1
|
Bhat SA, Kumar V, Dhanjal DS, Gandhi Y, Mishra SK, Singh S, Webster TJ, Ramamurthy PC. Biogenic nanoparticles: pioneering a new era in breast cancer therapeutics-a comprehensive review. DISCOVER NANO 2024; 19:121. [PMID: 39096427 PMCID: PMC11297894 DOI: 10.1186/s11671-024-04072-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 07/25/2024] [Indexed: 08/05/2024]
Abstract
Breast cancer, a widespread malignancy affecting women globally, often arises from mutations in estrogen/progesterone receptors. Conventional treatments like surgery, radiotherapy, and chemotherapy face limitations such as low efficacy and adverse effects. However, nanotechnology offers promise with its unique attributes like targeted delivery and controlled drug release. Yet, challenges like poor size distribution and environmental concerns exist. Biogenic nanotechnology, using natural materials or living cells, is gaining traction for its safety and efficacy in cancer treatment. Biogenic nanoparticles synthesized from plant extracts offer a sustainable and eco-friendly approach, demonstrating significant toxicity against breast cancer cells while sparing healthy ones. They surpass traditional drugs, providing benefits like biocompatibility and targeted delivery. Thus, this current review summarizes the available knowledge on breast cancer (its types, stages, histopathology, symptoms, etiology and epidemiology) with the importance of using biogenic nanomaterials as a new and improved therapy. The novelty of this work lies in its comprehensive examination of the challenges and strategies for advancing the industrial utilization of biogenic metal and metal oxide NPs. Additionally; it underscores the potential of plant-mediated synthesis of biogenic NPs as effective therapies for breast cancer, detailing their mechanisms of action, advantages, and areas for further research.
Collapse
Affiliation(s)
- Shahnawaz Ahmad Bhat
- Jamia Milia Islamia, New Delhi, 110011, India
- Central Ayurveda Research Institute, Jhansi, U.P., 284003, India
| | - Vijay Kumar
- Central Ayurveda Research Institute, Jhansi, U.P., 284003, India.
| | | | - Yashika Gandhi
- Central Ayurveda Research Institute, Jhansi, U.P., 284003, India
| | - Sujeet K Mishra
- Central Ayurveda Research Institute, Jhansi, U.P., 284003, India
| | | | - Thomas J Webster
- School of Health Sciences and Biomedical Engineering, Hebei University of Technology, Tianjin, China
- Program in Materials Science, UFPI, Teresina, Brazil
| | | |
Collapse
|
2
|
Flaherty RL, Sflomos G, Brisken C. Is There a Special Role for Ovarian Hormones in the Pathogenesis of Lobular Carcinoma? Endocrinology 2024; 165:bqae031. [PMID: 38551031 PMCID: PMC10988861 DOI: 10.1210/endocr/bqae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Indexed: 04/04/2024]
Abstract
Lobular carcinoma represent the most common special histological subtype of breast cancer, with the majority classed as hormone receptor positive. Rates of invasive lobular carcinoma in postmenopausal women have been seen to increase globally, while other hormone receptor-positive breast cancers proportionally have not followed the same trend. This has been linked to exposure to exogenous ovarian hormones such as hormone replacement therapy. Reproductive factors resulting in increased lifetime exposure to endogenous ovarian hormones have also been linked to an increased risk of lobular breast cancer, and taken together, these data make a case for the role of ovarian hormones in the genesis and progression of the disease. In this review, we summarize current understanding of the epidemiological associations between ovarian hormones and lobular breast cancer and highlight mechanistic links that may underpin the etiology and biology.
Collapse
Affiliation(s)
- Renée L Flaherty
- Division of Breast Cancer Research, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
| | - George Sflomos
- Swiss Institute for Experimental Cancer Research, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Cathrin Brisken
- Division of Breast Cancer Research, The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
- Swiss Institute for Experimental Cancer Research, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| |
Collapse
|
3
|
Yaghjyan L, Heng YJ, Baker GM, Bret-Mounet VC, Murthy D, Mahoney MB, Rosner B, Tamimi RM. Associations of reproductive breast cancer risk factors with expression of stem cell markers in benign breast tissue. Front Oncol 2024; 14:1354094. [PMID: 38577336 PMCID: PMC10991780 DOI: 10.3389/fonc.2024.1354094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/20/2024] [Indexed: 04/06/2024] Open
Abstract
Background We investigated the associations of reproductive factors known to influence breast cancer risk with the expression of breast stem cell markers CD44, CD24, and ALDH1A1 in benign breast biopsy samples. Methods We included 439 cancer-free women with biopsy-confirmed benign breast disease within the Nurses' Health Study (NHS) and NHSII. The data on reproductive and other breast cancer risk factors were obtained from biennial questionnaires. Immunohistochemistry (IHC) was performed on tissue microarrays. For each core, the IHC expression was assessed using a semi-automated platform and expressed as % of cells that stained positive for a specific marker out of the total cell count. Generalized linear regression was used to examine the associations of reproductive factors with a log-transformed expression of each marker (in epithelium and stroma), adjusted for other breast cancer risk factors. Results In multivariate analysis, the time between menarche and age at first birth was inversely associated with CD44 in epithelium (β per 5 years = -0.38, 95% CI -0.69; -0.06). Age at first birth and the time between menarche and age at first birth were inversely associated with ALDH1A1 (stroma: β per 5 years = -0.43, 95% CI -0.76; -0.10 and β = -0.47, 95% CI -0.79; -0.15, respectively; epithelium: β = -0.15, 95% CI -0.30; -0.01 and β = -0.17, 95% CI -0.30; -0.03, respectively). Time since last pregnancy was inversely associated with stromal ALDH1A1 (β per 5 years = -0.55, 95% CI -0.98; -0.11). No associations were found for CD24. The observed associations were similar in premenopausal women. In postmenopausal women, lifetime duration of breastfeeding was inversely associated with stromal ALDH1A1 expression (β for ≥24 vs. 0 to <1 months = -2.24, 95% CI 3.96; -0.51, p-trend = 0.01). Conclusion Early-life reproductive factors may influence CD44 and ALDH1A1 expression in benign breast tissue.
Collapse
Affiliation(s)
- Lusine Yaghjyan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States
| | - Yujing J. Heng
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Gabrielle M. Baker
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Vanessa C. Bret-Mounet
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Divya Murthy
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Matt B. Mahoney
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Rulla M. Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| |
Collapse
|
4
|
Paik PS, Choi JE, Lee SW, Lee YJ, Kang YJ, Lee HJ, Bae SY. Clinical characteristics and prognosis of postpartum breast cancer. Breast Cancer Res Treat 2023; 202:275-286. [PMID: 37542632 DOI: 10.1007/s10549-023-07069-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/20/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE Postpartum breast cancer (PPBC) is a not well-established subset of breast cancer, and only few studies address its poorer prognosis. However, previous studies show that PPBC is associated with worse outcome with higher rates of metastasis than in young women's breast cancer (YWBC). We aimed to analyze the clinical characteristics and prognosis of PPBC based on the diagnosis period of PPBC. METHODS We retrospectively reviewed 208,780 patients with breast cancer from the Korean Breast Cancer Society registry (KBCSR) database between January 2000 and December 2014. We included premenopausal women aged 20-50 years who underwent breast cancer surgery. The patients were classified by 5-year intervals according to the diagnosis period of breast cancer, from the first birth to the breast cancer diagnosis. RESULTS Compared with patients in the other groups, patients diagnosed within postpartum 5 years (PPBC < 5 years) group were younger, had a more advanced stage, had lower estrogen receptor (ER) and progesterone receptor (PR) expression, and had a higher human epidermal growth factor receptor 2 (HER2) positive rate. Further, PPBC < 5 years group had a worse survival rate than the nulliparous and other groups (5-year cumulative survival: PPBC < 5 years group, 89%; nulliparous group, 97.3%; 5 ≤ PPBC < 10 years group, 93%). In the multivariate analysis, the PPBC < 5 years group was associated with a worse survival rate (hazard ratio 1.55, 95% confidence interval [CI] 1.148-2.094, p 0.004) after adjustment for age at diagnosis, breast cancer stage, ER and HER2 status, Ki-67 level, and chemotherapy. CONCLUSION Our findings indicated that patients diagnosed with breast cancer within the first 5 years after delivery had aggressive characteristics and a poor survival rate. It is important to elucidate the pathophysiology of PPBC and establish novel therapeutic strategies to improve the survival rate.
Collapse
Affiliation(s)
- Pill Sun Paik
- Department of Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Eun Choi
- Department of Surgery, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Seok Won Lee
- Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, School of Medicine, Pusan National University, Pusan, Republic of Korea
| | - Young Joo Lee
- Department of Surgery,incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Joon Kang
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyouk Jin Lee
- Breast & Thyroid Clinic, Saegyaero Hospital, Busan, Republic of Korea
| | - Soo Youn Bae
- Department of Surgery,incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
5
|
Nimbalkar VP, Rajarajan S, V P S, Alexander A, Kaluve R, Selvam S, Ramesh R, B S S, Prabhu JS. A comparative analysis of clinicopathological features and survival between pre and postmenopausal breast cancer from an Indian cohort. Sci Rep 2023; 13:3938. [PMID: 36894588 PMCID: PMC9998443 DOI: 10.1038/s41598-023-30912-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Breast cancer (BC) among premenopausal women is an aggressive disease associated with poor outcome despite intensive treatment. Higher burden is observed in southeast Asian countries attributed to younger population structure. We compared the reproductive and clinicopathological characteristics, distribution of subtypes and survival between pre and postmenopausal women from a retrospective cohort of BC patients with median follow up over 6 years to examine the differences. In our cohort of 446 BC patients, 162/446 (36.3%) were premenopausal. Parity and age at last childbirth were significantly different between pre and postmenopausal women. Premenopausal BC had a higher proportion of HER2 amplified and triple negative breast cancer (TNBC) tumors (p = 0.012). Stratified analysis by molecular subtypes showed TNBC had significantly better disease free (DFS) and overall survival (OS) among premenopausal group (mean survival, pre vs. post, DFS = 79.2 vs. 54.0 months, OS = 72.5 vs. 49.5 months, p = 0.002 for both). Analysis on external datasets (SCAN-B, METABRIC) confirmed this finding for overall survival. Our data confirmed the previously observed association of clinical and pathological features between pre and postmenopausal BC. Exploration of better survival among premenopausal TNBC tumors is warranted in larger cohorts with long term follow up.
