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Open Access 01-12-2023 | Breast Cancer | Research

Association of reproductive risk factors and breast cancer molecular subtypes: a systematic review and meta-analysis

Authors: Xihua Mao, Chioma Omeogu, Shama Karanth, Ashwini Joshi, Clare Meernik, Lauren Wilson, Amy Clark, April Deveaux, Chunyan He, Tisha Johnson, Karen Barton, Samantha Kaplan, Tomi Akinyemiju

Published in: BMC Cancer | Issue 1/2023

Abstract

Background

Associations between reproductive factors and breast cancer (BC) risk vary by molecular subtype (i.e., luminal A, luminal B, HER2, and triple negative/basal-like [TNBC]). In this systematic review and meta-analysis, we summarized the associations between reproductive factors and BC subtypes.

Methods

Studies from 2000 to 2021 were included if BC subtype was examined in relation to one of 11 reproductive risk factors: age at menarche, age at menopause, age at first birth, menopausal status, parity, breastfeeding, oral contraceptive (OC) use, hormone replacement therapy (HRT), pregnancy, years since last birth and abortion. For each reproductive risk factor, BC subtype, and study design (case–control/cohort or case-case), random-effects models were used to estimate pooled relative risks and 95% confidence intervals.

Results

A total of 75 studies met the inclusion criteria for systematic review. Among the case–control/cohort studies, later age at menarche and breastfeeding were consistently associated with decreased risk of BC across all subtypes, while later age at menopause, later age of first childbirth, and nulliparity/low parity were associated with increased risk of luminal A, luminal B, and HER2 subtypes. In the case-only analysis, compared to luminal A, postmenopausal status increased the risk of HER2 and TNBC. Associations were less consistent across subtypes for OC and HRT use.

Conclusion

Identifying common risk factors across BC subtypes can enhance the tailoring of prevention strategies, and risk stratification models can benefit from subtype specificity. Adding breastfeeding status to current BC risk prediction models can enhance predictive ability, given the consistency of the associations across subtypes.

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Title: Association of reproductive risk factors and breast cancer molecular subtypes: a systematic review and meta-analysis
Authors: Xihua Mao
Chioma Omeogu
Shama Karanth
Ashwini Joshi
Clare Meernik
Lauren Wilson
Amy Clark
April Deveaux
Chunyan He
Tisha Johnson
Karen Barton
Samantha Kaplan
Tomi Akinyemiju
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Breast Cancer
Breast Cancer
Published in: BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-023-11049-0

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Keynote webinar | Spotlight on antibody–drug conjugates in cancer

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Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

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