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Cancer Causes & Control
Published in: Cancer Causes & Control 4/2013

01-04-2013 | Original paper

Estrogen receptor positive tumors: Do reproductive factors explain differences in incidence between black and white women?

Authors: Erica T. Warner, Rulla M. Tamimi, Deborah A. Boggs, Bernard Rosner, Lynn Rosenberg, Graham A. Colditz, Julie R. Palmer

Published in: Cancer Causes & Control | Issue 4/2013

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Abstract

Purpose

The incidence of estrogen receptor positive (ER+) breast cancer is higher among white women relative to black women. In two large prospective cohorts, the Black Women’s Health Study (BWHS) and the Nurses’ Health Study II (NHSII), we investigated whether reproductive factors explain the difference.

Methods

During 1,582,083 person-years of follow-up of 140,914 women observed from 1995 to 2007, 327 ER+ breast cancers were identified among black women in BWHS and NHSII and 1,179 among white women in NHSII. Cox proportional hazards regression models, stratified by race and pooled, were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for the association of race, parity, age at first birth, and lactation in relation to risk of ER+ cancer with adjustment for age and other breast cancer risk factors.

Results

Age at first birth differed markedly in the two groups, with 66 % of parous black women having their first child before age 25 as compared with 36 % of white women. Each additional year of age at first birth was associated with a 4 % increased risk of ER+ breast cancer among both racial groups. Relative to nulliparous women, parous women were at decreased risk of ER+ breast cancer (HR 0.59, 95 % CI 0.20, 1.77), in black women and (HR 0.63, 95 % CI 0.45, 0.87) in white women. The HR for the association of black race with ER+ cancer was 0.67 (95 % CI 0.53, 0.84) in a model that adjusted for age only, 0.77 (95 % CI 0.61, 0.99) in a model that controlled for parity, age at first birth, and other reproductive/hormonal factors, and 0.83 (95 % CI 0.70, 0.98) in a model that additionally controlled for other breast cancer risk factors such as alcohol consumption and use of hormone supplements. Similar associations were seen among premenopausal women and in an analysis restricted to ER+PR+ tumors.

