Ziogas, A, Shen, CY, Hsiung, CN, Wu, PE, Yang, SL, Yu, JC, Chen, ST, Hsu, GC, Haiman, CA, Henderson, BE, Le Marchand, L, Kolonel, LN, Lindblom, A, Margolin, S, Jakubowska, A, Lubiński, J, Huzarski, T, Byrski, T, Górski, B, Gronwald, J, Hooning, MJ, Hollestelle, A, Van Den Ouweland, AMW, Jager, A, Kriege, M, Tilanus-Linthorst, MMA, Collée, M, Wang-Gohrke, S, Pylkäs, K, Jukkola-Vuorinen, A, Mononen, K, Grip, M, Hirvikoski, P, Winqvist, R, Mannermaa, A, Kosma, VM, Kauppinen, J, Kataja, V, Auvinen, P, Soini, Y, Sironen, R, Bojesen, SE, Dynnes Ørsted, D, Kaur-Knudsen, D, Flyger, H, Nordestgaard, BG, Holland, H, Chenevix-Trench, G, Manoukian, S, Barile, M, Radice, P, Hankinson, SE, Hunter, DJ, Tamimi, R, Sangrajrang, S, Brennan, P, McKay, J, Odefrey, F, Gaborieau, V, Devilee, P, Huijts, PEA, Tollenaar, R, Seynaeve, C, Dite, GS, Apicella, C, Hopper, JL, Hammet, F, Tsimiklis, H, Smith, LD, Southey, MC, Humphreys, MK, Easton, D, Pharoah, P, Sherman, ME & Garcia-Closas, M 2011, 'Associations of breast cancer risk factors with tumor subtypes: A pooled analysis from the breast cancer association consortium studies', Journal of the National Cancer Institute, vol. 103, no. 3, pp. 250-263. https://doi.org/10.1093/jnci/djq526
Yang, Xiaohong R. ; Chang-Claude, Jenny ; Goode, Ellen L. ; Couch, Fergus J. ; Nevanlinna, Heli ; Milne, Roger L. ; Gaudet, Mia ; Schmidt, Marjanka K. ; Broeks, Annegien ; Cox, Angela ; Fasching, Peter A. ; Hein, Rebecca ; Spurdle, Amanda B. ; Blows, Fiona ; Driver, Kristy ; Flesch-Janys, Dieter ; Heinz, Judith ; Sinn, Peter ; Vrieling, Alina ; Heikkinen, Tuomas ; Aittomäki, Kristiina ; Heikkilä, Päivi ; Blomqvist, Carl ; Lissowska, Jolanta ; Peplonska, Beata ; Chanock, Stephen ; Figueroa, Jonine ; Brinton, Louise ; Hall, Per ; Czene, Kamila ; Humphreys, Keith ; Darabi, Hatef ; Liu, Jianjun ; Van 'T Veer, Laura J. ; Van Leeuwen, Flora E. ; Andrulis, Irene L. ; Glendon, Gord ; Knight, Julia A. ; Mulligan, Anna Marie ; O'Malley, Frances P. ; Weerasooriya, Nayana ; John, Esther M. ; Beckmann, Matthias W. ; Hartmann, Arndt ; Weihbrecht, Sebastian B. ; Wachter, David L. ; Jud, Sebastian M. ; Loehberg, Christian R. ; Baglietto, Laura ; English, Dallas R. ; Giles, Graham G. ; McLean, Catriona A. ; Severi, Gianluca ; Lambrechts, Diether ; Vandorpe, Thijs ; Weltens, Caroline ; Paridaens, Robert ; Smeets, Ann ; Neven, Patrick ; Wildiers, Hans ; Wang, Xianshu ; Olson, Janet E. ; Cafourek, Victoria ; Fredericksen, Zachary ; Kosel, Matthew ; Vachon, Celine ; Cramp, Helen E. ; Connley, Daniel ; Cross, Simon S. ; Balasubramanian, Sabapathy P. ; Reed, Malcolm W R ; Dörk, Thilo ; Bremer, Michael ; Meyer, Andreas ; Karstens, Johann H. ; Ay, Aysun ; Park-Simon, Tjoung Won ; Hillemanns, Peter ; Arias Pérez, Jose Ignacio ; Rodríguez, Primitiva Menéndez ; Zamora, Pilar ; Benítez, Javier ; Ko, Yon Dschun ; Fischer, Hans Peter ; Hamann, Ute ; Pesch, Beate ; Brüning, Thomas ; Justenhoven, Christina ; Brauch, Hiltrud ; Eccles, Diana M. ; Tapper, William J. ; Gerty, Sue M. ; Sawyer, Elinor J. ; Tomlinson, Ian P. ; Jones, Angela ; Kerin, Michael ; Miller, Nicola ; McInerney, Niall ; Anton-Culver, Hoda ; Ziogas, Argyrios ; Shen, Chen Yang ; Hsiung, Chia Ni ; Wu, Pei Ei ; Yang, Show Lin ; Yu, Jyh Cherng ; Chen, Shou Tung ; Hsu, Giu Cheng ; Haiman, Christopher A. ; Henderson, Brian E. ; Le Marchand, Loic ; Kolonel, Laurence N. ; Lindblom, Annika ; Margolin, Sara ; Jakubowska, Anna ; Lubiński, Jan ; Huzarski, Tomasz ; Byrski, Tomasz ; Górski, Bohdan ; Gronwald, Jacek ; Hooning, Maartje J. ; Hollestelle, Antoinette ; Van Den Ouweland, Ans M W ; Jager, Agnes ; Kriege, Mieke ; Tilanus-Linthorst, Madeleine M A ; Collée, Margriet ; Wang-Gohrke, Shan ; Pylkäs, Katri ; Jukkola-Vuorinen, Arja ; Mononen, Kari ; Grip, Mervi ; Hirvikoski, Pasi ; Winqvist, Robert ; Mannermaa, Arto ; Kosma, Veli Matti ; Kauppinen, Jaana ; Kataja, Vesa ; Auvinen, Päivi ; Soini, Ylermi ; Sironen, Reijo ; Bojesen, Stig E. ; Dynnes Ørsted, David ; Kaur-Knudsen, Diljit ; Flyger, Henrik ; Nordestgaard, Børge G. ; Holland, Helene ; Chenevix-Trench, Georgia ; Manoukian, Siranoush ; Barile, Monica ; Radice, Paolo ; Hankinson, Susan E. ; Hunter, David J. ; Tamimi, Rulla ; Sangrajrang, Suleeporn ; Brennan, Paul ; McKay, James ; Odefrey, Fabrice ; Gaborieau, Valerie ; Devilee, Peter ; Huijts, P. E A ; Tollenaar, Raem ; Seynaeve, C. ; Dite, Gillian S. ; Apicella, Carmel ; Hopper, John L. ; Hammet, Fleur ; Tsimiklis, Helen ; Smith, Letitia D. ; Southey, Melissa C. ; Humphreys, Manjeet K. ; Easton, Douglas ; Pharoah, Paul ; Sherman, Mark E. ; Garcia-Closas, Montserrat. / Associations of breast cancer risk factors with tumor subtypes : A pooled analysis from the breast cancer association consortium studies. In: Journal of the National Cancer Institute. 2011 ; Vol. 103, No. 3. pp. 250-263.
@article{36481a9694754a008aa7ef463c2eb0c2,
title = "Associations of breast cancer risk factors with tumor subtypes: A pooled analysis from the breast cancer association consortium studies",
abstract = "Background Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors. Methods We pooled tumor marker and epidemiological risk factor data from 35568 invasive breast cancer case patients from 34 studies participating in the Breast Cancer Association Consortium. Logistic regression models were used in case-case analyses to estimate associations between epidemiological risk factors and tumor subtypes, and case-control analyses to estimate associations between epidemiological risk factors and the risk of developing specific tumor subtypes in 12 population-based studies. All statistical tests were two-sided. Results In case-case analyses, of the epidemiological risk factors examined, early age at menarche (≤12 years) was less frequent in case patients with PR- than PR+ tumors (P =. 001). Nulliparity (P = 3 × 10 -6) and increasing age at first birth (P = 2 × 10-9) were less frequent in ER- than in ER+ tumors. Obesity (body mass index [BMI] ≥ 30 kg/m2) in younger women (≤50 years) was more frequent in ER-/PR- than in ER +/PR+ tumors (P = 1 × 10-7), whereas obesity in older women (>50 years) was less frequent in PR- than in PR+ tumors (P = 6 × 10-4). The triple-negative (ER-/PR-/HER2-) or core basal phenotype (CBP; triple-negative and cytokeratins [CK]5/6+ and/or epidermal growth factor receptor [EGFR]+) accounted for much of the heterogeneity in parity-related variables and BMI in younger women. Case-control analyses showed that nulliparity, increasing age at first birth, and obesity in younger women showed the expected associations with the risk of ER+ or PR + tumors but not triple-negative (nulliparity vs parity, odds ratio [OR] = 0.94, 95{\%} confidence interval [CI] = 0.75 to 1.19, P =. 61; 5-year increase in age at first full-term birth, OR = 0.95, 95{\%} CI = 0.86 to 1.05, P =. 34; obesity in younger women, OR = 1.36, 95{\%} CI = 0.95 to 1.94, P =. 09) or CBP tumors. Conclusion sThis study shows that reproductive factors and BMI are most clearly associated with hormone receptor-positive tumors and suggest that triple-negative or CBP tumors may have distinct etiology.",
