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Analysis of Colorectal Carcinogenesis Paradigm between Cold Constitution and Heat Constitution: Earlier ECM Collagen Deposition. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5547578. [PMID: 34335820 PMCID: PMC8313331 DOI: 10.1155/2021/5547578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/26/2021] [Accepted: 07/09/2021] [Indexed: 11/17/2022]
Abstract
Colorectal cancer (CRC) is a common malignant tumor around the world. Studying the unique constitution of CRC patients is conducive to the application of personalized medical treatment for CRC. The most common types of constitution in CRC are cold and heat constitution. A previous study has suggested that the malignant progression in cold and heat constitution CRC are different; however, the mechanism remains unclear. The tumor microenvironment (TME) is likely to vary with each individual constitution, which may affect the tumor growth in different constitutions. The extracellular matrix (ECM), the most important component of TME, plays a critical role in disease progression and outcome in patients with CRC. Moreover, collagen, the major component of the ECM, determines the main functional characteristics of ECM and tissue fibrosis caused by collagen deposition, which is one of the signs of CRC malignant progression. This study aimed to explore the mechanisms leading to different colorectal carcinogenesis paradigms between the cold constitution and heat constitution within the context of ECM collagen deposition. We established the CRC rat models and enrolled 30 CRC patients with cold and heat constitution. The collagen-related parameters were detected by using Sirius red staining combined with polarized light microscope, and expressions of collagen (COL I and COL III) and lysyl oxidase (LOX and LOXL2) were determined using immunohistochemistry, while the mRNA levels of COL1A1, COL3A1, LOX, and LOXL2 were measured by qRT-PCR. We found that a higher degree of collagen deposition in the cold-constitution group. The results suggest cold and heat constitution may affect the colorectal carcinogenesis paradigm by influencing the early collagen deposition in colon tissue. The study may provide an effective idea for clinicians to improve the prognosis of CRC patients with different constitutions.
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Impact of breast cancer risk factors on clinically relevant prognostic biomarkers for primary breast cancer. Breast Cancer Res Treat 2021; 189:483-495. [PMID: 34185195 PMCID: PMC8357643 DOI: 10.1007/s10549-021-06294-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/12/2021] [Indexed: 12/13/2022]
Abstract
Purpose In addition to impacting incidence, risk factors for breast cancer may also influence recurrence and survival from the disease. However, it is unclear how these factors affect combinatorial biomarkers for aiding treatment decision-making in breast cancer. Methods Patients were 8179 women with histologically confirmed invasive breast cancer, diagnosed and treated in a large cancer hospital in Beijing, China. Individual clinicopathological (tumor size, grade, lymph nodes) and immunohistochemical (IHC: ER, PR, HER2, KI67) markers were used to define clinically relevant combinatorial prognostic biomarkers, including the Nottingham Prognostic Index (NPI: combining size, grade, nodes) and IHC4 score (combining ER, PR, HER2, KI67). Odds ratios (ORs) and 95% confidence intervals (CIs) for associations between breast cancer risk factors and quartiles (Q1–Q4) of NPI and IHC4 were assessed in multivariable polytomous logistic regression models. Results Overall, increasing parity (ORtrend(95% CI) = 1.20(1.05–1.37);Ptrend = 0.007), overweight (OR(95% CI)vs normal = 1.60(1.29–1.98)), and obesity (OR(95% CI) vs normal = 2.12(1.43–3.14)) were associated with higher likelihood of developing tumors with high (Q4) versus low (Q1) NPI score. Conversely, increasing age (ORtrend(95% CI) = 0.75(0.66–0.84);Ptrend < 0.001) and positive family history of breast cancer (FHBC) (OR(95% CI) = 0.66(0.45–0.95)) were inversely associated with NPI. Only body mass index (BMI) was associated with IHC4, with overweight (OR(95% CI) vs normal = 0.82(0.66–1.02)) and obese (OR(95% CI) vs normal = 0.52(0.36–0.76)) women less likely to develop high IHC4 tumors. Notably, elevated BMI was associated with higher NPI irrespective of hormone receptor-expression status. Conclusions Our findings indicate that factors affecting breast cancer incidence, particularly age, parity, FHBC, and BMI, may impact clinically relevant prognostic biomarkers with implications for surveillance, prognostication, and counseling. Supplementary Information The online version contains supplementary material available at 10.1007/s10549-021-06294-5.
