Christine B Ambrosone1, Gary Zirpoli2, Chi-Chen Hong2, Song Yao2, Melissa A Troester2, Elisa V Bandera2, Pepper Schedin2, Traci N Bethea2, Virginia Borges2, Song-Yi Park2, Dhyan Chandra2, Lynn Rosenberg2, Laurence N Kolonel2, Andrew F Olshan2, Julie R Palmer2. 1. Roswell Park Cancer Institute, Buffalo, NY (CBA, GZ, CCH, SY, DC); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Oregon Health & Science University, Portland, OR (PS); Slone Epidemiology Center at Boston University, Boston, MA (TNB, LR, JRP); University of Colorado Denver School of Medicine, Denver, CO (VB); University of Hawaii Cancer Center, Honolulu, HI (SYP, LNK). christine.ambrosone@roswellpark.org. 2. Roswell Park Cancer Institute, Buffalo, NY (CBA, GZ, CCH, SY, DC); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Oregon Health & Science University, Portland, OR (PS); Slone Epidemiology Center at Boston University, Boston, MA (TNB, LR, JRP); University of Colorado Denver School of Medicine, Denver, CO (VB); University of Hawaii Cancer Center, Honolulu, HI (SYP, LNK).
Abstract
BACKGROUND: Menarche is a critical time point for diverging fates of mammary cells of origin. African American women have young age at menarche, which could be associated with their high rates of estrogen receptor-negative (ER-) breast cancer. METHODS: In the AMBER Consortium, using harmonized data from 4426 African American women with breast cancer and 17 474 controls, we used polytomous logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for ages at menarche and first live birth (FLB), and the interval between, in relation to ER+ and ER- breast cancer. All statistical tests were two-sided. RESULTS: Risk of ER- breast cancer was reduced with later age at menarche among both parous and nulliparous women (≥15 vs <11 years OR = 0.62, 95% CI = 0.48 to 0.81 and OR = 0.56, 95% CI = 0.29 to 1.10, respectively), with no effect of age at FLB. For ER+ breast cancer, the inverse association was weaker among nulliparous women. While longer intervals between menarche and FLB were associated with increased risk of ER+ breast cancer in a dose-response fashion (OR for 20 year interval = 1.39, 95% CI = 1.08 to 1.79, P trend = .003), ER- risk was only increased for intervals up to 14 years and not beyond (P trend = .33). CONCLUSIONS: While ER- breast cancer risk was markedly reduced in women with a late age at menarche, there was not a clear pattern of increased risk with longer interval between menarche and FLB, as was observed for ER+ breast cancer. These findings indicate that etiologic pathways involving adolescence and pregnancy may differ for ER- and ER+ breast cancer.
BACKGROUND: Menarche is a critical time point for diverging fates of mammary cells of origin. African American women have young age at menarche, which could be associated with their high rates of estrogen receptor-negative (ER-) breast cancer. METHODS: In the AMBER Consortium, using harmonized data from 4426 African American women with breast cancer and 17 474 controls, we used polytomous logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for ages at menarche and first live birth (FLB), and the interval between, in relation to ER+ and ER- breast cancer. All statistical tests were two-sided. RESULTS: Risk of ER- breast cancer was reduced with later age at menarche among both parous and nulliparous women (≥15 vs <11 years OR = 0.62, 95% CI = 0.48 to 0.81 and OR = 0.56, 95% CI = 0.29 to 1.10, respectively), with no effect of age at FLB. For ER+ breast cancer, the inverse association was weaker among nulliparous women. While longer intervals between menarche and FLB were associated with increased risk of ER+ breast cancer in a dose-response fashion (OR for 20 year interval = 1.39, 95% CI = 1.08 to 1.79, P trend = .003), ER- risk was only increased for intervals up to 14 years and not beyond (P trend = .33). CONCLUSIONS: While ER- breast cancer risk was markedly reduced in women with a late age at menarche, there was not a clear pattern of increased risk with longer interval between menarche and FLB, as was observed for ER+ breast cancer. These findings indicate that etiologic pathways involving adolescence and pregnancy may differ for ER- and ER+ breast cancer.
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