author = "Yang, {Xiaohong R.} and Jenny Chang-Claude and Goode, {Ellen L.} and Couch, {Fergus J.} and Heli Nevanlinna and Milne, {Roger L.} and Mia Gaudet and Schmidt, {Marjanka K.} and Annegien Broeks and Angela Cox and Fasching, {Peter A.} and Rebecca Hein and Spurdle, {Amanda B.} and Fiona Blows and Kristy Driver and Dieter Flesch-Janys and Judith Heinz and Peter Sinn and Alina Vrieling and Tuomas Heikkinen and Kristiina Aittom{\"a}ki and P{\"a}ivi Heikkil{\"a} and Carl Blomqvist and Jolanta Lissowska and Beata Peplonska and Stephen Chanock and Jonine Figueroa and Louise Brinton and Per Hall and Kamila Czene and Keith Humphreys and Hatef Darabi and Jianjun Liu and {Van 'T Veer}, {Laura J.} and {Van Leeuwen}, {Flora E.} and Andrulis, {Irene L.} and Gord Glendon and Knight, {Julia A.} and Mulligan, {Anna Marie} and O'Malley, {Frances P.} and Nayana Weerasooriya and John, {Esther M.} and Beckmann, {Matthias W.} and Arndt Hartmann and Weihbrecht, {Sebastian B.} and Wachter, {David L.} and Jud, {Sebastian M.} and Loehberg, {Christian R.} and Laura Baglietto and English, {Dallas R.} and Giles, {Graham G.} and McLean, {Catriona A.} and Gianluca Severi and Diether Lambrechts and Thijs Vandorpe and Caroline Weltens and Robert Paridaens and Ann Smeets and Patrick Neven and Hans Wildiers and Xianshu Wang and Olson, {Janet E.} and Victoria Cafourek and Zachary Fredericksen and Matthew Kosel and Celine Vachon and Cramp, {Helen E.} and Daniel Connley and Cross, {Simon S.} and Balasubramanian, {Sabapathy P.} and Reed, {Malcolm W R} and Thilo D{\"o}rk and Michael Bremer and Andreas Meyer and Karstens, {Johann H.} and Aysun Ay and Park-Simon, {Tjoung Won} and Peter Hillemanns and {Arias P{\'e}rez}, {Jose Ignacio} and Rodr{\'i}guez, {Primitiva Men{\'e}ndez} and Pilar Zamora and Javier Ben{\'i}tez and Ko, {Yon Dschun} and Fischer, {Hans Peter} and Ute Hamann and Beate Pesch and Thomas Br{\"u}ning and Christina Justenhoven and Hiltrud Brauch and Eccles, {Diana M.} and Tapper, {William J.} and Gerty, {Sue M.} and Sawyer, {Elinor J.} and Tomlinson, {Ian P.} and Angela Jones and Michael Kerin and Nicola Miller and Niall McInerney and Hoda Anton-Culver and Argyrios Ziogas and Shen, {Chen Yang} and Hsiung, {Chia Ni} and Wu, {Pei Ei} and Yang, {Show Lin} and Yu, {Jyh Cherng} and Chen, {Shou Tung} and Hsu, {Giu Cheng} and Haiman, {Christopher A.} and Henderson, {Brian E.} and {Le Marchand}, Loic and Kolonel, {Laurence N.} and Annika Lindblom and Sara Margolin and Anna Jakubowska and Jan Lubiński and Tomasz Huzarski and Tomasz Byrski and Bohdan G{\'o}rski and Jacek Gronwald and Hooning, {Maartje J.} and Antoinette Hollestelle and {Van Den Ouweland}, {Ans M W} and Agnes Jager and Mieke Kriege and Tilanus-Linthorst, {Madeleine M A} and Margriet Coll{\'e}e and Shan Wang-Gohrke and Katri Pylk{\"a}s and Arja Jukkola-Vuorinen and Kari Mononen and Mervi Grip and Pasi Hirvikoski and Robert Winqvist and Arto Mannermaa and Kosma, {Veli Matti} and Jaana Kauppinen and Vesa Kataja and P{\"a}ivi Auvinen and Ylermi Soini and Reijo Sironen and Bojesen, {Stig E.} and {Dynnes {\O}rsted}, David and Diljit Kaur-Knudsen and Henrik Flyger and Nordestgaard, {B{\o}rge G.} and Helene Holland and Georgia Chenevix-Trench and Siranoush Manoukian and Monica Barile and Paolo Radice and Hankinson, {Susan E.} and Hunter, {David J.} and Rulla Tamimi and Suleeporn Sangrajrang and Paul Brennan and James McKay and Fabrice Odefrey and Valerie Gaborieau and Peter Devilee and Huijts, {P. E A} and Raem Tollenaar and C. Seynaeve and Dite, {Gillian S.} and Carmel Apicella and Hopper, {John L.} and Fleur Hammet and Helen Tsimiklis and Smith, {Letitia D.} and Southey, {Melissa C.} and Humphreys, {Manjeet K.} and Douglas Easton and Paul Pharoah and Sherman, {Mark E.} and Montserrat Garcia-Closas",
year = "2011",
month = "2",
day = "2",
doi = "10.1093/jnci/djq526",
language = "English (US)",
volume = "103",
pages = "250--263",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
number = "3",