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Molecular mechanisms linking high body mass index to breast cancer etiology in post-menopausal breast tumor and tumor-adjacent tissues. Breast Cancer Res Treat 2018; 173:667-677. [PMID: 30387004 DOI: 10.1007/s10549-018-5034-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE In post-menopausal women, high body mass index (BMI) is an established breast cancer risk factor and is associated with worse breast cancer prognosis. We assessed the associations between BMI and gene expression of both breast tumor and adjacent tissue in estrogen receptor-positive (ER+) and estrogen receptor-negative (ER-) diseases to help elucidate the mechanisms linking obesity with breast cancer biology in 519 post-menopausal women from the Nurses' Health Study (NHS) and NHSII. METHODS Differential gene expression was analyzed separately in ER+ and ER- disease both comparing overweight (BMI ≥ 25 to < 30) or obese (BMI ≥ 30) women to women with normal BMI (BMI < 25), and per 5 kg/m2 increase in BMI. Analyses controlled for age and year of diagnosis, physical activity, alcohol consumption, and hormone therapy use. Gene set enrichment analyses were performed and validated among a subset of post-menopausal cases in The Cancer Genome Atlas (for tumor) and Polish Breast Cancer Study (for tumor-adjacent). RESULTS No gene was differentially expressed by BMI (FDR < 0.05). BMI was significantly associated with increased cellular proliferation pathways, particularly in ER+ tumors, and increased inflammation pathways in ER- tumor and ER- tumor-adjacent tissues (FDR < 0.05). High BMI was associated with upregulation of genes involved in epithelial-mesenchymal transition in ER+ tumor-adjacent tissues. CONCLUSIONS This study provides insights into molecular mechanisms of BMI influencing post-menopausal breast cancer biology. Tumor and tumor-adjacent tissues provide independent information about potential mechanisms.
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Abstract
Statin drugs have been used for more than two decades to treat hypercholesterolemia and as cardio-preventive drugs, resulting in a marked decrease in cardiovascular morbidity and mortality worldwide. Statins halt hepatic cholesterol biosynthesis by inhibiting the rate-limiting enzyme in the mevalonate pathway, hydroxymethylglutaryl-coenzyme A reductase (HMGCR). The mevalonate pathway regulates a host of biochemical processes in addition to cholesterol production. Attenuation of these pathways is likely responsible for the myriad benefits of statin therapy beyond cholesterol reduction - the so-called pleiotropic effects of statins. Chief amongst these purported effects is anti-cancer activity. A considerable body of preclinical, epidemiologic and clinical evidence shows that statins impair proliferation of breast cancer cells and reduce the risk of breast cancer recurrence. Potential mechanisms for this effect have been explored in laboratory models, but remain poorly understood and require further investigation. The number of clinical trials assessing the putative clinical benefit of statins in breast cancer is increasing. Currently, a total of 30 breast cancer/statin trials are listed at the global trial identifier website clinicaltrials.gov. Given the compelling evidence from performed trials in a variety of clinical settings, there have been calls for a clinical trial of statins in the adjuvant breast cancer setting. It would be imperative for such a trial to incorporate tumour biomarkers predictive of statin response in its design and analysis plan. Ongoing translational clinical trials aimed at biomarker discovery will help identify, which breast cancer patients are most likely to benefit from adjuvant statin therapy, and will add valuable clinical knowledge to the field.
