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Cancer Causes & Control
Published in: Cancer Causes & Control 2/2016

01-02-2016 | Original paper

Breast cancer risk factor associations differ for pure versus invasive carcinoma with an in situ component in case–control and case–case analyses

Authors: Melanie Ruszczyk, Gary Zirpoli, Shicha Kumar, Elisa V. Bandera, Dana H. Bovbjerg, Lina Jandorf, Thaer Khoury, Helena Hwang, Gregory Ciupak, Karen Pawlish, Pepper Schedin, Patricia Masso-Welch, Christine B. Ambrosone, Chi-Chen Hong

Published in: Cancer Causes & Control | Issue 2/2016

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Abstract

Purpose

Invasive ductal carcinoma (IDC) is diagnosed with or without a ductal carcinoma in situ (DCIS) component. Previous analyses have found significant differences in tumor characteristics between pure IDC lacking DCIS and mixed IDC with DCIS. We will test our hypothesis that pure IDC represents a form of breast cancer with etiology and risk factors distinct from mixed IDC/DCIS.

Methods

We compared reproductive risk factors for breast cancer risk, as well as family and smoking history between 831 women with mixed IDC/DCIS (n = 650) or pure IDC (n = 181), and 1,620 controls, in the context of the Women’s Circle of Health Study (WCHS), a case–control study of breast cancer in African-American and European-American women. Data on reproductive and lifestyle factors were collected during interviews, and tumor characteristics were abstracted from pathology reports. Case–control and case–case analyses were conducted using unconditional logistic regression.

Results

Most risk factors were similarly associated with pure IDC and mixed IDC/DCIS. However, among postmenopausal women, risk of pure IDC was lower in women with body mass index (BMI) 25 to <30 [odds ratio (OR) 0.66; 95 % confidence interval (CI) 0.35–1.23] and BMI ≥ 30 (OR 0.33; 95 % CI 0.18–0.67) compared to women with BMI < 25, with no associations with mixed IDC/DCIS. In case–case analyses, women who breastfed up to 12 months (OR 0.55; 95 % CI 0.32–0.94) or longer (OR 0.47; 95 % CI 0.26–0.87) showed decreased odds of pure IDC than mixed IDC/DCIS compared to those who did not breastfeed.

Conclusions

Associations with some breast cancer risk factors differed between mixed IDC/DCIS and pure IDC, potentially suggesting differential developmental pathways. These findings, if confirmed in a larger study, will provide a better understanding of the developmental patterns of breast cancer and the influence of modifiable risk factors, which in turn could lead to better preventive measures for pure IDC, which have worse disease prognosis compared to mixed IDC/DCIS.
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Metadata
Title
Breast cancer risk factor associations differ for pure versus invasive carcinoma with an in situ component in case–control and case–case analyses
Authors
Melanie Ruszczyk
Gary Zirpoli
Shicha Kumar
Elisa V. Bandera
Dana H. Bovbjerg
Lina Jandorf
Thaer Khoury
Helena Hwang
Gregory Ciupak
Karen Pawlish
Pepper Schedin
Patricia Masso-Welch
Christine B. Ambrosone
Chi-Chen Hong
Publication date
01-02-2016
Publisher
Springer International Publishing
Published in
Cancer Causes & Control / Issue 2/2016
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-015-0696-z

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