Collapse
Affiliation(s)
- Vidya P Nimbalkar
- Division of Molecular Medicine, St. John's Research Institute, St. John's Medical College, Bangalore, Karnataka, India
| | - Savitha Rajarajan
- Division of Molecular Medicine, St. John's Research Institute, St. John's Medical College, Bangalore, Karnataka, India.,Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Snijesh V P
- Division of Molecular Medicine, St. John's Research Institute, St. John's Medical College, Bangalore, Karnataka, India.,Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Annie Alexander
- Division of Molecular Medicine, St. John's Research Institute, St. John's Medical College, Bangalore, Karnataka, India
| | - Rohini Kaluve
- Division of Molecular Medicine, St. John's Research Institute, St. John's Medical College, Bangalore, Karnataka, India
| | - Sumithra Selvam
- Division of Epidemiology, Biostatistics and Population Health, St. John's Research Institute, St John's Medical College, Bangalore, Karnataka, India
| | - Rakesh Ramesh
- Department of Surgical Oncology, St. John's Medical College and Hospital, Bangalore, Karnataka, India
| | - Srinath B S
- Department of Surgery, Sri Shankara Cancer Hospital and Research Centre, Bangalore, Karnataka, India
| | - Jyothi S Prabhu
- Division of Molecular Medicine, St. John's Research Institute, St. John's Medical College, Bangalore, Karnataka, India.
| |
Collapse
|
6
|
Do Aging and Parity Affect VEGF-A/VEGFR Content and Signaling in the Ovary?-A Mouse Model Study. Int J Mol Sci 2023; 24:ijms24043318. [PMID: 36834730 PMCID: PMC9966908 DOI: 10.3390/ijms24043318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/26/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
In this study, the effects of aging and parity on VEGF-A/VEGFR protein content and signaling in the mice ovaries were determined. The research group consisted of nulliparous (virgins, V) and multiparous (M) mice during late-reproductive (L, 9-12 months) and post-reproductive (P, 15-18 months) stages. Whilst ovarian VEGFR1 and VEGFR2 remained unchanged in all the experimental groups (LM, LV, PM, PV), protein content of VEGF-A and phosphorylated VEGFR2 significantly decreased only in PM ovaries. VEGF-A/VEGFR2-dependent activation of ERK1/2, p38, as well as protein content of cyclin D1, cyclin E1, and Cdc25A were then assessed. In ovaries of LV and LM, all of these downstream effectors were maintained at a comparable low/undetectable level. Conversely, the decrease recorded in PM ovaries did not occur in the PV group, in which the significant increase of kinases and cyclins, as well phosphorylation levels mirrored the trend of the pro-angiogenic markers. Altogether, the present results demonstrated that, in mice, ovarian VEGF-A/VEGFR2 protein content and downstream signaling can be modulated in an age- and parity-dependent manner. Moreover, the lowest levels of pro-angiogenic and cell cycle progression markers detected in PM mouse ovaries sustains the hypothesis that parity could exert a protective role by downregulating the protein content of key mediators of pathological angiogenesis.
Collapse
|
7
|
Shen CT, Hsieh HM, Chuang YS, Pan CH, Wu MT. Breast Cancer Incidence among Female Workers by Different Occupations and Industries: A Longitudinal Population-Based Matched Case-Control Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10352. [PMID: 36011986 PMCID: PMC9408650 DOI: 10.3390/ijerph191610352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Breast cancer is the leading cause of cancer incidence worldwide and in Taiwan. The relationship between breast cancer and occupational types remains unclear. This study aimed to investigate lifetime breast cancer incidence by different occupational industries among female workers in Taiwan. METHODS A population-based retrospective case-control study was conducted using three nationwide population-based databases. Matched case and control groups were identified with 1-to-4 exact matching among 103,047 female workers with breast cancer diagnosed in 2008-2017 and those without breast cancer. Their lifetime labor enrollment records were tracked using the National Labor Insurance Database, 1950-2017. Conditional logistic regression was used to analyze the association between types of occupational industries and risk of incident breast cancer. RESULTS Our study found slightly significant breast cancer risk among the following major occupational classifications: manufacturing (OR: 1.027, 95% CI: 1.011-1.043); wholesale and retail trade (OR: 1.068, 95% CI: 1.052-1.084); information and communication (OR: 1.074, 95% CI: 1.043-1.105); financial and insurance activities (OR: 1.109, 95% CI: 1.086-1.133); real estate activities (OR: 1.050, 95% CI: 1.016-1.085); professional, scientific, and technical activities (OR: 1.118, 95% CI: 1.091-1.145); public administration, defense, and social security (OR: 1.054, 95% CI: 1.023-1.087), education (OR: 1.199, 95% CI: 1.168-1.230); and human health and social work activities (OR: 1.125, 95% CI: 1.096-1.156). CONCLUSIONS Greater percentages of industrial occupations (i.e., manufacturing, wholesale and retail, or health professionals) were associated with slightly increased breast cancer risk. Further studies should investigate the possible risk factors among female workers in those industries with slightly higher incidence of breast cancer.
Collapse
Affiliation(s)
- Cheng-Ting Shen
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
| | - Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
- Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
| | - Yun-Shiuan Chuang
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
| | - Chih-Hong Pan
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, Taipei 40767, Taiwan
| | - Ming-Tsang Wu
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
- Department of Public Health and PhD Program in Environmental and Occupational Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
| |
Collapse
|
8
|
Levels of Vitamin D and Expression of the Vitamin D Receptor in Relation to Breast Cancer Risk and Survival. Nutrients 2022; 14:nu14163353. [PMID: 36014861 PMCID: PMC9414444 DOI: 10.3390/nu14163353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/21/2022] Open
Abstract
Previous research suggests associations between low systemic levels of vitamin D and poor breast cancer prognosis and between expression of the vitamin D receptor (VDR) in breast cancers and survival. This study aimed to study associations between pre-diagnostic systemic levels of vitamin D and expression of VDR in subsequent breast tumors, and interactions between vitamin D and VDR on breast cancer mortality. Systemic vitamin D levels were measured in women within the Malmö Diet and Cancer Study. The expression of VDR was evaluated immunohistochemically in a tissue microarray of subsequent breast cancers. Statistical analyses followed. Women with high levels of vitamin D had a smaller proportion of VDR negative breast tumors compared to women with low levels of vitamin D (odds ratio: 0.68; 95% confidence interval: 0.41–1.13). Vitamin D levels were not found to modify the association between low VDR expression and high breast cancer mortality. To conclude, there was no statistical evidence for an association between pre-diagnostic levels of vitamin D and the expression of VDRs in breast cancer, nor did vitamin D levels influence the association between VDR expression and breast cancer mortality. Further studies are needed in order to establish the effects of vitamin D on breast cancer.
Collapse
|
9
|
Shen CT, Hsieh HM, Pan CH, Wu MT, Chuang YS. Breast Cancer Risk Among Female Health Professionals: A 35-Year Population-Based Longitudinal Cohort Study in Taiwan. Am J Prev Med 2021; 61:831-840. [PMID: 34384653 DOI: 10.1016/j.amepre.2021.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Breast cancer is the most frequently diagnosed cancer among women worldwide. Previous studies have found a higher risk in nurses but no clear relationship among other health professionals. This study aims to investigate the risks of incident breast cancer among female health professionals compared with that among nonhealth professionals in Taiwan. METHODS This longitudinal observational cohort study included >35 years (1979-2016) of data from 4 nationwide population-based databases in Taiwan and identified matched cohorts with 1-to-2 propensity score matching between 277,543 health professionals and 555,086 nonhealth professionals. This study calculated total person-years for study subjects and compared breast cancer incidence between matched health and nonhealth professionals. Multivariable Cox proportional hazards and competing risk analyses were used, stratified by birth age, job tenure categories, and types of health professional license. Statistical analyses were conducted in 2019-2020. RESULTS Health professionals had a significantly higher risk of breast cancer (hazard ratio=1.34, 95% CI=1.28-1.41; subdistribution hazard ratio=1.36, 95% CI=1.30, 1.42). Elevated risk of breast cancer incidence was associated with birth age, job tenure, and several health professional license types, including physician, pharmacist, registered nurse, midwife, medical technologist, and psychologist. CONCLUSIONS Elevated breast cancer risk was found overall in female health professionals. Regular ultrasonography for younger women and mammography for those aged >45 years may be necessary in the annual labor physical examination for female health professionals.