}

TY - JOUR

T1 - Associations of breast cancer risk factors with tumor subtypes

T2 - A pooled analysis from the breast cancer association consortium studies

AU - Yang, Xiaohong R.

AU - Chang-Claude, Jenny

AU - Goode, Ellen L.

AU - Couch, Fergus J.

AU - Nevanlinna, Heli

AU - Milne, Roger L.

AU - Gaudet, Mia

AU - Schmidt, Marjanka K.

AU - Broeks, Annegien

AU - Cox, Angela

AU - Fasching, Peter A.

AU - Hein, Rebecca

AU - Spurdle, Amanda B.

AU - Blows, Fiona

AU - Driver, Kristy

AU - Flesch-Janys, Dieter

AU - Heinz, Judith

AU - Sinn, Peter

AU - Vrieling, Alina

AU - Heikkinen, Tuomas

AU - Aittomäki, Kristiina

AU - Heikkilä, Päivi

AU - Blomqvist, Carl

AU - Lissowska, Jolanta

AU - Peplonska, Beata

AU - Chanock, Stephen

AU - Figueroa, Jonine

AU - Brinton, Louise

AU - Hall, Per

AU - Czene, Kamila

AU - Humphreys, Keith

AU - Darabi, Hatef

AU - Liu, Jianjun

AU - Van 'T Veer, Laura J.

AU - Van Leeuwen, Flora E.

AU - Andrulis, Irene L.

AU - Glendon, Gord

AU - Knight, Julia A.

AU - Mulligan, Anna Marie

AU - O'Malley, Frances P.

AU - Weerasooriya, Nayana

AU - John, Esther M.

AU - Beckmann, Matthias W.

AU - Hartmann, Arndt

AU - Weihbrecht, Sebastian B.

AU - Wachter, David L.

AU - Jud, Sebastian M.

AU - Loehberg, Christian R.

AU - Baglietto, Laura

AU - English, Dallas R.

AU - Giles, Graham G.

AU - McLean, Catriona A.

AU - Severi, Gianluca

AU - Lambrechts, Diether

AU - Vandorpe, Thijs

AU - Weltens, Caroline

AU - Paridaens, Robert

AU - Smeets, Ann

AU - Neven, Patrick

AU - Wildiers, Hans

AU - Wang, Xianshu

AU - Olson, Janet E.

