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

Rebecca Ritte 1 Kaja Tikk 1 Annekatrin Lukanova 1 Anne Tjønneland 2 Anja Olsen 2 Kim Overvad 3 Laure Dossus 4 Agnès Fournier 4 Françoise Clavel-Chapelon 4 Verena Grote 1 Heiner Boeing 5 Krasimira Aleksandrova 5 Antonia Trichopoulou 6, 7 Pagona Lagiou 6, 8, 9 Dimitrios Trichopoulos 8, 9 Domenico Palli 10 Franco Berrino 11 Amalia Mattiello 12 Rosario Tumino 13 Carlotta Sacerdote 14, 15 José Quirós 16 Genevieve Buckland 17 Esther Molina-Montes 18, 19 María-Dolores Chirlaque 19, 20 Eva Ardanaz 19, 21 Pilar Amiano 19, 22 Bas Bueno-De-Mesquita 23, 24, 25 Carla van Gils 26 Petra Peeters 26, 27 Nick Wareham 28 Kay-Tee Khaw 29 Timothy Key 30 Ruth Travis 30 Elisabete Weiderpass 31, 32, 33 Vanessa Dumeaux 31, 34 Eliv Lund 31 Malin Sund 35 Anne Andersson 36 Isabelle Romieu 37 Sabina Rinaldi 38 Paulo Vineis 15, 39 Melissa Merritt 39 Elio Riboli 39 Rudolf Kaaks 1, *
* Corresponding author
1 Division of Cancer Epidemiology
2 Cancer Epidemiology Institute
3 Section of Epidemiology
4 CESP - Centre de recherche en épidémiologie et santé des populations
5 Department of Epidemiology
6 Department of Hygiene, Epidemiology and Medical Statistics
7 Nutrition and Cancer
8 Department of Epidemiology
9 Bureau of Epidemiologic Research
10 Molecular and Nutritional Epidemiology Unit
11 Epidemiology and Prevention Unit
12 Department of Clinical and Experimental Medicine
13 Cancer Registry and Histopathology Unit
14 Center for Cancer Prevention
15 Unità di epidemiologia dei tumori
16 Public Health and Health Planning Directorate
17 Unit of Nutrition, Environment and Cancer
18 Andalusian School of Public Health [Granada]
19 Consortium for Biomedical Research in Epidemiology and Public Health
20 Department of Epidemiology
21 Sección de Epidemiología de Enfermedades No Transmisibles
22 Public Health division of Gipuzkoa
23 Department of Gastroenterology and Hepatology
24 Department of Gastroenterology and Hepatology
25 RIVM - National Institute for Public Health and the Environment [Bilthoven]
26 Julius Center for Health Sciences and Primary Care
27 Department of Epidemiology and Biostatistics
28 MRC epidemiology Unit
29 Clinical Gerontology
30 Cancer Epidemiology Unit
31 Department of Community Medicine
32 Department of Research
33 Department of Medical Epidemiology and Biostatistics
34 Department of Mining and Materials Engineering [Montréal]
35 Department of Surgery and Perioperative Sciences
36 Department of Oncology and Radiation Sciences
37 Nutritional Epidemiology Group
38 Biomarkers Group
39 Biomarkers Research
Abstract : INTRODUCTION: 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] ptrend < 0.001 for ER+PR+ tumors; >=35 vs. <=19 years HR: 0.93 [95%CI 0.53-1.65] ptrend = 0.96 for ER-PR- tumors; Phet = 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 (phet = 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.
Keywords : ER-receptor PR-receptor Reproductive factors Risk factors Menopause Parity Oral contraceptive Breast cancer
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Rebecca Ritte, Kaja Tikk, Annekatrin Lukanova, Anne Tjønneland, Anja Olsen, et al.. Reproductive factors and risk of hormone receptor positive and negative breast cancer: a cohort study.. BMC Cancer, BioMed Central, 2013, 13 (1), pp.584. ⟨10.1186/1471-2407-13-584⟩. ⟨inserm-00920375⟩

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