Collapse
Affiliation(s)
- Cheng-Ting Shen
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Medical Research, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Community Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung City, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chih-Hong Pan
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, Taipei, Taiwan
| | - Ming-Tsang Wu
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Public Health, Kaohsiung Medical University, Kaohsiung City, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yun-Shiuan Chuang
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung City, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
10
|
Yaghjyan L, Austin-Datta RJ, Oh H, Heng YJ, Vellal AD, Sirinukunwattana K, Baker GM, Collins LC, Murthy D, Rosner B, Tamimi RM. Associations of reproductive breast cancer risk factors with breast tissue composition. Breast Cancer Res 2021; 23:70. [PMID: 34225771 PMCID: PMC8258947 DOI: 10.1186/s13058-021-01447-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 06/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We investigated the associations of reproductive factors with the percentage of epithelium, stroma, and fat tissue in benign breast biopsy samples. METHODS This study included 983 cancer-free women with biopsy-confirmed benign breast disease (BBD) within the Nurses' Health Study and Nurses' Health Study II cohorts. The percentage of each tissue type (epithelium, stroma, and fat) was measured on whole-section images with a deep-learning technique. All tissue measures were log-transformed in all the analyses to improve normality. The data on reproductive variables and other breast cancer risk factors were obtained from biennial questionnaires. Generalized linear regression was used to examine the associations of reproductive factors with the percentage of tissue types, while adjusting for known breast cancer risk factors. RESULTS As compared to parous women, nulliparous women had a smaller percentage of epithelium (β = - 0.26, 95% confidence interval [CI] - 0.41, - 0.11) and fat (β = - 0.34, 95% CI - 0.54, - 0.13) and a greater percentage of stroma (β = 0.04, 95% CI 0.01, 0.08). Among parous women, the number of children was inversely associated with the percentage of stroma (β per child = - 0.01, 95% CI - 0.02, - 0.00). The duration of breastfeeding of ≥ 24 months was associated with a reduced proportion of fat (β = - 0.30, 95% CI - 0.54, - 0.06; p-trend = 0.04). In a separate analysis restricted to premenopausal women, older age at first birth was associated with a greater proportion of epithelium and a smaller proportion of stroma. CONCLUSIONS Our findings suggest that being nulliparous as well as having a fewer number of children (both positively associated with breast cancer risk) is associated with a smaller proportion of epithelium and a greater proportion of stroma, potentially suggesting the importance of epithelial-stromal interactions. Future studies are warranted to confirm our findings and to elucidate the underlying biological mechanisms.
Collapse
Affiliation(s)
- Lusine Yaghjyan
- College of Public Health and Health Professions and College of Medicine, Department of Epidemiology, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA.
| | - Rebecca J Austin-Datta
- College of Public Health and Health Professions and College of Medicine, Department of Epidemiology, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA
| | - Hannah Oh
- Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul, South Korea
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, South Korea
| | - Yujing J Heng
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Adithya D Vellal
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Korsuk Sirinukunwattana
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Institute of Biomedical Engineering (IBME), Department of Engineering Science, Old Road Campus Research Building, University of Oxford, Oxford, UK
| | - Gabrielle M Baker
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Laura C Collins
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Divya Murthy
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| |
Collapse
|
11
|
Shanker N, Mathur P, Das P, Sathishkumar K, Shalini AM, Chaturvedi M. Cancer scenario in North-East India & need for an appropriate research agenda. Indian J Med Res 2021; 154:27-35. [PMID: 34782528 PMCID: PMC8715693 DOI: 10.4103/ijmr.ijmr_347_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Indexed: 11/14/2022] Open
Abstract
Background & objectives The North-Eastern (NE) region has the highest incidence of cancer in India, and is also burdened by higher prevalence of risk factors and inadequate cancer treatment facilities. The aim of this study was to describe the cancer profile of the NE region, focussing on the cancer sites that have high incidence and to identify research priorities. Methods Incidence data from population-based cancer registries (PBCRs) in the North-East region (8 States) were utilized and relevant literature was reviewed to identify risk factors. Results Aizawl district in Mizoram had the highest incidence of cancer in men [age-adjusted rate (AAR) of 269.4 per 100,000]. Among women, Papumpare district of Arunachal Pradesh had the highest incidence (AAR of 219.8) in India. East Khasi Hills district in Meghalaya had the highest incidence of oesophageal cancer (AAR of 75.4 in men and 33.6 in women). Aizawl district in Mizoram had the highest incidence of stomach (AAR-44.2 in men) and Papumpare district had highest incidence of stomach (AAR 27.1 in women), liver (AAR- 35.2 in men and 14.4 in women) and cervical cancers (AAR- 27.7). Lung cancer (AAR- 38.8 in men and 37.9 in women) and gall bladder cancer incidence (AAR- 7.9 in men and 16.2 in women) were highest in Aizawl and Assam (Kamrup urban) PBCRs, respectively. Nagaland had the highest incidence of nasopharyngeal cancer (AAR of 14.4 in men and 6.5 in women), a relatively rare cancer in other regions of India. Four States (Arunachal Pradesh, Manipur, Sikkim and Tripura) in NE had only one cancer treating facility. Interpretation & conclusions Further research on specific aetiological factors in the region and multi-disciplinary research for development of tools, techniques and guidelines for cancer control are the need of the hour.
Collapse
Affiliation(s)
- Neha Shanker
- National Centre for Disease Informatics & Research, Bengaluru, Karnataka, India
| | - Prashant Mathur
- National Centre for Disease Informatics & Research, Bengaluru, Karnataka, India
| | - Priyanka Das
- National Centre for Disease Informatics & Research, Bengaluru, Karnataka, India
| | - K. Sathishkumar
- National Centre for Disease Informatics & Research, Bengaluru, Karnataka, India
| | | | - Meesha Chaturvedi
- National Centre for Disease Informatics & Research, Bengaluru, Karnataka, India
| |
Collapse
|
12
|
Aurin J, Thorlacius H, Butt ST. Age at first childbirth and breast cancer survival: a prospective cohort study. BMC Res Notes 2020; 13:9. [PMID: 31907014 PMCID: PMC6945722 DOI: 10.1186/s13104-019-4864-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 12/16/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Late age at first childbirth is a well-established risk factor for breast cancer. Previous studies have, however, shown conflicting results to whether late age at first childbirth also influences the prognosis of breast cancer survival. The aim of this study was to examine age at first birth in relation to survival after breast cancer diagnosis. RESULTS We used information from the Malmö Diet and Cancer study. At baseline 17,035 women were included. All women were followed from the year they developed breast cancer until they either died or until the end of follow-up. All women were asked how many children they had given birth to and were then divided into different groups, ≤ 20, > 20 to ≤ 25, > 25 to ≤ 30 and > 30. Nulliparous women form a separate group. Survival analyses were then performed using Cox proportional hazard survival analysis. Women in all age groups had a lower risk of breast cancer specific death as compared to the reference group ≤ 20, however non-significantly. Nulliparous women had a higher risk of breast cancer specific death as compared to the same reference group, however these results were not statistically significant. We could not see any negative effect of late first childbirth on breast cancer specific survival.
Collapse
Affiliation(s)
- Johanna Aurin
- Institution of Clinical Sciences Malmö, Department of Surgery, Skåne University Hospital Malmo, Lund University, 205 02, Malmö, Sweden.
| | - Henrik Thorlacius
- Institution of Clinical Sciences Malmö, Department of Surgery, Skåne University Hospital Malmo, Lund University, 205 02, Malmö, Sweden
| | - Salma Tunå Butt
- Institution of Clinical Sciences Malmö, Department of Surgery, Skåne University Hospital Malmo, Lund University, 205 02, Malmö, Sweden
| |
Collapse
|
13
|
Zhang JY, Wang MX, Wang X, Li YL, Liang ZZ, Lin Y, Liu Q, Xie XM, Tang LY, Ren ZF. Associations of reproductive factors with breast cancer prognosis and the modifying effects of menopausal status. Cancer Med 2019; 9:385-393. [PMID: 31724329 PMCID: PMC6943140 DOI: 10.1002/cam4.2707] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 12/11/2022] Open
Abstract
Reproductive factors associated with breast cancer risk may also affect the prognosis. This study aimed to evaluate the associations of multiple reproductive factors with breast cancer prognosis and the modifying effects of menopausal status. We obtained data from 3805 breast cancer patients recruited between October 2008 and June 2016 in Guangzhou. The subjects were followed up until 30 June 2018. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using multivariate Cox models to estimate the associations. It was found that there were U‐shaped patterns for the associations of age at first birth and durations from first/last birth to diagnosis with breast cancer prognosis. The adverse effects of old age at first birth [>30 years vs 23‐30 years, HR (95% CI): 1.59 (1.01‐2.50)] and long intervals from first [≥20 years vs 10‐19 years, HR (95% CI): 1.55 (1.07‐2.27)] or last [≥20 years vs 10‐19 years, HR (95% CI): 1.63 (1.08‐2.46)] birth to diagnosis on progression‐free survival (PFS) were significantly more pronounced among premenopausal women. Additionally, long interval (>5 years) between first and second birth was associated with a better PFS [HR (95% CI): 0.64 (0.42‐0.97)]. These results suggested that age at first birth, durations from first/last birth to diagnosis, and intervals between first and second birth should be taken into account when following the patients and assessing the prognosis of breast cancer, particularly for premenopausal patients. These findings would also have implications for further insight into the mechanisms of breast cancer development.