AU - Cafourek, Victoria

AU - Fredericksen, Zachary

AU - Kosel, Matthew

AU - Vachon, Celine

AU - Cramp, Helen E.

AU - Connley, Daniel

AU - Cross, Simon S.

AU - Balasubramanian, Sabapathy P.

AU - Reed, Malcolm W R

AU - Dörk, Thilo

AU - Bremer, Michael

AU - Meyer, Andreas

AU - Karstens, Johann H.

AU - Ay, Aysun

AU - Park-Simon, Tjoung Won

AU - Hillemanns, Peter

AU - Arias Pérez, Jose Ignacio

AU - Rodríguez, Primitiva Menéndez

AU - Zamora, Pilar

AU - Benítez, Javier

AU - Ko, Yon Dschun

AU - Fischer, Hans Peter

AU - Hamann, Ute

AU - Pesch, Beate

AU - Brüning, Thomas

AU - Justenhoven, Christina

AU - Brauch, Hiltrud

AU - Eccles, Diana M.

AU - Tapper, William J.

AU - Gerty, Sue M.

AU - Sawyer, Elinor J.

AU - Tomlinson, Ian P.

AU - Jones, Angela

AU - Kerin, Michael

AU - Miller, Nicola

AU - McInerney, Niall

AU - Anton-Culver, Hoda

AU - Ziogas, Argyrios

AU - Shen, Chen Yang

AU - Hsiung, Chia Ni

AU - Wu, Pei Ei

AU - Yang, Show Lin

AU - Yu, Jyh Cherng

AU - Chen, Shou Tung

AU - Hsu, Giu Cheng

AU - Haiman, Christopher A.

AU - Henderson, Brian E.

AU - Le Marchand, Loic

AU - Kolonel, Laurence N.

AU - Lindblom, Annika

AU - Margolin, Sara

AU - Jakubowska, Anna

AU - Lubiński, Jan

AU - Huzarski, Tomasz

AU - Byrski, Tomasz

AU - Górski, Bohdan

AU - Gronwald, Jacek

AU - Hooning, Maartje J.

AU - Hollestelle, Antoinette

AU - Van Den Ouweland, Ans M W

AU - Jager, Agnes

AU - Kriege, Mieke

AU - Tilanus-Linthorst, Madeleine M A

AU - Collée, Margriet

AU - Wang-Gohrke, Shan

AU - Pylkäs, Katri

AU - Jukkola-Vuorinen, Arja

AU - Mononen, Kari

AU - Grip, Mervi

AU - Hirvikoski, Pasi

AU - Winqvist, Robert

AU - Mannermaa, Arto

AU - Kosma, Veli Matti

AU - Kauppinen, Jaana

AU - Kataja, Vesa

AU - Auvinen, Päivi

AU - Soini, Ylermi

AU - Sironen, Reijo

AU - Bojesen, Stig E.

AU - Dynnes Ørsted, David

AU - Kaur-Knudsen, Diljit

AU - Flyger, Henrik

AU - Nordestgaard, Børge G.

AU - Holland, Helene

AU - Chenevix-Trench, Georgia

AU - Manoukian, Siranoush

AU - Barile, Monica

AU - Radice, Paolo

AU - Hankinson, Susan E.

AU - Hunter, David J.

AU - Tamimi, Rulla

AU - Sangrajrang, Suleeporn

AU - Brennan, Paul

AU - McKay, James

AU - Odefrey, Fabrice

AU - Gaborieau, Valerie

AU - Devilee, Peter

AU - Huijts, P. E A

AU - Tollenaar, Raem

AU - Seynaeve, C.

AU - Dite, Gillian S.

AU - Apicella, Carmel

AU - Hopper, John L.

AU - Hammet, Fleur

AU - Tsimiklis, Helen

AU - Smith, Letitia D.

AU - Southey, Melissa C.

AU - Humphreys, Manjeet K.

AU - Easton, Douglas

AU - Pharoah, Paul

AU - Sherman, Mark E.

