期刊
BREAST CANCER RESEARCH AND TREATMENT
卷 137, 期 1, 页码 237-246出版社
SPRINGER
DOI: 10.1007/s10549-012-2313-0
关键词
Breast cancer; Breast tumor subtypes; Etiologic heterogeneity; HER2; Hispanic; Parity
类别
资金
- National Cancer Institute [UO1CA153086]
- Susan G. Komen for the Cure(R) Post-baccalaureate Training in Disparities Research Grant [KG090934]
- Avon Foundation
- Arizona Cancer Center Core Grant from the National Cancer Institute [CA-023074-2953]
- Cancer Center SPORE in Breast Cancer [P50 CA116199-02S1]
- FIS Intrasalud [PS09/02368]
- Programa Grupos Emergentes EMER ISCIII, Instituto de Salud Carlos III, Servicio Galego Saude (SERGAS)
- Oncology and Genetics Unit
Breast cancer incidence rates have declined among older but not younger women; the latter are more likely to be diagnosed with breast cancers carrying a poor prognosis. Epidemiological evidence supports an increase in breast cancer incidence following pregnancy with risk elevated as much as 10 years post-partum. We investigated the association between years since last full-term pregnancy at the time of diagnosis (a parts per thousand currency sign10 or > 10 years) and breast tumor subtype in a case series of premenopausal Hispanic women (n = 627). Participants were recruited in the United States, Mexico, and Spain. Cases with known estrogen receptor (ER), progesterone receptor (PR), and HER2 status, with one or more full-term pregnancies a parts per thousand yen1 year prior to diagnosis were eligible for this analysis. Cases were classified into three tumor subtypes according to hormone receptor (HR+ = ER+ and/or PR+; HR- = ER- and PR-) expression and HER2 status: HR+/HER2-, HER2+ (regardless of HR), and triple negative breast cancer. Case-only odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated for HER2+ tumors in reference to HR+/HER2- tumors. Participants were pooled in a mixed-effects logistic regression model with years since pregnancy as a fixed effect and study site as a random effect. When compared to HR+/HER2- cases, women with HER2+ tumors were more likely be diagnosed in the post-partum period of a parts per thousand currency sign10 years (OR = 1.68; 95 % CI, 1.12-2.52). The effect was present across all source populations and independent of the HR status of the HER2+ tumor. Adjusting for age at diagnosis (a parts per thousand currency sign45 or > 45 years) did not materially alter our results (OR = 1.78; 95 % CI, 1.08-2.93). These findings support the novel hypothesis that factors associated with the post-partum breast, possibly hormonal, are involved in the development of HER2+ tumors.
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