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Etiology of hormone receptor positive breast cancer differs by levels of histologic grade and proliferation
Author(s) -
Abubakar Mustapha,
ChangClaude Jenny,
Ali H. Raza,
Chatterjee Nilanjan,
Coulson Penny,
Daley Frances,
Blows Fiona,
Benitez Javier,
Milne Roger L.,
Brenner Hermann,
Stegmaier Christa,
Mannermaa Arto,
Rudolph Anja,
Sinn Peter,
Couch Fergus J.,
Devilee Peter,
Tollenaar Rob A.E.M.,
Seynaeve Caroline,
Figueroa Jonine,
Lissowska Jolanta,
Hewitt Stephen,
Hooning Maartje J.,
Hollestelle Antoinette,
Foekens Renée,
Koppert Linetta B.,
Investigators kConFab,
Bolla Manjeet K.,
Wang Qin,
Jones Michael E.,
Schoemaker Minouk J.,
Keeman Renske,
Easton Douglas F.,
Swerdlow Anthony J.,
Sherman Mark E.,
Schmidt Marjanka K.,
Pharoah Paul D.,
GarciaClosas Montserrat
Publication year - 2018
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.31352
Subject(s) - medicine , odds ratio , quartile , epidemiology , breast cancer , confidence interval , case control study , etiology , obesity , hormone receptor , cancer , oncology , endocrinology , pathology , gastroenterology
Limited epidemiological evidence suggests that the etiology of hormone receptor positive (HR+) breast cancer may differ by levels of histologic grade and proliferation. We pooled risk factor and pathology data on 5,905 HR+ breast cancer cases and 26,281 controls from 11 epidemiological studies. Proliferation was determined by centralized automated measures of KI67 in tissue microarrays. Odds ratios (OR), 95% confidence intervals (CI) and p ‐values for case–case and case–control comparisons for risk factors in relation to levels of grade and quartiles (Q1–Q4) of KI67 were estimated using polytomous logistic regression models. Case–case comparisons showed associations between nulliparity and high KI67 [OR (95% CI) for Q4 vs . Q1 = 1.54 (1.22, 1.95)]; obesity and high grade [grade 3 vs . 1 = 1.68 (1.31, 2.16)] and current use of combined hormone therapy (HT) and low grade [grade 3 vs . 1 = 0.27 (0.16, 0.44)] tumors. In case–control comparisons, nulliparity was associated with elevated risk of tumors with high but not low levels of proliferation [1.43 (1.14, 1.81) for KI67 Q4 vs . 0.83 (0.60, 1.14) for KI67 Q1]; obesity among women ≥50 years with high but not low grade tumors [1.55 (1.17, 2.06) for grade 3 vs . 0.88 (0.66, 1.16) for grade 1] and HT with low but not high grade tumors [3.07 (2.22, 4.23) for grade 1 vs . 0.85 (0.55, 1.30) for grade 3]. Menarcheal age and family history were similarly associated with HR+ tumors of different grade or KI67 levels. These findings provide insights into the etiologic heterogeneity of HR+ tumors.