AU - Garcia-Closas, Montserrat

PY - 2011/2/2

Y1 - 2011/2/2

N2 - Background Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors. Methods We pooled tumor marker and epidemiological risk factor data from 35568 invasive breast cancer case patients from 34 studies participating in the Breast Cancer Association Consortium. Logistic regression models were used in case-case analyses to estimate associations between epidemiological risk factors and tumor subtypes, and case-control analyses to estimate associations between epidemiological risk factors and the risk of developing specific tumor subtypes in 12 population-based studies. All statistical tests were two-sided. Results In case-case analyses, of the epidemiological risk factors examined, early age at menarche (≤12 years) was less frequent in case patients with PR- than PR+ tumors (P =. 001). Nulliparity (P = 3 × 10 -6) and increasing age at first birth (P = 2 × 10-9) were less frequent in ER- than in ER+ tumors. Obesity (body mass index [BMI] ≥ 30 kg/m2) in younger women (≤50 years) was more frequent in ER-/PR- than in ER +/PR+ tumors (P = 1 × 10-7), whereas obesity in older women (>50 years) was less frequent in PR- than in PR+ tumors (P = 6 × 10-4). The triple-negative (ER-/PR-/HER2-) or core basal phenotype (CBP; triple-negative and cytokeratins [CK]5/6+ and/or epidermal growth factor receptor [EGFR]+) accounted for much of the heterogeneity in parity-related variables and BMI in younger women. Case-control analyses showed that nulliparity, increasing age at first birth, and obesity in younger women showed the expected associations with the risk of ER+ or PR + tumors but not triple-negative (nulliparity vs parity, odds ratio [OR] = 0.94, 95% confidence interval [CI] = 0.75 to 1.19, P =. 61; 5-year increase in age at first full-term birth, OR = 0.95, 95% CI = 0.86 to 1.05, P =. 34; obesity in younger women, OR = 1.36, 95% CI = 0.95 to 1.94, P =. 09) or CBP tumors. Conclusion sThis study shows that reproductive factors and BMI are most clearly associated with hormone receptor-positive tumors and suggest that triple-negative or CBP tumors may have distinct etiology.

AB - Background Previous studies have suggested that breast cancer risk factors are associated with estrogen receptor (ER) and progesterone receptor (PR) expression status of the tumors. Methods We pooled tumor marker and epidemiological risk factor data from 35568 invasive breast cancer case patients from 34 studies participating in the Breast Cancer Association Consortium. Logistic regression models were used in case-case analyses to estimate associations between epidemiological risk factors and tumor subtypes, and case-control analyses to estimate associations between epidemiological risk factors and the risk of developing specific tumor subtypes in 12 population-based studies. All statistical tests were two-sided. Results In case-case analyses, of the epidemiological risk factors examined, early age at menarche (≤12 years) was less frequent in case patients with PR- than PR+ tumors (P =. 001). Nulliparity (P = 3 × 10 -6) and increasing age at first birth (P = 2 × 10-9) were less frequent in ER- than in ER+ tumors. Obesity (body mass index [BMI] ≥ 30 kg/m2) in younger women (≤50 years) was more frequent in ER-/PR- than in ER +/PR+ tumors (P = 1 × 10-7), whereas obesity in older women (>50 years) was less frequent in PR- than in PR+ tumors (P = 6 × 10-4). The triple-negative (ER-/PR-/HER2-) or core basal phenotype (CBP; triple-negative and cytokeratins [CK]5/6+ and/or epidermal growth factor receptor [EGFR]+) accounted for much of the heterogeneity in parity-related variables and BMI in younger women. Case-control analyses showed that nulliparity, increasing age at first birth, and obesity in younger women showed the expected associations with the risk of ER+ or PR + tumors but not triple-negative (nulliparity vs parity, odds ratio [OR] = 0.94, 95% confidence interval [CI] = 0.75 to 1.19, P =. 61; 5-year increase in age at first full-term birth, OR = 0.95, 95% CI = 0.86 to 1.05, P =. 34; obesity in younger women, OR = 1.36, 95% CI = 0.95 to 1.94, P =. 09) or CBP tumors. Conclusion sThis study shows that reproductive factors and BMI are most clearly associated with hormone receptor-positive tumors and suggest that triple-negative or CBP tumors may have distinct etiology.

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U2 - 10.1093/jnci/djq526

DO - 10.1093/jnci/djq526

M3 - Article

VL - 103

SP - 250

EP - 263

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 3

ER -