The epidemiology of triple-negative breast cancer, including race
- 866 Downloads
Predictors of intrinsic breast cancer subtypes, including the triple-negative (TN) subtype, are largely unknown. We evaluated whether anthropometrics, demographics, and reproductive history were associated with distinct breast cancer subtypes.
Invasive breast tumors from a population-based case–control study of 476 (116 black and 360 white) Atlanta women aged 20–54, diagnosed between 1990 and 1992, were centrally reviewed and immunohistochemically analyzed for estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2); then grouped [TN (ER−PR−HER2−); ER−PR−HER2+; ER/PR+HER2+; ER/PR+HER2− (case-only reference group)]. Data were from interviews and anthropometric measurements; adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression, including both case-only and case-control comparisons.
From the case-only analyses and compared with the ER/PR+HER2− subtype, women with TN tumors were more likely to be obese than normal/underweight [OR = 1.89 (95% CI = 1.22, 2.92)]. Regardless of HER2 status, ER−PR− tumors were associated with black race, young age at first birth, having a recent birth, and being overweight.
Distinct breast cancer subtypes have unique sociodemographic, anthropometric and reproductive characteristics and possibly different pathways for development.
KeywordsBreast neoplasms Molecular epidemiology Tumor biology Race
Human epidermal growth factor receptor 2
Waist to hip ratio
Body mass index
Surveillance, Epidemiology and End Results
- 13.Bauer KR, Brown M, Cress RD, Parise CR, Caggiano V (2007) Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California Cancer Registry. Cancer 109:1721–1728. doi:10.1002/cncr.22618 PubMedCrossRefGoogle Scholar
- 15.Morris GJ, Naidu S, Topham AK et al (2007) Differences in breast carcinoma characteristics in newly diagnosed African–American and Caucasian patients: a single-institution compilation compared with the National Cancer Institute’s surveillance, epidemiology, and end results database. Cancer 110:876–884. doi:10.1002/cncr.22836 PubMedCrossRefGoogle Scholar
- 16.Stark A, Kapke A, Schultz D, Brown R, Linden M, Raju U (2008) Advanced stages and poorly differentiated grade are associated with an increased risk of HER2/neu positive breast carcinoma only in white women: findings from a prospective cohort study of African–American and white-American women. Breast Cancer Res Treat 107:405–414. doi:10.1007/s10549-007-9560-5 PubMedCrossRefGoogle Scholar
- 22.National Heart Blood Lung Institute (NHLBI) expert panel on the identification, evaluation, treatment of overweight, obesity in adults (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obes Res 6(suppl 2):51S–209SGoogle Scholar
- 24.American Joint Committee on Cancer (1988) Manual for staging of cancer, 3rd edn. JB Lippincott Company, PhilladelphiaGoogle Scholar
- 30.Taylor CR, Shi SR, Chaiwun B, Young L, Imam SA, Cote RJ (1994) Strategies for improving the immunohistochemical staining of various intranuclear prognostic markers in formalin-paraffin sections: androgen receptor, estrogen receptor, progesterone receptor, p53 protein, proliferating cell nuclear antigen, and Ki-67 antigen revealed by antigen retrieval techniques (see comment). Hum Pathol 25:263–270. doi:10.1016/0046-8177(94)90198-8 PubMedCrossRefGoogle Scholar
- 31.Andersen J, Poulsen HS (1989) Immunohistochemical estrogen receptor determination in paraffin-embedded tissue. Prediction of response to hormonal treatment in advanced breast cancer. Cancer 64:1901–1908. doi:10.1002/1097-0142(19891101)64:9<1901::AID-CNCR2820640924>3.0.CO;2-W PubMedCrossRefGoogle Scholar
- 47.Ries LAG, Melbert D, Krapcho M et al (2006) SEER cancer statistics review, 1975–2004. National Cancer Institute, BethesdaGoogle Scholar