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Affiliation(s)
- S Borgquist
- Department of Oncology, Aarhus University Hospital, Aarhus C, Denmark.,Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - O Bjarnadottir
- Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - S Kimbung
- Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - T P Ahern
- Departments of Surgery and Biochemistry, The Robert Larner, MD College of Medicine, The University of Vermont, Burlington, VT, USA
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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.
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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
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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.
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Affiliation(s)
- Salma Butt
- Department of Surgery, Skåne University Hospital, Malmö, Lund University, Malmö, Sweden.
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Wangefjord S, Manjer J, Gaber A, Nodin B, Eberhard J, Jirström K. Cyclin D1 expression in colorectal cancer is a favorable prognostic factor in men but not in women in a prospective, population-based cohort study. Biol Sex Differ 2011; 2:10. [PMID: 21888663 PMCID: PMC3179695 DOI: 10.1186/2042-6410-2-10] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 09/03/2011] [Indexed: 11/13/2022] Open
Abstract
Background Although colorectal cancer (CRC) is generally not considered to be a hormone-dependent malignancy, several sex-related differences in incidence, molecular characteristics and survival have been reported. Epidemiological studies have consistently shown that increased exposure to female sex hormones is associated with a lower risk of CRC in women, and cyclin D1, an important downstream effector in estrogen-mediated signaling, is commonly activated in CRC. In this study, we analyzed the prognostic significance of cyclin D1 expression in CRC, with particular reference to sex-related differences, in tumors from a large, prospective, population-based cohort. Methods Using tissue microarrays and immunohistochemistry, the fraction and intensity of cyclin D1 expression was evaluated in 527 incident CRC cases from the Malmö Diet and Cancer Study. The χ2 and Spearman's rho (ρ) tests were used for comparison of cyclin D1 expression and relevant clinicopathological characteristics. Kaplan-Meier analysis and Cox proportional hazards modeling were used to assess the effect of cyclin D1 expression on cancer-specific survival (CSS) in univariate and multivariate analysis, adjusted for established prognostic factors. Results Cyclin D1 intensity was significantly lower in male compared with female CRC (P = 0.018). In the full cohort, cyclin D1 expression was associated with a significantly prolonged CSS (hazard ratio (HR) = 0.69; 95% CI 0.49 to 0.96, P = 0.026) but subgroup analysis according to gender revealed a strongly accentuated prognostic effect of cyclin D1 in male CRC (HR = 0.48; 95% CI 0.31 to 0.74, P < 0.001), which was in contrast to female CRC, where cyclin D1 was not prognostic (HR = 1.05; 95% CI 0.62 to 1.78, P = 0.864) (Pinteraction = 0.024). The prognostic value of cyclin D1 was not retained in multivariate analysis, either in the full cohort or in male CRC. Conclusions Cyclin D1 expression is strongly associated with prolonged survival in male CRC. These findings not only support an important role for cyclin D1 in colorectal carcinogenesis, but also add further weight to the accumulating evidence that CRC is indeed a hormone-dependent malignancy, for which prognostic and treatment-predictive molecular biomarkers should be evaluated differently in women and men.
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Affiliation(s)
- Sakarias Wangefjord
- Department of Clinical Sciences, Division of Pathology, Lund University, Skåne University Hospital, 221 85 Lund, Sweden.