Collapse
Affiliation(s)
- Jia-Yi Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Mei-Xia Wang
- Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
| | - Xiang Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yue-Lin Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhuo-Zhi Liang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ying Lin
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiang Liu
- The Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | | | - Lu-Ying Tang
- The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ze-Fang Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
14
|
Abubakar M, Guo C, Koka H, Sung H, Shao N, Guida J, Deng J, Li M, Hu N, Zhou B, Lu N, Yang XR. Clinicopathological and epidemiological significance of breast cancer subtype reclassification based on p53 immunohistochemical expression. NPJ Breast Cancer 2019; 5:20. [PMID: 31372496 PMCID: PMC6658470 DOI: 10.1038/s41523-019-0117-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/02/2019] [Indexed: 01/10/2023] Open
Abstract
TP53 mutations are common in breast cancer and are typically associated with more aggressive tumor characteristics, but little is known about the clinicopathological and epidemiological relevance of p53 protein expression, a TP53 mutation surrogate, in breast cancer subtypes. In this study of 7226 Chinese women with invasive breast cancer, we defined breast cancer subtypes using immunohistochemical (IHC) measures of hormone receptors and HER2 in conjunction with histologic grade. p53 expression status was then used to further stratify subtypes into p53-positive and p53-negative. Odds ratios (ORs) and 95% confidence intervals (CIs) in case-only logistic regression analyses were used to examine heterogeneity across different subtypes. The frequency of p53 protein expression varied by breast cancer subtype, being lowest in the luminal A-like and highest in the triple-negative and HER2-enriched subtypes (P-value < 0.01). In luminal A-like and B-like/HER2-negative subtypes, p53 positivity was associated with early-onset tumors, high grade, high proliferative index, and basal marker (CK5/6 and EGFR) expression. Further, compared with luminal A-like/p53-negative patients, A-like/p53-positive patients were more likely to be parous [adjusted OR parous vs. nulliparous = 2.67 (1.60, 4.51); P-value < 0.01] and to have breastfed [adjusted OR ever vs. never = 1.38 (1.03, 1.85); P-value = 0.03]. p53 positivity was not associated with examined clinical and risk factors in other tumor subtypes. Overall, these findings suggest that p53 expression, which is readily available in many settings, can be used to identify phenotypes of luminal A-like breast cancer with distinct clinical and epidemiological implications.
Collapse
Affiliation(s)
- Mustapha Abubakar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
| | - Changyuan Guo
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing, China
| | - Hela Koka
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
| | - Hyuna Sung
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA 30303 USA
| | - Nan Shao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Sun Yat-sen University, 510275 Guangzhou, China
| | - Jennifer Guida
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
- Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
| | - Joseph Deng
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
| | - Mengjie Li
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
- Vanderbilt University, Nashville, TN 37235 USA
| | - Nan Hu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
| | - Bin Zhou
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing, China
| | - Ning Lu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021 Beijing, China
| | - Xiaohong R. Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD 20892 USA
| |
Collapse
|
15
|
Minami Y, Nishino Y, Kawai M, Tada H, Kanemura S, Miyashita M, Ishida T, Kakugawa Y. Reproductive history and breast cancer survival: a prospective patient cohort study in Japan. Breast Cancer 2019; 26:687-702. [PMID: 30993643 DOI: 10.1007/s12282-019-00972-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 04/05/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Reproductive factors may influence breast cancer progression and patient survival; however, evidence has been limited. METHODS The associations of reproductive factors with tumor characteristics and patient survival were analyzed among 1468 breast cancer patients diagnosed during 1997-2013 at a single institute in Japan. The patients were followed until 2016. During a median follow-up period of 8.6 years, 272 all-cause and 199 breast cancer deaths were documented. RESULTS In case-case comparisons, later age at menarche was inversely associated with advanced tumors. Nulliparous patients tended to have receptor-positive [estrogen receptor (ER)+ or progesterone receptor (PR)+] tumors. Conversely, the Cox proportional-hazards model including adjustment for tumor characteristics revealed U-shaped relationship between parity number and the risk of all-cause death among the patients overall [hazard ratio (HR) = 2.10 for nulliparous, 1.28 for 2, and 1.50 for ≥ 3 vs. one child]. According to hormone receptor, later age at menarche and later age at last birth were positively associated with the risk of all-cause death among patients with ER- and PR- cancer (menarche, HR = 2.18 for ≥ 15 vs. ≤ 12 years, ptrend = 0.03; last birth, HR = 3.10 for ≥ 35 vs. ≤ 29 years, ptrend = 0.01). A shorter time since last birth was associated with the risk of death among receptor-positive patients (HR = 5.72 for ≤ 4 vs. ≥ 10 years, ptrend = 0.004). CONCLUSION The results indicate that the timing of menarche and parity have significant effects on patient survival, providing clues for understanding the association between women's life course and breast cancer outcome.
Collapse
Affiliation(s)
- Yuko Minami
- Division of Community Health, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. .,Division of Cancer Epidemiology and Prevention, Miyagi Cancer Center Research Institute, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1293, Japan. .,Center for Preventive Medicine, Osaki Citizen Hospital, 2-3-15 Senjuji-machi, Furukawa, Osaki, Miyagi, 989-6174, Japan.
| | - Yoshikazu Nishino
- Division of Cancer Epidemiology and Prevention, Miyagi Cancer Center Research Institute, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1293, Japan.,Department of Epidemiology and Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan
| | - Masaaki Kawai
- Department of Breast Surgery, Miyagi Cancer Center Hospital, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1239, Japan
| | - Hiroshi Tada
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Seiki Kanemura
- Division of Cancer Epidemiology and Prevention, Miyagi Cancer Center Research Institute, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1293, Japan
| | - Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Takanori Ishida
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yoichiro Kakugawa
- Department of Breast Surgery, Miyagi Cancer Center Hospital, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1239, Japan
| |
Collapse
|
16
|
Abubakar M, Chang‐Claude J, Ali HR, Chatterjee N, Coulson P, Daley F, Blows F, Benitez J, Milne RL, Brenner H, Stegmaier C, Mannermaa A, Rudolph A, Sinn P, Couch FJ, Devilee P, Tollenaar RA, Seynaeve C, Figueroa J, Lissowska J, Hewitt S, Hooning MJ, Hollestelle A, Foekens R, Koppert LB, Investigators KC, Bolla MK, Wang Q, Jones ME, Schoemaker MJ, Keeman R, Easton DF, Swerdlow AJ, Sherman ME, Schmidt MK, Pharoah PD, Garcia‐Closas M. Etiology of hormone receptor positive breast cancer differs by levels of histologic grade and proliferation. Int J Cancer 2018; 143:746-757. [PMID: 29492969 PMCID: PMC6041155 DOI: 10.1002/ijc.31352] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/24/2018] [Accepted: 01/26/2018] [Indexed: 01/14/2023]
Abstract
Limited epidemiological evidence suggests that the etiology of hormone receptor positive (HR+) breast cancer may differ by levels of histologic grade and proliferation. We pooled risk factor and pathology data on 5,905 HR+ breast cancer cases and 26,281 controls from 11 epidemiological studies. Proliferation was determined by centralized automated measures of KI67 in tissue microarrays. Odds ratios (OR), 95% confidence intervals (CI) and p-values for case-case and case-control comparisons for risk factors in relation to levels of grade and quartiles (Q1-Q4) of KI67 were estimated using polytomous logistic regression models. Case-case comparisons showed associations between nulliparity and high KI67 [OR (95% CI) for Q4 vs. Q1 = 1.54 (1.22, 1.95)]; obesity and high grade [grade 3 vs. 1 = 1.68 (1.31, 2.16)] and current use of combined hormone therapy (HT) and low grade [grade 3 vs. 1 = 0.27 (0.16, 0.44)] tumors. In case-control comparisons, nulliparity was associated with elevated risk of tumors with high but not low levels of proliferation [1.43 (1.14, 1.81) for KI67 Q4 vs. 0.83 (0.60, 1.14) for KI67 Q1]; obesity among women ≥50 years with high but not low grade tumors [1.55 (1.17, 2.06) for grade 3 vs. 0.88 (0.66, 1.16) for grade 1] and HT with low but not high grade tumors [3.07 (2.22, 4.23) for grade 1 vs. 0.85 (0.55, 1.30) for grade 3]. Menarcheal age and family history were similarly associated with HR+ tumors of different grade or KI67 levels. These findings provide insights into the etiologic heterogeneity of HR+ tumors.
