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Impact of reproductive factors on breast cancer subtypes in postmenopausal women: a retrospective single-center study

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Some reproductive factors are well-known general risk factors for breast cancer (BC). On the other hand, BC subtypes also have a high prognostic value. Correlations, however, that link these risk factors to the development of a particular one of the different BC subtypes are still poorly understood. The primary objective of our study was to assess the influence of different reproductive factors (duration of breastfeeding, parity, and age at first childbirth) on pathological BC subtypes. Secondarily, we correlated body mass index (BMI), age at primary diagnosis, and smoking behavior with tumor subclasses.

Patients and methods

We performed a retrospective chart review of 1082 patients with BC who had been treated for postmenopausal BC at the Heidelberg University Hospital during the period 2009–2014. For statistical analysis, different types of correlation analysis as well as a logistic regression model were used.

Results

Relating to the primary objective, we found that patients with luminal-like BC had significantly fewer children than patients with triple-negative or HER2-positive subtype tumors (P = 0.027). Concerning the duration of breastfeeding, patients with a luminal A-like tumor had a significantly lower mean nursing period than patients with other subtypes (P = 0.012). Furthermore, patients who did breastfeed presented with a significantly lower number of hormone receptor-positive tumors (estrogen receptor-positive, P = 0.04; progesterone receptor-positive, P = 0.017) but the highest rate of HER2-overexpressing malignancies (P = 0.011). Moreover, late first childbirth was associated with the occurrence of luminal tumors (OR 0.952; P = 0.041). Regarding our secondary aim, higher BMI (P = 0.031) and higher age at primary diagnosis (P = 0.038) were both found to be significantly associated with luminal-like BC.

Conclusion

The results suggest a correlation of the occurrence of luminal-like BC subtypes with low parity and short or no duration of breastfeeding. Prospective investigations are needed for further confirmation and to evaluate the molecular basis of our findings.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics / National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany

    Alexandra von Au, Mona Klotzbuecher, Mark Boudewijns, Laura Michel, Markus Wallwiener, Joerg Heil, Michael Golatta, Joachim Rom, Christof Sohn, Andreas Schneeweiss, Florian Schuetz & Christoph Domschke

  2. Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Im Neuenheimer Feld 130, 69120, Heidelberg, Germany

    Lorenz Uhlmann

Authors
  1. Alexandra von Au
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  2. Mona Klotzbuecher
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  3. Lorenz Uhlmann
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  4. Mark Boudewijns
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  5. Laura Michel
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  6. Markus Wallwiener
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  7. Joerg Heil
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  8. Michael Golatta
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  9. Joachim Rom
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  10. Christof Sohn
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  11. Andreas Schneeweiss
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  12. Florian Schuetz
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  13. Christoph Domschke
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Corresponding author

Correspondence to Christoph Domschke.

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No actual or potential conflicts of interest were disclosed.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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von Au, A., Klotzbuecher, M., Uhlmann, L. et al. Impact of reproductive factors on breast cancer subtypes in postmenopausal women: a retrospective single-center study. Arch Gynecol Obstet 295, 971–978 (2017). https://doi.org/10.1007/s00404-017-4298-8

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  • DOI: https://doi.org/10.1007/s00404-017-4298-8

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