A Pooled Case-only Analysis of Reproductive Risk Factors and Breast Cancer Subtype Among Black Women in the Southeastern United States.
A Pooled Case-only Analysis of Reproductive Risk Factors and Breast Cancer Subtype Among Black Women in the Southeastern United States.
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DOI：
10.1158/1055-9965.epi-20-1784
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发表时间：
2021-07
期刊：
影响因子：
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通讯作者：
Lipworth L
中科院分区：
文献类型：
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作者：
Sanderson M;Pal T;Beeghly-Fadiel A;Fadden MK;Dujon SA;Clinton C;Jimenez C;Davis J;Fortune M;Thompson J;Benson K;Conley N;Reid S;Tezak A;Shu XO;Zheng W;Blot WJ;Lipworth L
我们调查了黑人妇女生殖危险因素与乳腺癌亚型之间的关系。基于先前的文献，我们假设特定乳腺癌亚型的相对患病率可能因生殖因素而异。我们对来自美国东南部四项研究的2,188名（591名绝经前，1,597名绝经后）初步诊断为乳腺癌的黑人妇女进行了汇总分析。乳腺癌按临床亚型分类。仅病例多分类logistic回归模型用于估计生殖风险因素的HER 2+和TNBC状态与ER+/HER 2 −状态（参照）的比值比（OR）和95%置信区间（CI）。相对于ER+/HER 2 −肿瘤的女性，首次生育时年龄为19-24岁的女性（OR 1.78，95% CI 1.22-2.59）更有可能患有TNBC。相对于ER+/HER 2 −乳腺癌，经产妇女不太可能被诊断为HER 2+乳腺癌，更可能被诊断为TNBC。母乳喂养的绝经后经产妇女患TNBC的可能性较低[OR 0.65（95% CI 0.43-0.99）]。这项针对黑人乳腺癌女性的大型汇总研究揭示了乳腺癌亚型之间的病因异质性。不进行母乳喂养的黑人经产妇女更有可能被诊断为TNBC，其预后比ER+/HER 2 −乳腺癌更差。
We investigated the association between reproductive risk factors and breast cancer subtype in Black women. Based on the previous literature, we hypothesized that the relative prevalence of specific breast cancer subtypes might differ according to reproductive factors. We conducted a pooled analysis of 2,188 (591 premenopausal, 1,597 postmenopausal) Black women with a primary diagnosis of breast cancer from four studies in the southeastern US. Breast cancers were classified by clinical subtype. Case-only polytomous logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for HER2+ and TNBC status in relation to ER+/HER2− status (referent) for reproductive risk factors. Relative to women who had ER+/HER2− tumors, women who were age 19–24 years at first birth (OR 1.78, 95% CI 1.22–2.59) were more likely to have TNBC. Parous women were less likely to be diagnosed with HER2+ breast cancer and more likely to be diagnosed with TNBC relative to ER+/HER2− breast cancer. Postmenopausal parous women who breastfed were less likely to have TNBC [OR 0.65 (95% CI 0.43–0.99)]. This large pooled study of Black women with breast cancer revealed etiologic heterogeneity among breast cancer subtypes. Black parous women who do not breastfeed are more likely to be diagnosed with TNBC, which has a worse prognosis, than with ER+/HER2− breast cancer.