Skip to main content

Advertisement

Log in

A case–control study of reproductive factors associated with subtypes of breast cancer in Northeast China

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Based on the expression of estrogen receptor (ER), progesterone receptor (PR) and HER2/neu (HER2), breast cancer is classified into several subtypes: luminal A (ER+ and/or PR+, HER2−), luminal B (ER+ and/or PR+, HER2+), HER2-overexpressing (ER−, PR−, and HER2+) and triple-negative (ER−, PR−, and HER2−). The aim of this case–control study is to determine reproductive factors associated with breast cancer subtypes in Chinese women. A total of 1,417 patients diagnosed with breast cancer in the First Affiliated Hospital, China Medical University, Shenyang, China between 2001 and 2009 and 1,587 matched controls without a prior breast cancer were enrolled. Personal interviews were conducted to obtain information on reproductive characteristics and clinical history. Relationships between the factors and the subtypes of breast cancer were examined using logistic regression to compute odds ratios (OR) and 95% confidence intervals (CI). Notably, luminal A (50.0%) was the most prevalent subtype relative to luminal B (15.10%), HER2-overexpressing (10.87%) and triple-negative (23.08%). Menarche at an early age was associated with a reduced risk of luminal A (OR, 2.35; 95% CI, 1.45–3.81). Breastfeeding protected parous women from any subtype of breast cancer. Postmenopause and spontaneous abortion were inversely associated with the risk of luminal tumors. By contrast, multiparity, family history of breast cancer and induced abortion increased the risk of breast cancer. Collectively, our findings suggest that reproductive factors such as age at menarche, parity, breastfeeding, menopausal status and abortion history have different effects on the subtypes of breast cancer in Chinese women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Perou C, et al. Molecular portraits of human breast tumors. Nature. 2000;406:747–52.

    Article  CAS  PubMed  Google Scholar 

  2. Sorlie T, et al. Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci USA. 2003;100:8418–23.

    Article  CAS  PubMed  Google Scholar 

  3. Nielsen TO, et al. Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res. 2004;10:5367–74.

    Article  CAS  PubMed  Google Scholar 

  4. Carey LA, et al. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA. 2006;295:2492–502.

    Article  CAS  PubMed  Google Scholar 

  5. Rakha EA, et al. Basal phenotype identifies a poor prognostic subgroup of breast cancer of clinical importance. Eur J Cancer. 2006;42:3149–56.

    Article  CAS  PubMed  Google Scholar 

  6. Sørlie T, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2001;98:10869–74.

    Article  PubMed  Google Scholar 

  7. Cleator S, Heller W, Coombes RC. Triple-negative breast cancer: therapeutic options. Lancet Oncol. 2007;8:235–44.

    Article  PubMed  Google Scholar 

  8. Shantakumar S, et al. Reproductive factors and breast cancer risk among older women. Breast Cancer Res Treat. 2007;102:365–74.

    Article  PubMed  Google Scholar 

  9. Kwan ML, et al. Epidemiology of breast cancer subtypes in two prospective cohort studies of breast cancer survivors. Breast Cancer Res. 2009;11:R31.

    Article  PubMed  Google Scholar 

  10. Phipps AI, Malone KE, Porter PL, Daling JR, Li CI. Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer. Cancer. 2008;113:1521–6.

    Article  PubMed  Google Scholar 

  11. Phipps AI, Malone KE, Porter PL, Daling JR, Li CI. Body size and risk of luminal, HER2-overexpressing, and triple-negative breast cancer in postmenopausal women. Cancer Epidemiol Biomarkers Prev. 2008;17:2078–86.

    Article  CAS  PubMed  Google Scholar 

  12. Li CI, Malone KE, Daling JR. Differences in breast cancer hormone receptor status and histology by race and ethnicity among women 50 years of age and older. Cancer Epidemiol Biomarkers Prev. 2002;11:601–7.

    PubMed  Google Scholar 

  13. Piper GL, Patel NA, Patel JA, Malay MB, Julian TB. Neoadjuvant chemotherapy for locally advanced breast cancer results in alterations in preoperative tumor marker status. Am Surg. 2004;70:1103–6.

