Parity, lactation, and breast cancer subtypes in African American Women: Results from the AMBER Consortium

Julie R. Palmer, Emma Viscidi, Melissa A. Troester, Chi Chen Hong, Pepper Schedin, Traci N. Bethea, Elisa V. Bandera, Virginia Borges, Craig McKinnon, Christopher A. Haiman, Kathryn Lunetta, Laurence N. Kolonel, Lynn Rosenberg, Andrew F. Olshan, Christine B. Ambrosone

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Background African American (AA) women have a disproportionately high incidence of estrogen receptor-negative (ER-) breast cancer, a subtype with a largely unexplained etiology. Because childbearing patterns also differ by race/ ethnicity, with higher parity and a lower prevalence of lactation in AA women, we investigated the relation of parity and lactation to risk of specific breast cancer subtypes. Methods Questionnaire data from two cohort and two case-control studies of breast cancer in AA women were combined and harmonized. Case patients were classified as ER+ (n = 2446), ER- (n = 1252), or triple negative (ER-, PR-, HER2-; n = 567) based on pathology data; there were 14 180 control patients. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated in polytomous logistic regression analysis with adjustment for study, age, reproductive and other risk factors. Results ORs for parity relative to nulliparity was 0.92 (95% CI = 0.81 to 1.03) for ER+, 1.33 (95% CI = 1.11 to 1.59) for ER-, and 1.37 (95% CI = 1.06 to 1.70) for triple-negative breast cancer. Lactation was associated with a reduced risk of ER- (OR = 0.81, 95% CI = 0.69 to 0.95) but not ER+ cancer. ER- cancer risk increased with each additional birth in women who had not breastfed, with an OR of 1.68 (95% CI = 1.15 to 2.44) for 4 or more births relative to one birth with lactation. Conclusions The findings suggest that parous women who have not breastfed are at increased risk of ER- and triple-negative breast cancer. Promotion of lactation may be an effective tool for reducing occurrence of the subtypes that contribute disproportionately to breast cancer mortality.

Original languageEnglish (US)
Article numberdju237
JournalJournal of the National Cancer Institute
Volume106
Issue number10
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Fingerprint

Parity
Lactation
Estrogen Receptors
African Americans
Breast Neoplasms
Confidence Intervals
Odds Ratio
Triple Negative Breast Neoplasms
Parturition
Case-Control Studies
Neoplasms
Logistic Models
Regression Analysis
Pathology
Mortality
Incidence

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

Parity, lactation, and breast cancer subtypes in African American Women : Results from the AMBER Consortium. / Palmer, Julie R.; Viscidi, Emma; Troester, Melissa A.; Hong, Chi Chen; Schedin, Pepper; Bethea, Traci N.; Bandera, Elisa V.; Borges, Virginia; McKinnon, Craig; Haiman, Christopher A.; Lunetta, Kathryn; Kolonel, Laurence N.; Rosenberg, Lynn; Olshan, Andrew F.; Ambrosone, Christine B.

In: Journal of the National Cancer Institute, Vol. 106, No. 10, dju237, 01.10.2014.

Research output: Contribution to journalArticle

Palmer, JR, Viscidi, E, Troester, MA, Hong, CC, Schedin, P, Bethea, TN, Bandera, EV, Borges, V, McKinnon, C, Haiman, CA, Lunetta, K, Kolonel, LN, Rosenberg, L, Olshan, AF & Ambrosone, CB 2014, 'Parity, lactation, and breast cancer subtypes in African American Women: Results from the AMBER Consortium', Journal of the National Cancer Institute, vol. 106, no. 10, dju237. https://doi.org/10.1093/jnci/dju237
Palmer, Julie R. ; Viscidi, Emma ; Troester, Melissa A. ; Hong, Chi Chen ; Schedin, Pepper ; Bethea, Traci N. ; Bandera, Elisa V. ; Borges, Virginia ; McKinnon, Craig ; Haiman, Christopher A. ; Lunetta, Kathryn ; Kolonel, Laurence N. ; Rosenberg, Lynn ; Olshan, Andrew F. ; Ambrosone, Christine B. / Parity, lactation, and breast cancer subtypes in African American Women : Results from the AMBER Consortium. In: Journal of the National Cancer Institute. 2014 ; Vol. 106, No. 10.
@article{3044eb5f769c452eb600bcad3275212b,
title = "Parity, lactation, and breast cancer subtypes in African American Women: Results from the AMBER Consortium",
abstract = "Background African American (AA) women have a disproportionately high incidence of estrogen receptor-negative (ER-) breast cancer, a subtype with a largely unexplained etiology. Because childbearing patterns also differ by race/ ethnicity, with higher parity and a lower prevalence of lactation in AA women, we investigated the relation of parity and lactation to risk of specific breast cancer subtypes. Methods Questionnaire data from two cohort and two case-control studies of breast cancer in AA women were combined and harmonized. Case patients were classified as ER+ (n = 2446), ER- (n = 1252), or triple negative (ER-, PR-, HER2-; n = 567) based on pathology data; there were 14 180 control patients. Odds ratios (ORs) and 95{\%} confidence intervals (CIs) were estimated in polytomous logistic regression analysis with adjustment for study, age, reproductive and other risk factors. Results ORs for parity relative to nulliparity was 0.92 (95{\%} CI = 0.81 to 1.03) for ER+, 1.33 (95{\%} CI = 1.11 to 1.59) for ER-, and 1.37 (95{\%} CI = 1.06 to 1.70) for triple-negative breast cancer. Lactation was associated with a reduced risk of ER- (OR = 0.81, 95{\%} CI = 0.69 to 0.95) but not ER+ cancer. ER- cancer risk increased with each additional birth in women who had not breastfed, with an OR of 1.68 (95{\%} CI = 1.15 to 2.44) for 4 or more births relative to one birth with lactation. Conclusions The findings suggest that parous women who have not breastfed are at increased risk of ER- and triple-negative breast cancer. Promotion of lactation may be an effective tool for reducing occurrence of the subtypes that contribute disproportionately to breast cancer mortality.",
author = "Palmer, {Julie R.} and Emma Viscidi and Troester, {Melissa A.} and Hong, {Chi Chen} and Pepper Schedin and Bethea, {Traci N.} and Bandera, {Elisa V.} and Virginia Borges and Craig McKinnon and Haiman, {Christopher A.} and Kathryn Lunetta and Kolonel, {Laurence N.} and Lynn Rosenberg and Olshan, {Andrew F.} and Ambrosone, {Christine B.}",
year = "2014",
month = "10",
day = "1",
doi = "10.1093/jnci/dju237",
language = "English (US)",
volume = "106",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
number = "10",