Collapse
Affiliation(s)
- Mustapha Abubakar
- Division of Cancer Epidemiology and GeneticsNational Cancer Institute, National Institutes of HealthRockvilleMD
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUnited Kingdom
| | - Jenny Chang‐Claude
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
- University Cancer Center Hamburg, University Medical Center Hamburg‐EppendorfHamburgGermany
| | - H. Raza Ali
- Cancer Research UK Cambridge Institute, University of CambridgeCambridgeUnited Kingdom
| | - Nilanjan Chatterjee
- Department of BiostatisticsBloomberg School of Public Health, Johns Hopkins UniversityBaltimoreMD
- Department of Oncology, School of Medicine, Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins UniversityBaltimoreMD
| | - Penny Coulson
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUnited Kingdom
| | - Frances Daley
- Division of Breast Cancer Research, Breast Cancer Now Toby Robins Research CentreThe Institute of Cancer ResearchLondonUnited Kingdom
| | - Fiona Blows
- Department of Oncology, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUnited Kingdom
| | - Javier Benitez
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO)MadridSpain
- Centro de Investigacion en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Roger L. Milne
- Cancer Epidemiology Centre, Cancer Council VictoriaMelbourneVICAustralia
- Melbourne School of Population and Global Health, Centre for Epidemiology and BiostatisticsThe University of MelbourneMelbourneVICAustralia
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
- Division of Preventive OncologyGerman Cancer Research Center (DKFZ), and National Center for Tumor Diseases (NCT)HeidelbergGermany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ)HeidelbergGermany
| | | | - Arto Mannermaa
- School of MedicineInstitute of Clinical Medicine, Pathology and Forensic Medicine, Cancer Center of Eastern Finland, University of Eastern FinlandKuopioFinland
- Department of Clinical Pathology, Imaging CenterKuopio University HospitalKuopioFinland
| | - Anja Rudolph
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Peter Sinn
- Department of PathologyInstitute of Pathology, Heidelberg University HospitalHeidelbergGermany
| | - Fergus J. Couch
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMN
| | - Peter Devilee
- Department of Human Genetics & Department of PathologyLeiden University Medical CenterLeidenThe Netherlands
| | | | - Caroline Seynaeve
- Department of Medical OncologyFamily Cancer Clinic, Erasmus MC Cancer InstituteRotterdamThe Netherlands
| | - Jonine Figueroa
- Usher Institute of Population Health Sciences and Informatics, The University of EdinburghScotlandUnited Kingdom
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and PreventionM. Sklodowska‐Curie Memorial Cancer Center and Institute of OncologyWarsawPoland
| | - Stephen Hewitt
- Laboratory of PathologyNational Cancer Institute, National Institutes of HealthRockvilleMD
| | - Maartje J. Hooning
- Department of Medical OncologyFamily Cancer Clinic, Erasmus MC Cancer InstituteRotterdamThe Netherlands
| | - Antoinette Hollestelle
- Department of Medical OncologyFamily Cancer Clinic, Erasmus MC Cancer InstituteRotterdamThe Netherlands
| | - Renée Foekens
- Department of Medical OncologyFamily Cancer Clinic, Erasmus MC Cancer InstituteRotterdamThe Netherlands
| | - Linetta B. Koppert
- Department of Surgical OncologyErasmus MC Cancer InstituteRotterdamThe Netherlands
| | - kConFab Investigators
- Research DepartmentPeter MacCallum Cancer CentreMelbourneVICAustralia
- The Sir Peter MacCallum Department of Oncology University of Melbourne, ParkvilleMelbourneVICAustralia
| | - Manjeet K. Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUnited Kingdom
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUnited Kingdom
| | - Michael E. Jones
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUnited Kingdom
| | - Minouk J. Schoemaker
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUnited Kingdom
| | - Renske Keeman
- Division of Molecular PathologyNetherlands Cancer Institute, Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
| | - Douglas F. Easton
- Department of Oncology, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUnited Kingdom
- Department of Public Health and Primary Care, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUnited Kingdom
| | - Anthony J. Swerdlow
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUnited Kingdom
- Division of Breast Cancer ResearchThe Institute of Cancer ResearchLondonUnited Kingdom
| | - Mark E. Sherman
- Division of Epidemiology, Department of Health Sciences ResearchMayo ClinicJacksonvilleFL
| | - Marjanka K. Schmidt
- Department of Public Health and Primary Care, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUnited Kingdom
- Division of Psychosocial Research and EpidemiologyNetherlands Cancer Institute, Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
| | - Paul D. Pharoah
- Department of Oncology, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUnited Kingdom
- Department of Public Health and Primary Care, Centre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUnited Kingdom
| | - Montserrat Garcia‐Closas
- Division of Cancer Epidemiology and GeneticsNational Cancer Institute, National Institutes of HealthRockvilleMD
| |
Collapse
|
17
|
Yaghjyan L, Stoll E, Ghosh K, Scott CG, Jensen MR, Brandt KR, Visscher D, Vachon CM. Tissue-based associations of mammographic breast density with breast stem cell markers. Breast Cancer Res 2017; 19:100. [PMID: 28851411 PMCID: PMC5576318 DOI: 10.1186/s13058-017-0889-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/04/2017] [Indexed: 12/15/2022] Open
Abstract
Background Mammographic breast density is a well-established, strong breast cancer risk factor but the biology underlying this association remains unclear. Breast density may reflect underlying alterations in the size and activity of the breast stem cell pool. We examined, for the first time, associations of CD44, CD24, and aldehyde dehydrogenase family 1 member A1 (ALDH1A1) breast stem cell markers with breast density. Methods We included in this study 64 asymptomatic healthy women who previously volunteered for a unique biopsy study of normal breast tissue at the Mayo Clinic (2006-2008). Mammographically identified dense and non-dense areas were confirmed/localized by ultrasound and biopsied. Immunohistochemical analysis of the markers was performed according to a standard protocol and the staining was assessed by a single blinded pathologist. In core biopsy samples retrieved from areas of high vs. low density within the same woman, we compared staining extent and an expression score (the product of staining intensity and extent), using the signed rank test. All tests of statistical significance were two-sided. Results A total of 64, 28, and 10 women were available for CD44, CD24, and ALDH1A1 staining, respectively. For all three markers, we found higher levels of staining extent in dense as compared to non-dense tissue, though for CD24 and ALDH1A1 the difference did not reach statistical significance (CD44, 6.3% vs. 2.0%, p < 0.001; CD24, 8.0% vs. 5.6%, p = 0.10; and ALDH1A1, 0.5% vs. 0.3%, p = 0.12). The expression score for CD44 was significantly greater in dense as compared to non-dense tissue (9.8 vs.3.0, p < 0.001). Conclusions Our findings suggest an increased presence and/or activity of stem cells in dense as compared to non-dense breast tissue. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0889-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Lusine Yaghjyan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32610, USA.
| | - Ethan Stoll
- Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL, 32610, USA
| | - Karthik Ghosh
- Division of General Internal Medicine, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN, 55902, USA
| | - Christopher G Scott
- Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Matthew R Jensen
- Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Kathleen R Brandt
- Department of Radiology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Daniel Visscher
- Department of Anatomic Pathology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| | - Celine M Vachon
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN, 55905, USA
| |
Collapse
|
18
|
Dossus L, Benusiglio PR. Lobular breast cancer: incidence and genetic and non-genetic risk factors. Breast Cancer Res 2015; 17:37. [PMID: 25848941 PMCID: PMC4357148 DOI: 10.1186/s13058-015-0546-7] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 03/03/2015] [Indexed: 12/12/2022] Open
Abstract
While most invasive breast cancers consist of carcinomas of the ductal type, about 10% are invasive lobular carcinomas. Invasive lobular and ductal carcinomas differ with respect to risk factors. Invasive lobular carcinoma is more strongly associated with exposure to female hormones, and therefore its incidence is more subject to variation. This is illustrated by US figures during the 1987 to 2004 period: after 12 years of increases, breast cancer incidence declined steadily from 1999 to 2004, reflecting among other causes the decreasing use of menopausal hormone therapy, and these variations were stronger for invasive lobular than for invasive ductal carcinoma. Similarly, invasive lobular carcinoma is more strongly associated with early menarche, late menopause and late age at first birth. As for genetic risk factors, four high-penetrance genes are tested in clinical practice when genetic susceptibility to breast cancer is suspected, BRCA1, BRCA2, TP53 and CDH1. Germline mutations in BRCA1 and TP53 are predominantly associated with invasive ductal carcinoma, while BRCA2 mutations are associated with both ductal and lobular cancers. CDH1, the gene coding for the E-cadherin adhesion protein, is of special interest as mutations are associated with invasive lobular carcinoma, but never with ductal carcinoma. It was initially known as the main susceptibility gene for gastric cancer of the diffuse type, but the excess of breast cancers of the lobular type in CDH1 families led researchers to identify it also as a susceptibility gene for invasive lobular carcinoma. The risk of invasive lobular carcinoma is high in female mutation carriers, as about 50% are expected to develop the disease. Carriers must therefore undergo intensive breast cancer screening, with, for example, yearly magnetic resonance imaging and mammogram starting at age 30 years.
Collapse
|
19
|
Yuri T, Tsubura A. Relation between parity and pregnancy-related hormones and breast cancer control. BREAST CANCER MANAGEMENT 2015. [DOI: 10.2217/bmt.14.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Epidemiological research has indicated the beneficial effects of full-term pregnancy at an early age for a reduction in breast cancer risk. Experimental data have shown that pregnancy and pregnancy-related hormones, such as estrogen plus progesterone, estrogen alone and human chorionic gonadotropin, are involved in parity-induced protection. Pregnancy and short-duration treatment of a young host with pregnancy-related hormones to mimic the pregnancy environment provide mammary cancer protection by making cells refractory to carcinogenic stimuli and causing growth arrest and programmed cell death. Experimental data concerning pregnancy and pregnancy-related hormones are reviewed in relation to intrinsic subtypes of mammary cancer.
Collapse
Affiliation(s)
- Takashi Yuri
- Department of Pathology II, Kansai Medical University, Hirakata, Osaka, Japan
| | - Airo Tsubura
- Department of Pathology II, Kansai Medical University, Hirakata, Osaka, Japan
| |
Collapse
|
20
|
The protective effect of parity in hormone receptor-positive, Ki-67 expressing breast cancer. World J Surg 2014; 38:1065-9. [PMID: 24481994 DOI: 10.1007/s00268-014-2468-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Epidemiologic studies showed that the experience of pregnancy is associated with a reduced risk of breast cancer. We hypothesized that parity may differentially be associated with the development of invasive breast cancer by each subtype. METHODS We reviewed the clinical, radiological, and pathological records of women diagnosed with invasive ductal carcinoma of the breast at Samsung Medical Center between 2005 and 2009. Clinicopathologic results were assessed by χ(2) and Fisher's exact tests with a Bonferroni correction for categorical variables, and by the Kruskal-Wallis test for nonparametric continuous variables. A multinomial logistic regression model was used for multivariate analysis. RESULTS Among a total of 3,095 patients, 283 (9.14 %) patients were nulliparous. Older age, higher pN, and expression of HER2 were associated with parity. In the analysis between parity and molecular subtypes, parity also had a variable influence on breast cancer subtypes (p = 0.032). Intergroup analysis with multiple comparison showed that luminal B subtype was related to nulliparity compared with HER2-positive subtypes (p = 0.03). CONCLUSIONS The effect of parity on the development of breast cancer differed by hormone receptor and HER2 expression. It seems that parity might have a protective effect against hormone receptor-positive breast cancer, especially cancers expressing HR+ and Ki-67. Further basic research to define and understand this result is ongoing.