Conclusions

Reproductive factors explained some of the higher incidence of ER+ tumors among white women as compared to black women.
Literature
1.
Jemal A, Ward E, Thun M (2007) Recent trends in breast cancer incidence rates by age and tumor characteristics among US women. Breast Cancer Res 9:R28PubMedCrossRef
2.
Anderson WF, Chatterjee N, Ershler WB, Brawley OW (2002) Estrogen receptor breast cancer phenotypes in the surveillance, epidemiology, and end results database. Breast Cancer Res Treat 76:27–36PubMedCrossRef
3.
Chu KC, Anderson WF, Fritz A, Ries LAG, Brawley OW (2001) Frequency distributions of breast cancer characteristics classified by estrogen receptor and progesterone receptor status for eight racial/ethnic groups. Cancer 92:37–45PubMedCrossRef
4.
Furberg H, Millikan R, Dressler L, Newman B, Geradts J (2001) Tumor characteristics in African American and white women. Breast Cancer Res Treat 68:33–43PubMedCrossRef
5.
Kelsey JL, Gammon MD, John EM (1993) Reproductive factors and breast cancer. Epidemiol Rev 15:36PubMed
6.
Hankinson SE, Colditz GA, Hunter DJ et al (1995) Reproductive factors and family history of breast cancer in relation to plasma estrogen and prolactin levels in postmenopausal women in the Nurses’ Health Study (United States). Cancer Causes Control 6:217–224PubMedCrossRef
7.
Rosner B, Colditz GA, Willett WC (1994) Reproductive risk factors in a prospective study of breast cancer: the Nurses’ Health Study. Am J Epidemiol 139:819PubMed
8.
Palmer JR, Boggs DA, Wise LA, Ambrosone CB, Adams-Campbell LL, Rosenberg L (2011) Parity and lactation in relation to estrogen receptor negative breast cancer in African American women. Cancer Epidemiol Biomarkers Prev 20:1883–1891PubMedCrossRef
9.
Ma H, Bernstein L, Pike MC, Ursin G (2006) Reproductive factors and breast cancer risk according to joint estrogen and progesterone receptor status: a meta-analysis of epidemiological studies. Breast Cancer Res 8:R43PubMedCrossRef
10.
Colditz GA, Rosner BA, Chen WY, Holmes MD, Hankinson SE (2004) Risk factors for breast cancer according to estrogen and progesterone receptor status. J Natl Cancer Inst 96:218PubMedCrossRef
11.
Ursin G, Bernstein L, Wang Y et al (2004) Reproductive factors and risk of breast carcinoma in a study of white and African-American women. Cancer 101:353–362PubMedCrossRef
12.
Furberg H, Newman B, Moorman P, Millikan R (1999) Lactation and breast cancer risk. Int J Epidemiol 28:396–402PubMedCrossRef
13.
Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Mathews TJ, Osterman MJK (2010) Births: final data for 2008. National Vital Statistics Reports 59
14.
Mathews TJ, Hamilton BE (2009) Delayed childbearing: more women are having their first child later in life. NCHS Data Brief 21
15.
Yoo K, Tajima K, Miura S et al (1997) Breast cancer risk factors according to combined estrogen and progesterone receptor status: a case-control analysis. Am J Epidemiol 146:307–314PubMedCrossRef
16.
Arpino G, Weiss H, Lee AV et al (2005) Estrogen receptor–positive, progesterone receptor–negative breast cancer: association with growth factor receptor expression and tamoxifen resistance. J Natl Cancer Inst 97:1254PubMedCrossRef
17.
Bardou VJ, Arpino G, Elledge RM, Osborne CK, Clark GM (2003) Progesterone receptor status significantly improves outcome prediction over estrogen receptor status alone for adjuvant endocrine therapy in two large breast cancer databases. J Clin Oncol 21:1973PubMedCrossRef
18.
Colditz GA, Hankinson SE (2005) The Nurses’ Health Study: lifestyle and health among women. Nat Rev Cancer 5:388–396PubMedCrossRef
19.
Rosenberg L, Adams-Campbell L, Palmer JR (1995) The Black Women’s Health Study: a follow-up study for causes and preventions of illness. J Am Med Womens Assoc 50:56–58PubMed
20.
Collins LC, Marotti JD, Baer HJ, Tamimi RM (2008) Comparison of estrogen receptor results from pathology reports with results from central laboratory testing. J Natl Cancer Inst 100:218PubMedCrossRef
21.
Ghafoor A, Jemal A, Ward E, Cokkinides V, Smith R, Thun M (2003) Trends in breast cancer by race and ethnicity. CA Cancer J Clin 53:342–355PubMedCrossRef
22.
Chlebowski RT, Chen Z, Anderson GL et al (2005) Ethnicity and breast cancer: factors influencing differences in incidence and outcome. J Natl Cancer Inst 97:439–448PubMedCrossRef
23.
Clarke CA, Keegan TH, Yang J et al (2012) Age-specific incidence of breast cancer subtypes: understanding the black-white crossover. J Natl Cancer Inst 104:1094–1101PubMedCrossRef
24.
25.
Smigal C, Jemal A, Ward E et al (2006) Trends in breast cancer by race and ethnicity: update 2006. CA Cancer J Clin 56:168–183PubMedCrossRef
26.
Anderson WF, Chu KC, Chang S, Sherman ME (2004) Comparison of age-specific incidence rate patterns for different histopathologic types of breast carcinoma. Cancer Epidemiol Biomark Prev 13:1128
27.
Li CI, Malone KE, Daling JR (2002) Differences in breast cancer hormone receptor status and histology by race and ethnicity among women 50 years of age and older. Cancer Epidemiol Biomark Prev 11:601
28.
Chu KC, Anderson WF (2002) Rates for breast cancer characteristics by estrogen and progesterone receptor status in the major racial/ethnic groups. Breast Cancer Res Treat 74:199–211
Metadata
Title
Estrogen receptor positive tumors: Do reproductive factors explain differences in incidence between black and white women?
Authors
Erica T. Warner
Rulla M. Tamimi
Deborah A. Boggs
Bernard Rosner
Lynn Rosenberg
Graham A. Colditz
Julie R. Palmer
Publication date
01-04-2013
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 4/2013
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-013-0153-9

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