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The impact of selected risk factors among breast cancer molecular subtypes: a case-only study

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Breast cancer (BC) risk factors have been differentially associated with BC subtypes, but quantification is still undefined. Therefore, we compared selected risk factors with BC subtypes, using a case-case approach.

Methods

We retrieved 1321 invasive female BCs from the Piedmont Cancer Registry. Through record linkage of clinical records, we obtained data on estrogen (Er) and progesterone (Pr) receptors, Ki67 and HER2+ status, BC family history, breast imaging reporting and data system (BI-RADS) density, reproductive risk factors and education. We defined BC subtypes as follows : luminal A (Er+ and/or Pr+ , HER2− , low Ki67), luminal BH- (Er+ and/or Pr + , HER2− , Ki67 high), luminal BH+ (Er+ and/or Pr + , HER2+), HER2+ (Er − , Pr − , HER2+), ) and triple negative (Er − , Pr − , HER2−). Using a multinomial regression model, we estimated the odds ratios (ORs) for selected BC risk factors considering luminal A as reference.

Results

For triple negative, the OR for BC family history was 1.83 (95% confidence interval (CI) 1.13–2.97). Compared to BI-RADS 1, for triple negative, the OR for BI-RADS 2 was 0.56 (95% CI 0.27–1.14) and for BI-RADS 3–4 was 0.37 (95% CI 0.15–0.88); for luminal BH +, the OR for BI-RADS 2 was 2.36 (95% CI 1.08–5.11). For triple negative, the OR for high education was 1.78 (95% CI 1.03–3.07), and for late menarche, the OR was 1.69 (95% CI 1.02–2.81). For luminal BH + , the OR for parous women was 0.56 (95% CI 0.34–0.92).

Conclusions

This study supported BC etiologic heterogeneity across subtypes, particularly for triple negative.

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Data availability

The data that support the findings of this study are available from Piedmont Cancer Registry (Registro Tumori Piemonte – RTP), but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of RTP.

Abbreviations

BC:

Breast cancer

Er:

Estrogen receptor

Pr:

Progesterone receptor

BI-RADS:

Breast imaging reporting and data system

OR:

Odds ratio

CI:

Confidence interval

IHC:

Immunohistochemistry

Registro Tumori Piemonte – RTP:

Piedmont Cancer Registry

ICD-O-3:

International Classification of Disease for Oncology 3rd edition

AOU:

Azienda Ospedaliera Universitaria

BMI:

Body mass index

WHO:

World Health Organization

BD:

Breast density

FISH:

Fluorescence in situ hybridization

pTNM:

Pathological Tumour-Node-Metastasis

CDI:

Invasive ductal carcinoma

BCAC:

Breast Cancer Association Consortium

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Authors and Affiliations

  1. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Augusto Vanzetti 5, 20133, Milano, Milan, Italy

    Margherita Pizzato, Greta Carioli & Carlo La Vecchia

  2. Piedmont Cancer Registry, Città della Salute e della Scienza di Torino, A.O.U, Turin, Italy

    Stefano Rosso & Roberto Zanetti

  3. Fondo Elena Moroni for Oncology https://www.fondoelenamoroni.org

    Roberto Zanetti

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  1. Margherita Pizzato
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  2. Greta Carioli
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  4. Roberto Zanetti
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  5. Carlo La Vecchia
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Contributions

Margherita Pizzato: study concepts and design, data acquisition, data analysis and interpretation, manuscript writing, editing and review. Greta Carioli: data analysis and interpretation, manuscript preparation, editing and review. Stefano Rosso: study design, data acquisition, manuscript writing and review. Roberto Zanetti: study design, manuscript writing and review. Carlo La Vecchia: study concepts and design, results interpretation, manuscript writing and review.

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Correspondence to Greta Carioli.

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The investigation did not involve any human contact, but only record linkage analysis of administrative healthcare databases.

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Pizzato, M., Carioli, G., Rosso, S. et al. The impact of selected risk factors among breast cancer molecular subtypes: a case-only study. Breast Cancer Res Treat 184, 213–220 (2020). https://doi.org/10.1007/s10549-020-05820-1

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