    CAS  PubMed  Google Scholar 

  14. Adams AL, Eltoum I, Krontiras H, Wang W, Chhieng DC. The effect of neoadjuvant chemotherapy on histologic grade, hormone receptor status, and HER2/neu status in breast carcinoma. Breast J. 2008;14:141–6.

    Article  PubMed  Google Scholar 

  15. Huang HJ, et al. Hormone receptors do not predict the HER2/neu status in all age groups of women with an operable breast cancer. Ann Oncol. 2005;16:1755–61.

    Article  CAS  PubMed  Google Scholar 

  16. Carey LA, et al. American Joint Committee on Cancer tumor-node-metastasis stage after neoadjuvant chemotherapy and breast cancer outcome. J Natl Cancer Inst. 2005;97:1137–42.

    Article  PubMed  Google Scholar 

  17. Ihemelandu CU, et al. Molecular breast cancer subtypes in premenopausal African-American women, tumor biologic factors and clinical outcome. Ann Surg Oncol. 2007;14:2994–3003.

    Article  PubMed  Google Scholar 

  18. Peeters PH, Verbeek AL, Krol A, Matthyssen MM, de Waard F. Age at menarche and breast cancer risk in nulliparous women. Breast Cancer Res Treat. 1995;33:55–61.

    Article  CAS  PubMed  Google Scholar 

  19. Kotsopoulos J, et al. Age at menarche and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Cancer Causes Control. 2005;16:667–74.

    Article  PubMed  Google Scholar 

  20. Huo D, et al. Parity and breastfeeding are protective against breast cancer in Nigerian women. Br J Cancer. 2008;98:992–6.

    Article  CAS  PubMed  Google Scholar 

  21. Gajalakshmi V, et al. Breastfeeding and breast cancer risk in India: a multicenter case–control study. Int J Cancer. 2009;125:662–5.

    Article  CAS  PubMed  Google Scholar 

  22. Gao YT, et al. Association of menstrual and reproductive factors with breast cancer risk: results from the Shanghai Breast Cancer Study. Int J Cancer. 2000;87:295–300.

    Article  CAS  PubMed  Google Scholar 

  23. Shema L, Ore L, Ben-Shachar M, Haj M, Linn S. The association between breastfeeding and breast cancer occurrence among Israeli Jewish women: a case control study. J Cancer Res Clin Oncol. 2007;133:539–46.

    Article  PubMed  Google Scholar 

  24. Lord SJ, et al. Breast cancer risk and hormone receptor status in older women by parity, age of first birth, and breastfeeding: a case–control study. Cancer Epidemiol Biomarkers Prev. 2008;17:1723–30.

    Article  CAS  PubMed  Google Scholar 

  25. Michels KB, Xue F, Colditz GA, Willett WC. Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study. Arch Intern Med. 2007;167:814–20.

    Article  PubMed  Google Scholar 

  26. Clavel-Chapelon F, E3 N-EPIC Group. Differential effects of reproductive factors on the risk of pre- and postmenopausal breast cancer. Results from a large cohort of French women. Br J Cancer. 2002;86:723–7.

    Article  CAS  PubMed  Google Scholar 

  27. Burns PE, Lees AW, Hurlburt ME, May CL, Grace M. Reproductive events and family history as risk factors for breast cancer in northern Alberta. Can Med Assoc J. 1981;124:1451–7.

    CAS  PubMed  Google Scholar 

  28. Colditz GA, Rosner BA, Speizer FE. Risk factors for breast cancer according to family history of breast cancer. For the Nurses’ Health Study Research Group. J Natl Cancer Inst. 1996;88:365–71.

    Article  CAS  PubMed  Google Scholar 

  29. Olsson H, Bladström A. A cohort study of reproductive factors and family history of breast cancer in southern Sweden. Breast Cancer Res Treat. 2002;76:203–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jiguang Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Xing, P., Li, J. & Jin, F. A case–control study of reproductive factors associated with subtypes of breast cancer in Northeast China. Med Oncol 27, 926–931 (2010). https://doi.org/10.1007/s12032-009-9308-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12032-009-9308-7

Keywords

Navigation