Collapse
|
21
|
Lee JS, Oh M, Ahn S, Bae J, Bae Y, Baek J, Bong J, Cha K, Chang E, Chang I, Chang S, Cho J, Cho S, Cho Y, Choi J, Choi K, Choi M, Choi S, Choi S, Goo G, Han S, Han W, Hong S, Hwang J, Hyun T, Jegal Y, Im M, Joh Y, Jun S, Jung B, Jung J, Jung J, Jung K, Jung P, Jung S, Jung S, Jung Y, Jung Y, Kang D, Kang H, Kang Y, Kang Y, Keum J, Kim D, Kim H, Kim J, Kim J, Kim J, Kim J, Kim K, Kim S, Kim S, Kim S, Kim S, Kim S, Kim S, Kim S, Kim S, Kim Y, Ko B, Ko S, Koh S, Koo B, Koo J, Kwak B, Lee C, Lee C, Lee D, Lee D, Lee E, Lee G, Lee H, Lee H, Lee J, Lee J, Lee J, Lee J, Lee J, Lee K, Lee K, Lee K, Lee K, Lee M, Lee R, Lee S, Lee S, Lee S, Lee W, Lee Y, Leu J, Lim C, Lim C, Moon B, Nam Y, Nam S, Noh D, Noh W, Oh S, Oh S, Pae W, Paik I, Paik N, Park B, Park B, Park C, Park H, Park H, Park J, Park K, Park S, Park S, Park S, Park W, Park Y, Park Y, Seo H, Seo K, Seo Y, Sin Y, Son B, Son G, Song B.J, Song K, Song Y, Suh Y, Won J, Woo D, Yang D, Yang J, Yoo K, Yoo S, Yoon H, Yoon J, Yoon S. Reproductive Factors and Subtypes of Breast Cancer Defined by Estrogen Receptor, Progesterone Receptor, and Human Epidermal Growth Factor Receptor 2: A Register-Based Study From Korea. Clin Breast Cancer 2014; 14:426-34. [DOI: 10.1016/j.clbc.2014.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 05/15/2014] [Accepted: 05/27/2014] [Indexed: 12/30/2022]
|
22
|
Lee J, Oh M. Effects of interval between age at first pregnancy and age at diagnosis on breast cancer survival according to menopausal status: a register-based study in Korea. BMC WOMENS HEALTH 2014; 14:113. [PMID: 25231360 PMCID: PMC4180146 DOI: 10.1186/1472-6874-14-113] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 09/10/2014] [Indexed: 11/16/2022]
Abstract
Background The influence of parity and time interval between age at first pregnancy (AFP) and age at diagnosis on breast cancer survival is not established in the same way as their influence on breast cancer risk. We aimed to investigate the association of time interval or parity with prognosis in pre- and postmenopausal women in Korea. Methods We conducted a retrospective study of 29,167 women with breast cancer through the Korean Breast Cancer Registry from 1993–2009. Information on reproductive factors, including breastfeeding, AFP, and parity were collected from a routine questionnaire. Conditional logistic regression was used to estimate the associations between menopausal status and overall mortality (OM) and breast-cancer-specific mortality (BCSM), adjusting for treatment and stage. Results High parity (≥5) increased the hazard ratios (HR) of BCSM (HR = 1.33, 95% confidence interval (CI): 0.83–2.11, p < 0.001) and OM (HR = 1.20, 95% CI: 0.85–1.68.73, p < 0.001) in premenopausal and postmenopausal women (BCSM, HR: 1.62, 95% CI: 0.93–2.82, p < 0.001; OM, HR = 1.58, 95% CI: 1.14–2.21, p <0.001). A longer time interval between age at breast cancer diagnosis and AFP reduced the HRs of BCSM (HR = 0.97, 95% CI: 0.96–0.98, p = 0.001) and OM (HR = 0.98, 95% CI: 0.97–0.98, p < 0.001) in premenopausal women, but had an adverse effect on the HR of OM (HR = 1.03, 95% CI: 1.02–1.03, p < 0.001) in postmenopausal women. Conclusions High parity (≥5) was associated with poor breast cancer prognosis in both pre- and postmenopausal women. The time intervals between reproductive events had different effects on breast cancer outcomes depending on menopausal status. Electronic supplementary material The online version of this article (doi:10.1186/1472-6874-14-113) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- JungSun Lee
- Department of Surgery, College of Medicine, University of Inje, Haeundae paik Hospital, Busan, #1435, Jwa-dong, Haeundae-gu, Gimhae Zip-code: 612-030, Korea.
| | | | | |
Collapse
|
23
|
Surakasula A, Nagarjunapu GC, Raghavaiah KV. A comparative study of pre- and post-menopausal breast cancer: Risk factors, presentation, characteristics and management. J Res Pharm Pract 2014; 3:12-8. [PMID: 24991630 PMCID: PMC4078652 DOI: 10.4103/2279-042x.132704] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: Breast cancer is the most common female cancer worldwide and is the second most commonly diagnosed cancer in Indian women. This study evaluates the differences between pre- and post-menopausal breast cancer women regarding risk factors, nature of disease presentation, tumor characteristics, and management. Methods: This is a prospective observational study, conducted in the Oncology Department of St. Ann's Cancer Hospital, for a period of 6 months from January to August 2012. Data on basic demography, clinical and pathological tumor profile, and treatment details were collected prospectively for each patient based on patient interviews and medical records. Findings: Among 100 female patients taken up for the study, 48 were premenopausal and 52 had reached menopause. The mean age of presentation for breast carcinoma was a decade earlier in these patients compared with western patients. The risk factors for both pre-and post-menopausal breast cancer were found similar other than late menopause in postmenopausal patients. Having dense breast tissue was a predominant risk factor among all women. Late presentation was the common phenomenon in almost all patients. The treatment given was not based on any standard guidelines due to inadequate public health policies. Conclusion: Late stage at presentation of breast cancer is the main problem and possesses a challenge to the health care community. In order to reduce the burden of breast cancer, a multi-sectorial approach and evidence-based strategies aiming at early detection and effective management of the disease are required.
Collapse
Affiliation(s)
- Aruna Surakasula
- Department of Pharmacy Practice, GIET School of Pharmacy, East Godavari, India
| | | | - K V Raghavaiah
- Department of Radiation Oncology, St. Ann's Hospital, Warangal, India
| |
Collapse
|
24
|
Elebro K, Butt S, Dorkhan M, Jernström H, Borgquist S. Age at first childbirth and oral contraceptive use are associated with risk of androgen receptor-negative breast cancer: the Malmö Diet and Cancer Cohort. Cancer Causes Control 2014; 25:945-57. [PMID: 24825327 DOI: 10.1007/s10552-014-0394-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 05/03/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE Risk factors for breast cancer vary according to breast cancer subtype. This study analyzes the impact of potential risk factors in breast cancer by androgen receptor (AR) status. METHODS A total of 17,035 women were followed in the population-based prospective Malmö Diet and Cancer Study. Baseline data included lifestyle factors including anthropometry, reproductive history, and exogenous hormone use. During follow-up (mean: 12.8 years), 747 invasive breast cancers were diagnosed. Expression of AR was determined by immunohistochemistry in tumor tissue microarrays. RESULTS AR status was assessable in 516 of 747 tumors (69%). Among these, 467 tumors (90.5%) were AR positive (AR(+)) and 49 tumors (9.5%) were AR negative (AR(-)). AR negativity was significantly associated with estrogen receptor (ER) and progesterone receptor negativity, higher grade and proliferation (Ki67). Cox regression analyses stratified by AR status showed significant associations between reproductive factors and AR(-) breast cancer. The older the woman at first childbirth the higher the risk of AR(-) breast cancer; adjusted HR≤20yrs = 0.35, HR>20-≤25yrs = 0.62, HRnulliparous = 1.00, HR>25-≤30yrs = 1.29, HR>30yrs = 1.92, p trend = 0.001. No such association was seen for AR(+) tumors. Similarly, ever oral contraceptive use increased the risk of AR(-) breast cancer [Adj. HR = 2.59, 95% CI (1.26-5.34)] compared to never use, but not for AR(+) breast cancer. CONCLUSIONS Advanced age at first child birth and use of oral contraceptives were associated with increased risk of AR(-) breast cancer. This study may contribute to enhanced understanding of the role of the AR in breast carcinogenesis and improve risk stratification tools for personalized breast cancer prevention.
