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01-01-2018 | Original paper

Reproductive risk factor associations with lobular and ductal carcinoma in the Carolina Breast Cancer Study

Authors: Lindsay A. Williams, Hazel B. Nichols, Katherine A. Hoadley, Chiu Kit Tse, Joseph Geradts, Mary Elizabeth Bell, Charles M. Perou, Michael I. Love, Andrew F. Olshan, Melissa A. Troester

Published in: Cancer Causes & Control | Issue 1/2018

Abstract

Background

Invasive lobular breast tumors display unique reproductive risk factor profiles. Lobular tumors are predominantly Luminal A subtype, and it is unclear whether reported risk factor associations are independent of molecular subtype.

Methods

Polytomous logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the associations between risk factors and histologic subtype [ductal (n = 2,856), lobular (n = 326), and mixed ductal–lobular (n = 473)] in the Carolina Breast Cancer Study (1993–2013). Three-marker immunohistochemical clinical subtypes were defined as Luminal A (ER+ or PR+/HER2-), Luminal B (ER+ or PR+/HER2+), Triple Negative (ER−/PR−/HER2-), and HER2+ (ER−/PR−/HER2+).

Results

In case–case analyses compared to ductal, lobular tumors were significantly associated with lactation duration > 12 months [OR 1.86, 95% CI (1.33–2.60)], age at first birth ≥ 26 years [OR: 1.35, 95% CI: (1.03–1.78)], and current oral contraceptive use [OR: 1.86, 95% CI: (1.08–3.20)]. Differences in risk factor associations between ductal and lobular tumors persisted after restricting to Luminal A subtype.

Conclusions

Lobular tumors were associated with older age at first birth, increased lactation duration, and current oral contraceptive use. Etiologic heterogeneity by histology persisted after restricting to Luminal A subtype, suggesting both tumor histology and intrinsic subtype play integral parts in breast cancer risk.

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Title: Reproductive risk factor associations with lobular and ductal carcinoma in the Carolina Breast Cancer Study
Authors: Lindsay A. Williams
Hazel B. Nichols
Katherine A. Hoadley
Chiu Kit Tse
Joseph Geradts
Mary Elizabeth Bell
Charles M. Perou
Michael I. Love
Andrew F. Olshan
Melissa A. Troester
Publication date: 01-01-2018
Publisher: Springer International Publishing
Published in: Cancer Causes & Control / Issue 1/2018
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-017-0977-9

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