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Wirfält E, Li C, Manjer J, Ericson U, Sonestedt E, Borgquist S, Landberg G, Olsson H, Gullberg B. Food Sources of Fat and Sex Hormone Receptor Status of Invasive Breast Tumors in Women of the Malmö Diet and Cancer Cohort. Nutr Cancer 2011; 63:722-33. [DOI: 10.1080/01635581.2011.570897] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Butt S, Borgquist S, Anagnostaki L, Landberg G, Manjer J. Parity and age at first childbirth in relation to the risk of different breast cancer subgroups. Int J Cancer 2009; 125:1926-34. [PMID: 19569233 DOI: 10.1002/ijc.24494] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The aim of the present study was to examine parity and age at first childbirth, in relation to the risk of specific breast cancer subgroups. A prospective cohort, The Malmö Diet and Cancer Study, including 17,035 women were followed with linkage to Swedish Cancer Registry until December 31, 2004. A total of 622 incident breast cancers were diagnosed during follow-up and were evaluated regarding invasiveness, tumour size, axillary lymph node status, Nottingham grade, tumour proliferation (Ki67), HER2, cyclin D1 and p27. The tumours were also examined for WHO type and hormone receptor status. Nulliparity was associated with an overall increased risk of breast cancer, although not statistically significant (the relative risk was 1.39 with a 95% confidence interval of 0.92-2.08). Nulliparity was also associated with large tumours (>20 mm) (1.89: 0.91-3.91), high Ki67 levels (1.95: 0.93-4.10), high cyclin D1 levels (2.15: 0.88-5.27), grade III (2.93: 1.29-6.64) and HER2 positive tumours (3.24: 1.02-10.25). High parity was not statistically significantly associated with any specific breast cancer subgroup. Older age at first childbirth (>30) was associated with a slightly increased risk of breast cancer (1.39: 0.94-2.07). There was a statistically significant association between late first childbirth and lobular type (2.51: 1.01-6.28), grade III tumours (2.67: 1.19-6.02), high levels of cyclin D1 (2.69: 1.18-6.12) and low levels of p27 (2.23: 1.15-4.35). We conclude that nulliparity and late first childbirth are associated with relatively more aggressive breast cancer subgroups.
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Affiliation(s)
- Salma Butt
- Department of Surgery, Malmö University Hospital, 205 02 Malmö, Sweden.
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Borgquist S, Jirström K, Anagnostaki L, Manjer J, Landberg G. Anthropometric factors in relation to different tumor biological subgroups of postmenopausal breast cancer. Int J Cancer 2009; 124:402-11. [PMID: 18798278 DOI: 10.1002/ijc.23850] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Signe Borgquist
- Center for Molecular Pathology, Department of Laboratory Medicine, Lund University, University Hospital MAS, S-205 02 Malmö, Sweden.
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Sonestedt E, Borgquist S, Ericson U, Gullberg B, Landberg G, Olsson H, Wirfält E. Plant foods and oestrogen receptor alpha- and beta-defined breast cancer: observations from the Malmo Diet and Cancer cohort. Carcinogenesis 2008; 29:2203-9. [PMID: 18711147 DOI: 10.1093/carcin/bgn196] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The associations between plant foods and breast cancer incidence are inconsistent. The objective of this study was to examine prospectively the association between dietary fibre, plant foods and breast cancer, especially the association between plant food intake and oestrogen receptor (ER) alpha- and beta-defined breast cancer. Among women without prevalent cancer from the population-based prospective Malmö Diet and Cancer cohort (n = 15 773, 46-75 years at baseline), 544 women were diagnosed with incident invasive breast cancer during a mean follow-up of 10.3 years. Information on dietary habits was collected by a modified diet history method. ER status of the tumours was determined by immunohistochemistry using tissue microarray. Cox proportional hazards regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with fibre and 11 plant food groups. High-fibre bread was significantly associated with a decreased breast cancer incidence (HR, 0.75; 95% CI, 0.57-0.98, for highest compared with lowest quintile). The other plant food groups were not significantly associated with breast cancer incidence. There was a tendency for a negative association for high-fibre bread among ERalpha (+) breast cancer (P for trend = 0.06) and ERbeta (+) breast cancer (P for trend = 0.06). Fried potatoes were statistically significantly associated with increased risk of ERbeta (-) breast cancer (P = 0.01). This study suggests that different plant foods may be differently associated with breast cancer, with fibre-rich bread showing an inverse association. We did not observe strong evidence for differences in incidence according to the ERalpha and ERbeta status of breast cancer.
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Affiliation(s)
- Emily Sonestedt
- Department of Clinical Sciences in Malmö, Lund University, SE-205 02 Malmö, Sweden.
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