Collapse
Affiliation(s)
- Karin Elebro
- Division of Oncology and Pathology, Clinical Sciences, Skåne University Hospital, Lund University, 221 85, Lund, Sweden
| | | | | | | | | |
Collapse
|
25
|
Butt S, Borgquist S, Anagnostaki L, Landberg G, Manjer J. Breastfeeding in relation to risk of different breast cancer characteristics. BMC Res Notes 2014; 7:216. [PMID: 24708573 PMCID: PMC4022388 DOI: 10.1186/1756-0500-7-216] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 03/21/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The aim of this present study was to examine duration of breastfeeding in relation to the risk of different subgroups of breast cancer. A prospective cohort, The Malmö Diet and Cancer study, including 14092 parous women, were followed during a mean of 10.2 years and a total of 424 incident breast cancers were diagnosed. METHODS Tumours were classified regarding invasiveness, tumour size, axillary lymph node status, Nottingham grade, tumour proliferation (Ki67), HER2, cyclin D1 and p27, WHO histological type and hormone receptor status. Duration of breastfeeding was measured using total time of breastfeeding, categorized in quartiles using the lowest as the reference group (<4.0, ≥4.0- < 8.0, ≥8.0- < 13.0 and ≥13.0 months). Average duration of breastfeeding per child and breastfeeding duration of the first child were also used as exposures in separate analyses. Relative risks, with 95% confidence intervals, were obtained using a Cox's proportional hazards analysis adjusted for potential confounders. RESULTS Overall risk for breast cancer was similar in all quartiles of breastfeeding. No strong results regarding breastfeeding duration and breast cancer subgroups were seen. A few results indicated an association between a relatively long duration of breastfeeding and tumours with high proliferation (Ki67) and grade III histological grade. CONCLUSIONS Breastfeeding duration was not associated with breast cancer risk and no strong results were seen with regard to breast cancer subgroups.
Collapse
Affiliation(s)
- Salma Butt
- Department of Surgery, Skåne University Hospital, Malmö, Lund University, Malmö, Sweden.
| | | | | | | | | |
Collapse
|
26
|
Byrnes EM, Casey K, Carini LM, Bridges RS. Reproductive experience alters neural and behavioural responses to acute oestrogen receptor α activation. J Neuroendocrinol 2013; 25:1280-1289. [PMID: 24118285 PMCID: PMC4269101 DOI: 10.1111/jne.12113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 09/04/2013] [Accepted: 10/09/2013] [Indexed: 01/25/2023]
Abstract
Reproductive experience (i.e. parturition and lactation) leads to persistent alterations in anxiety-like behaviour that are influenced by the oestrous cycle. We recently found that repeated administration of the selective oestrogen receptors (ER)α agonist propyl-pyrazole triol (PPT) results in anxiolytic-like behaviours on the elevated plus maze (EPM) in primiparous (but not nulliparous) female rats. The present study examined the effects of the acute administration of PPT on EPM behaviour in primiparous and aged-matched, nulliparous female rats. In addition, corticosterone secretion, corticotrophin-releasing hormone (CRH) gene expression and expression of the immediate early gene product Fos in the paraventricular nucleus (PVN) and amygdala were measured either after EPM testing or in home cage controls. Acute PPT administration significantly modified EPM behaviour as a function of reproductive experience, with nulliparous females tending toward increased anxiety-like behaviours and primiparous females tending toward decreased anxiety-like behaviours. In home cage controls, PPT increased corticosterone secretion in all females; however, both vehicle- and PPT-treated, primiparous females had reduced corticosterone levels compared to their nulliparous counterparts. Significant effects of PPT on CRH mRNA within the PVN were observed after the administration of PPT but only in primiparous females tested on the EPM. PPT also increased Fos expression within the PVN of EPM-exposed females; however, both vehicle- and PPT-treated primiparous females had reduced Fos expression compared to nulliparous females. In the amygdala, PPT increased Fos immunoreactivity in the central but not the medial or basolateral amygdala, although these effects were only observed in home cage females. Additionally, both vehicle- and PPT-treated home cage, primiparous females had increased Fos in the central nucleus of the amygdala compared to nulliparous controls. Overall, these data demonstrate that reproductive experience alters the behavioural response to acute ERα activation. Moreover, the findings suggest that central regulation of the hypothalamic-adrenal-pituitary axis is modified as a consequence of reproductive experience.
Collapse
Affiliation(s)
- E M Byrnes
- Tufts University, Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - K Casey
- Tufts University, Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - L M Carini
- Tufts University, Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - R S Bridges
- Tufts University, Cummings School of Veterinary Medicine, North Grafton, MA, USA
| |
Collapse
|
27
|
Lin S, Lin C, Hsu W, Wang I, Chang C, Huang C, Kao C, Liu S, Sung F. A Comparison of Cancer Incidence among Physician Specialists and the General Population: A Taiwanese Cohort Study. J Occup Health 2013; 55:158-66. [DOI: 10.1539/joh.12-0263-oa] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Shih‐Yi Lin
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical UniversityTaiwan
- Division of Nephrology and Kidney InstituteChina Medical University HospitalTaiwan
| | - Cheng‐Li Lin
- Management Office for Health DataChina Medical University HospitalTaiwan
- Department of Public HealthChina Medical UniversityTaiwan
| | - Wu‐Huei Hsu
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical UniversityTaiwan
- Department of Internal MedicineChina Medical University HospitalTaiwan
| | - I‐Kuan Wang
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical UniversityTaiwan
- Division of Nephrology and Kidney InstituteChina Medical University HospitalTaiwan
| | - Chiz‐Chung Chang
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical UniversityTaiwan
- Division of Nephrology and Kidney InstituteChina Medical University HospitalTaiwan
| | - Chiu‐Ching Huang
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical UniversityTaiwan
- Division of Nephrology and Kidney InstituteChina Medical University HospitalTaiwan
| | - Chia‐Hung Kao
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical UniversityTaiwan
- Department of Nuclear Medicine and PET CenterChina Medical University HospitalTaiwan
| | - Shu‐Hui Liu
- Department of Health Care and Social WorkYu Da UniversityTaiwan
- Department of Public HealthChina Medical UniversityTaiwan
| | - Fung‐Chang Sung
- Department of Health Care and Social WorkYu Da UniversityTaiwan
| |
Collapse
|
28
|
Mousavi SM, Försti A, Sundquist K, Hemminki K. Do reproductive factors influence T, N, and M classes of ductal and lobular breast cancers? A nation-wide follow-up study. PLoS One 2013; 8:e58867. [PMID: 23734170 PMCID: PMC3667089 DOI: 10.1371/journal.pone.0058867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 02/07/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUNDS The clinical tumor-node-metastasis (T, N and M) classes of breast cancers provide important prognostic information. However, the possible association of TNM classes with reproductive factors has remained largely unexplored. Because every woman has a reproductive history, implications to outcome prediction are potentially significant. METHODS During the study period from 2002 through 2008, 5,614 pre- and 27,310 postmenopausal patients were identified in the Swedish Family-Cancer Database. Ordinal logistic regression analysis was used to estimate odds ratios (ORs) for TNM classes of breast cancers by histology. The reproductive variables were parity, age at first and last childbirth and time interval between first and last childbirth. RESULTS Among postmenopausal patients, the ORs for high-T class (T2-T4) (tumor size ≥2 cm) and metastasis were decreased by parity. A late age at first and last childbirth associated with high-T class and the effects were higher for lobular (OR for late age at first childbirth = 2.85) than ductal carcinoma. Overall, long time interval between first and last childbirth was related to high-T class and metastasis. However, a short time interval between first and last childbirth in patients with late age at first or last childbirth increased the risk of metastasis. Late age at last childbirth was associated with increased occurrence of lobular carcinoma in situ. Among premenopausal ductal carcinoma patients, nulliparity and early age at first childbirth were associated with high-T class. CONCLUSIONS Increasing parity was protective against high-T class and metastasis; late ages at first and last childbirth were risk factors for high-T class in postmenopausal breast cancers. The current decline in parity and delayed age at first childbirth in many countries may negatively influence prognosis of breast cancer.
Collapse
Affiliation(s)
- Seyed Mohsen Mousavi
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden
| |
Collapse
|
29
|
Nagatsuma AK, Shimizu C, Takahashi F, Tsuda H, Saji S, Hojo T, Sugano K, Takeuchi M, Fujii H, Fujiwara Y. Impact of recent parity on histopathological tumor features and breast cancer outcome in premenopausal Japanese women. Breast Cancer Res Treat 2013; 138:941-50. [PMID: 23553566 DOI: 10.1007/s10549-013-2507-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/25/2013] [Indexed: 02/03/2023]
Abstract
Although previous studies have reported that onset at young age is associated with poor prognosis in breast cancer, the correlation between reproductive factors, breast cancer characteristics, and prognosis remains unclear. Five hundred and twenty-six premenopausal young women diagnosed with primary invasive breast cancer between January 2000 and December 2007 were included in this study. Patients were classified into four groups according to their reproductive history: women who gave birth within the previous 2 years (group A), women who gave birth between 3 and 5 years previously (group B), women who gave birth more than 5 years previously (group C), and nulliparous women (group N). The correlation between the time since last childbirth to diagnosis, histopathological tumor features, and breast cancer prognosis was evaluated. Breast cancer patients who had given birth more recently had more advanced stage tumors; larger sized tumors; a higher rate of axillary lymph node metastases; a higher histological tumor grade; and increased progesterone receptor (PgR)-, HER2+, and triple negative tumors than patients who had given birth less recently or not at all. Group A patients had significantly shorter survival times than patients in both groups C and N (log rank test; p < 0.001). After adjusting for tumor characteristics, the hazard ratio for death in group A was 2.19 compared with group N (p = 0.036), and the adjusted hazard ratio restricted to patients in group A with hormone-receptor-positive, and HER2- tumors was 3.07 (p = 0.011). Young breast cancer patients who had given birth more recently had tumors with more aggressive features and worse prognoses compared with patients who had given birth less recently or were nulliparous.