}

TY - JOUR

T1 - Parity, lactation, and breast cancer subtypes in African American Women

T2 - Results from the AMBER Consortium

AU - Palmer, Julie R.

AU - Viscidi, Emma

AU - Troester, Melissa A.

AU - Hong, Chi Chen

AU - Schedin, Pepper

AU - Bethea, Traci N.

AU - Bandera, Elisa V.

AU - Borges, Virginia

AU - McKinnon, Craig

AU - Haiman, Christopher A.

AU - Lunetta, Kathryn

AU - Kolonel, Laurence N.

AU - Rosenberg, Lynn

AU - Olshan, Andrew F.

AU - Ambrosone, Christine B.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Background African American (AA) women have a disproportionately high incidence of estrogen receptor-negative (ER-) breast cancer, a subtype with a largely unexplained etiology. Because childbearing patterns also differ by race/ ethnicity, with higher parity and a lower prevalence of lactation in AA women, we investigated the relation of parity and lactation to risk of specific breast cancer subtypes. Methods Questionnaire data from two cohort and two case-control studies of breast cancer in AA women were combined and harmonized. Case patients were classified as ER+ (n = 2446), ER- (n = 1252), or triple negative (ER-, PR-, HER2-; n = 567) based on pathology data; there were 14 180 control patients. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated in polytomous logistic regression analysis with adjustment for study, age, reproductive and other risk factors. Results ORs for parity relative to nulliparity was 0.92 (95% CI = 0.81 to 1.03) for ER+, 1.33 (95% CI = 1.11 to 1.59) for ER-, and 1.37 (95% CI = 1.06 to 1.70) for triple-negative breast cancer. Lactation was associated with a reduced risk of ER- (OR = 0.81, 95% CI = 0.69 to 0.95) but not ER+ cancer. ER- cancer risk increased with each additional birth in women who had not breastfed, with an OR of 1.68 (95% CI = 1.15 to 2.44) for 4 or more births relative to one birth with lactation. Conclusions The findings suggest that parous women who have not breastfed are at increased risk of ER- and triple-negative breast cancer. Promotion of lactation may be an effective tool for reducing occurrence of the subtypes that contribute disproportionately to breast cancer mortality.

AB - Background African American (AA) women have a disproportionately high incidence of estrogen receptor-negative (ER-) breast cancer, a subtype with a largely unexplained etiology. Because childbearing patterns also differ by race/ ethnicity, with higher parity and a lower prevalence of lactation in AA women, we investigated the relation of parity and lactation to risk of specific breast cancer subtypes. Methods Questionnaire data from two cohort and two case-control studies of breast cancer in AA women were combined and harmonized. Case patients were classified as ER+ (n = 2446), ER- (n = 1252), or triple negative (ER-, PR-, HER2-; n = 567) based on pathology data; there were 14 180 control patients. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated in polytomous logistic regression analysis with adjustment for study, age, reproductive and other risk factors. Results ORs for parity relative to nulliparity was 0.92 (95% CI = 0.81 to 1.03) for ER+, 1.33 (95% CI = 1.11 to 1.59) for ER-, and 1.37 (95% CI = 1.06 to 1.70) for triple-negative breast cancer. Lactation was associated with a reduced risk of ER- (OR = 0.81, 95% CI = 0.69 to 0.95) but not ER+ cancer. ER- cancer risk increased with each additional birth in women who had not breastfed, with an OR of 1.68 (95% CI = 1.15 to 2.44) for 4 or more births relative to one birth with lactation. Conclusions The findings suggest that parous women who have not breastfed are at increased risk of ER- and triple-negative breast cancer. Promotion of lactation may be an effective tool for reducing occurrence of the subtypes that contribute disproportionately to breast cancer mortality.

UR - http://www.scopus.com/inward/record.url?scp=84985006685&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84985006685&partnerID=8YFLogxK

U2 - 10.1093/jnci/dju237

DO - 10.1093/jnci/dju237

M3 - Article

C2 - 25224496

AN - SCOPUS:84985006685

VL - 106

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 10

M1 - dju237

ER -