Recent Use of Oral Contraceptives and Risk of Luminal B, Triple-Negative, and HER2-Overexpressing Breast Cancer
- 9 Downloads
Oral contraceptive use is a well-established risk factor for breast cancer and is common among reproductive-aged women in the USA. Its relationship with less common, more aggressive, molecular subtypes is less clear. A population-based case-case analysis was conducted comparing three less common molecular subtypes to luminal A breast cancer among 1701 premenopausal cases aged 21–49 diagnosed with a first primary invasive breast cancer between 2004 and 2015. Medical record reviews and structured interviewer-administered questionnaires were used to collect data on oral contraceptive use. Multinomial logistic regression was used to estimate odds ratios (OR) and corresponding 95% confidence intervals (95% CI) for recency of oral contraceptive use for each subtype of breast cancer. Current use of oral contraceptives and use within 5 years before diagnosis was associated with lower odds of H2E tumors compared with luminal A tumors [OR = 0.5, 95% CI: 0.3, 0.9 and OR = 0.5, 95% CI: 0.4, 0.8, respectively] with increasing duration associated with decreasing odds (p for trend < 0.05). Oral contraceptive use was not associated with risks of TN or luminal B breast cancer. Oral contraceptive use may be more strongly positively associated with risks of luminal A, luminal B, and TN breast cancer than with risk of H2E tumors. These findings contribute to the etiological understanding of different molecular subtypes of breast cancer.
KeywordsOral contraceptives Breast cancer Triple-negative HER2-overexpressing Luminal
This project was supported by the National Cancer Institute (grant numbers: 261201000029C (to C.I. Li), P50 CA148143 (to L.S. Cook, D.A. Hill, C.I. Li), 261201000033C (to C.L. Wiggins), Cancer Center Support Grant 2 P30 CA118100-11 (to L.S. Cook, D.A. Hill, C.L. Wiggins), and Contract HHSN261201800014I, Task Order HHSN26100001 (to C.L. Wiggins)) and the Department of Defense Breast Cancer Research Program (grant number: BC112721 (to C.I. Li)).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
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.
Informed consent was obtained from all individual participants included in the study.
- 1.Collaborative Group on Hormonal Factors in Breast Cancer (1996) Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53,297 women with breast cancer and 100,239 women without breast cancer from 54 epidemiological studies. Lancet 347(9017):1713–1727CrossRefGoogle Scholar
- 2.Blows FM, Driver KE, Schmidt MK, Broeks A, van Leeuwen FE, Wesseling J, Cheang MC, Gelmon K, Nielsen TO, Blomqvist C, Heikkilä P, Heikkinen T, Nevanlinna H, Akslen LA, Bégin LR, Foulkes WD, Couch FJ, Wang X, Cafourek V, Olson JE, Baglietto L, Giles GG, Severi G, McLean CA, Southey MC, Rakha E, Green AR, Ellis IO, Sherman ME, Lissowska J, Anderson WF, Cox A, Cross SS, Reed MWR, Provenzano E, Dawson S-J, Dunning AM, Humphreys M, Easton DF, García-Closas M, Caldas C, Pharoah PD, Huntsman D (2010) Subtyping of breast cancer by immunohistochemistry to investigate a relationship between subtype and short and long term survival: a collaborative analysis of data for 10,159 cases from 12 studies. PLoS Med 7:e1000279. https://doi.org/10.1371/journal.pmed.1000279 CrossRefGoogle Scholar
- 4.Bethea TN, Rosenburg L, Hong C-C, Rosenberg L, Hong C-C, Troester MA, Lunetta KL, Bandera EV, Schedin P, Kolonel LN, Olshan AF, Ambrosone CB, Palmer JR (2015) A case–control analysis of oral contraceptive use and breast cancer subtypes in the African American Breast Cancer Epidemiology and Risk Consortium. Breast Cancer Res 17:22. https://doi.org/10.1186/s13058-015-0535-x CrossRefGoogle Scholar
- 6.Li L, Zhong Y, Zhang H et al (2017) Association between oral contraceptive use as a risk factor and triple-negative breast cancer: a systematic review and meta-analysis. Mol Clin Oncol. https://doi.org/10.3892/mco.2017.1259
- 7.Ma H, Wang Y, Sullivan-Halley J, Weiss L, Marchbanks PA, Spirtas R, Ursin G, Burkman RT, Simon MS, Malone KE, Strom BL, McDonald JA, Press MF, Bernstein L (2010) Use of four biomarkers to evaluate the risk of breast cancer subtypes in the Women’s Contraceptive and Reproductive Experiences Study. Cancer Res 70:575–587. https://doi.org/10.1158/0008-5472.CAN-09-3460 CrossRefGoogle Scholar
- 8.Phipps AI, Chlebowski RT, Prentice R, McTiernan A, Wactawski-Wende J, Kuller LH, Adams-Campbell LL, Lane D, Stefanick ML, Vitolins M, Kabat GC, Rohan TE, Li CI (2011) Reproductive history and oral contraceptive use in relation to risk of triple-negative breast cancer. J Natl Cancer Inst 103:470–477. https://doi.org/10.1093/jnci/djr030 CrossRefGoogle Scholar
- 9.Gaudet MM, Press MF, Haile RW, Lynch CF, Glaser SL, Schildkraut J, Gammon MD, Douglas Thompson W, Bernstein JL (2011) Risk factors by molecular subtypes of breast cancer across a population-based study of women 56 years or younger. Breast Cancer Res Treat 130:587–597. https://doi.org/10.1007/s10549-011-1616-x CrossRefGoogle Scholar
- 14.Margolese RG, Hortobagyi GN, Buchholz TA (2003) Breast cancer biology, ed. Kufe DW, Pollock RE, Weichselbaum RR, et al. Hamilton (ON): BC Decker Holland-Frei cancer medicine (6th edition). Available from: https://www.ncbi.nlm.nih.gov/books/NBK13081/
- 21.Collaborative Group on Hormonal Factors in Breast Cancer (2002) Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet 360(9328):187–195CrossRefGoogle Scholar
- 22.Gammon MD, Hibshoosh H, Terry MB et al (1999) Oral contraceptive use and other risk factors in relation to HER-2/neu overexpression in breast cancer among young women. Cancer Epidemiol Biomark Prev 8:413–419Google Scholar