Collapse
Affiliation(s)
- Akiko Kawano Nagatsuma
- Division of Breast and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Dior UP, Hochner H, Friedlander Y, Calderon-Margalit R, Jaffe D, Burger A, Avgil M, Manor O, Elchalal U. Association between number of children and mortality of mothers: results of a 37-year follow-up study. Ann Epidemiol 2012. [PMID: 23176782 DOI: 10.1016/j.annepidem.2012.10.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To examine the association between parity and long-term, all-cause mortality and mortality owing to specific causes in women. METHODS This prospective population-based study included 40,454 mothers who gave birth in Western Jerusalem, Israel, to 125,842 children and were followed for an average of 37 years after the birth of their first child. Cox proportional hazards models were used to evaluate long-term total and specific-cause mortality of women by their parity. RESULTS We found a U-shaped relationship between the number of offspring and risk of all-cause mortality in mothers. After adjustment for sociodemographic characteristics and maternal health and obstetric conditions, higher mortality rates were observed for mothers of 1 child (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.04-1.4), mothers of 5 to 9 children (HR, 1.21; 95% CI, 1.09-1.33), and mothers of 10 or more children (HR, 1.49; 95% CI, 1.12-1.99) compared with mothers of 2 to 4 children. Mortality risk from specific causes including coronary disease, circulatory disease, and cancer were increased for multiparous women. CONCLUSIONS In this long-term follow-up study, there was an association between number of children and mortality risk for mothers. These findings suggest that maternal pregnancies and postnatal characteristics as reflected by number of children may have consequences for long-term maternal health.
Collapse
Affiliation(s)
- Uri P Dior
- Braun School of Public Health, Hebrew University-Hadassah Medical Center, Jerusalem, Israel.
| | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Butt S, Harlid S, Borgquist S, Ivarsson M, Landberg G, Dillner J, Carlson J, Manjer J. Genetic predisposition, parity, age at first childbirth and risk for breast cancer. BMC Res Notes 2012; 5:414. [PMID: 22867275 PMCID: PMC3439270 DOI: 10.1186/1756-0500-5-414] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 07/18/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent studies have identified several single-nucleotide polymorphisms (SNPs) associated with the risk of breast cancer and parity and age at first childbirth are well established and important risk factors for breast cancer. The aim of the present study was to examine the interaction between these environmental factors and genetic variants on breast cancer risk. METHODS The Malmö Diet and Cancer Study (MDCS) included 17 035 female participants, from which 728 incident breast cancer cases were matched to 1448 controls. The associations between 14 SNPs and breast cancer risk were investigated in different strata of parity and age at first childbirth. A logistic regression analysis for the per allele risk, adjusted for potential confounders yielded odds ratios (OR) with 95% confidence intervals (CI). RESULTS Six of the previously identified SNPs showed a statistically significant association with breast cancer risk: rs2981582 (FGFR2), rs3803662 (TNRC9), rs12443621 (TNRC9), rs889312 (MAP3K1), rs3817198 (LSP1) and rs2107425 (H19). We could not find any statistically significant interaction between the effects of tested SNPs and parity/age at first childbirth on breast cancer risk after adjusting for multiple comparisons. CONCLUSIONS The results of this study are in agreement with previous studies of null interactions between tested SNPs and parity/age at first childbirth with regard to breast cancer risk.
Collapse
Affiliation(s)
- Salma Butt
- Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Alsaker MDK, Opdahl S, Romundstad PR, Vatten LJ. Association of time since last birth, age at first birth and parity with breast cancer survival among parous women: a register-based study from Norway. Int J Cancer 2012; 132:174-81. [PMID: 22511284 DOI: 10.1002/ijc.27593] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 03/28/2012] [Indexed: 01/13/2023]
Abstract
Reproductive factors that have a well-documented effect on breast cancer risk may also influence the prognosis of the disease, but previous studies on breast cancer survival have yielded conflicting results. We combined information from two population-based registries and obtained information on 16,970 parous women with invasive breast cancer. Cox regression analysis was used to assess breast cancer survival in relation to age at diagnosis, age at first birth, time since last birth and parity. We stratified the analyses by age at diagnosis (<50 and ≥ 50 years) as an approximation for menopausal age. In women diagnosed before 50 years of age, breast cancer survival was reduced with younger age at diagnosis (p for trend <0.001), whereas in women diagnosed at 50 years or later, survival was reduced with older age at diagnosis (p for trend 0.011). For breast cancer diagnosed before 50 years, survival was poorer in women with four or more births compared to women with one or two births (hazard ratio 1.3, 95% confidence interval 1.1-1.6). A short time since last birth was associated with reduced survival (p for trend 0.05), but adjustment for stage and grade attenuated the association. Among women diagnosed at 50 years or later, we found no association with survival for any of the reproductive factors. In summary, reproductive factors were associated with survival from breast cancer diagnosed before but not after age 50 years. Young women had a particularly poor prognosis throughout the study period.
Collapse
Affiliation(s)
- Mirjam D K Alsaker
- Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | | | | | | |
Collapse
|
33
|
Jenkins S, Betancourt AM, Wang J, Lamartiniere CA. Endocrine-active chemicals in mammary cancer causation and prevention. J Steroid Biochem Mol Biol 2012; 129:191-200. [PMID: 21729753 DOI: 10.1016/j.jsbmb.2011.06.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 05/31/2011] [Accepted: 06/01/2011] [Indexed: 01/11/2023]
Abstract
Endocrine-active chemicals alter or mimic physiological hormones. These compounds are reported to originate from a wide variety of sources, and recent studies have shown widespread human exposure to several of these compounds. Given the role of the sex steroid hormone, estradiol, in human breast cancer causation, endocrine-active chemicals which interfere with estrogen signaling constitute one potential factor contributing to the high incidence of breast cancer. Thus, the aim of this review is to examine several common endocrine-active chemicals and their respective roles in breast cancer causation or prevention. The plastic component, bisphenol A (BPA), the synthetic estrogen, diethylstilbestrol (DES), the by-product of organic combustion, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the soy component, genistein, and the red grape phytoalexin, resveratrol, have some degree of structural similarities to each other and estradiol. However, despite these structural similarities, the in vitro and in vivo properties of each of these chemicals vary greatly in terms of breast cancer causation and prevention. Early life exposure to BPA and DES increases rodent susceptibility to chemically induced mammary carcinogenesis, presumably through retardation of normal mammary gland maturation and/or disrupting the ratio of cell proliferation and apoptosis in the mammary gland. On the other hand, early exposures to genistein and resveratrol protect rodents against chemically induced and spontaneous mammary cancers. This is reported to occur through the ability of genistein and resveratrol to accelerate mammary gland maturation. Interestingly, TCDD, which is the most structurally dissimilar to the above chemicals and functions as an anti-estrogen, also increases chemically induced mammary carcinogenesis through retardation of mammary gland maturation. This article is part of a Special Issue entitled 'Endocrine disruptors'.
Collapse
Affiliation(s)
- Sarah Jenkins
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | | | | | | |
Collapse
|
34
|
Yli-Kuha AN, Gissler M, Klemetti R, Luoto R, Hemminki E. Cancer morbidity in a cohort of 9175 Finnish women treated for infertility. Hum Reprod 2012; 27:1149-55. [DOI: 10.1093/humrep/des031] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
|
35
|
Alsaker MDK, Opdahl S, Åsvold BO, Romundstad PR, Vatten LJ. The association of reproductive factors and breastfeeding with long term survival from breast cancer. Breast Cancer Res Treat 2011; 130:175-82. [DOI: 10.1007/s10549-011-1566-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 04/29/2011] [Indexed: 10/18/2022]
|
36
|
Chen Y, Pei J. Factors influencing the association between CYP17 T34C polymorphism and the risk of breast cancer: meta-regression and subgroup analysis. Breast Cancer Res Treat 2009; 122:471-81. [PMID: 20043206 DOI: 10.1007/s10549-009-0690-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Accepted: 12/12/2009] [Indexed: 12/22/2022]
Abstract
A number of studies have been investigated the association between CYP17 T34C polymorphism and the risk of breast cancer; the results of these studies are inconsistent, however. This fact implies that the effect of CYP17 T34C polymorphism on susceptibility to breast cancer may be modified by other risk factors. In order to provide a more definitive conclusion, a full meta-analysis combining and summarizing 24 studies was first performed. Both traditional method and Bayesian approach were applied. Odds ratio was estimated using a dominant mode of inheritance after a biological justification for the choice of genetic model. The results of homogeneity analysis (H = 1.16, I (2) = 25.4%, and P = 0.127) suggested the presence of heterogeneity across the studies. Thus, random effects models simulated by the DerSimonian-Laird method were employed. The capability of a Bayesian approach was highlighted in the estimation of a pooled odds ratio and 95% confidence interval. The results of meta-analysis (OR = 1.001, CI = 0.832-1.208) suggest no significant association in the combined populations. Furthermore, Bayesian meta-regression and subgroup analysis were conducted to investigate the sources of heterogeneity. The risk factors evaluated in the study were menopausal status, ethnicity, age at menarche, age at first birth, parity, use of oral contraceptives, body mass index (BMI), and use of hormone repair therapy (HRT). After these population stratifications, there was evidence indicating that a possible impact of menopausal status, age at menarche, and BMI on the association between CYP17 T34C polymorphism and the risk of breast cancer.
Collapse
Affiliation(s)
- Yun Chen
- Department of Pharmacology, Nanjing Medical University, 140 Hanzhong Road, Nanjing, 210029, China.
| | | |
Collapse
|