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Hypertensive diseases of pregnancy and risk of breast cancer in the Black Women’s Health Study

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

Abstract

Purpose

Compared to white women, Black women have increased risk of developing hypertensive diseases of pregnancy (HDOP) and have a higher incidence of aggressive breast cancer subtypes. Few studies of HDOP and breast cancer risk have included large numbers of Black women. This study examined the relation of HDOP to incidence of breast cancer overall and by estrogen receptor (ER) status in Black women.

Methods

We followed 42,982 parous women in the Black Women’s Health Study, a nationwide prospective study of Black women. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) to assess associations of self-reported HDOP, including preeclampsia and gestational hypertension, with breast cancer incidence overall and by ER subtype, adjusted for age and established breast cancer risk factors.

Results

Over 20 years of follow-up, we identified 2376 incident breast cancer cases. History of HDOP (11.7%) was not associated with breast cancer risk overall (HR 0.98; 95% CI 0.87, 1.11). HRs for invasive ER+ and ER– breast cancer were 1.11 (95% CI 0.93, 1.34) and 0.81 (95% CI 0.61, 1.07), respectively.

Conclusions

HDOP was not associated with risk of overall breast cancer in Black women. A suggestive inverse association with ER– breast cancer may reflect an anti-tumorigenic hormone profile in HDOP, but those results require confirmation in other studies.

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Data availability

The data underlying this article cannot be shared publicly to protect the confidentiality of of individuals who participated in the study. The data will be shared on reasonable request to the corresponding author.

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Acknowledgements

Data on breast cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA). The BWHS study protocol was approved by the Boston University Medical Campus Institutional Review Board (IRB) and by the IRBs of participating cancer registries as required. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, the National Institutes of Health, or the state cancer registries. We thank participants and staff of the BWHS for their contributions. We would also like to thank Rinka Murakami for her assistance with the literature search.

Funding

This work was supported by the National Institutes of Health (CA058420, CA164974, and CA151135). Julie R. Palmer received support from the Susan G. Komen Foundation (SAC180086) and the Karin Grunebaum Cancer Research Foundation. Zahna Bigham received support from the Medical Scientist Training Program at Tufts University (T32 GM00844826) and the Susan G. Komen Foundation (GTDR15333918). Karen M. Freund received support from the American Cancer Society (# CRP-17–112-06-COUN) and the Susan G. Komen Foundation (GTDR15333918).

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Authors and Affiliations

  1. Tufts University School of Medicine and Graduate School of Biomedical Sciences, Boston, MA, USA

    Zahna Bigham & Karen M. Freund

  2. Slone Epidemiology Center at Boston University, 72 East Concord Street, L-7, Boston, MA, USA

    Yvonne Robles, Julie R. Palmer & Kimberly A. Bertrand

  3. Department of Medicine, Tufts Medical Center, Boston, MA, USA

    Karen M. Freund

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  1. Zahna Bigham
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Correspondence to Kimberly A. Bertrand.

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Conflict of interest

Karen M. Freund receives support from the American Cancer Society (# CRP-17–112-06-COUN) and the Susan G. Komen Foundation (GTDR15333918). She received a $1000 honorarium from the National Minority Quality Forum to support the work of the National Minority Quality Forum in developing a framework on addressing cancer health disparities in 2019, which was prior to initiation of the current research.

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All study procedures received approval by the Boston University Institutional Review Board.

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Bigham, Z., Robles, Y., Freund, K.M. et al. Hypertensive diseases of pregnancy and risk of breast cancer in the Black Women’s Health Study. Breast Cancer Res Treat 194, 127–135 (2022). https://doi.org/10.1007/s10549-022-06606-3

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