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A case-control analysis of oral contraceptive use and breast cancer subtypes in the African American Breast Cancer Epidemiology and Risk Consortium.

Bethea TN, Rosenberg L, Hong CC, Troester MA, Lunetta KL, Bandera EV, Schedin P, Kolonel LN, Olshan AF, Ambrosone CB, Palmer JR - Breast Cancer Res. (2015)

Bottom Line: Multivariable polytomous logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for exposure categories relative to never use, controlling for potential confounding variables.Long duration of use was also associated with increased risk of each subtype, particularly ER-.Our results suggest that OC use, particularly recent use of long duration, is associated with an increased risk of ER+, ER-, and TN breast cancer in African American women.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Recent oral contraceptive (OC) use has been consistently associated with increased risk of breast cancer, but evidence on specific breast cancer subtypes is sparse.

Methods: We investigated recency and duration of OC use in relation to molecular subtypes of breast cancer in a pooled analysis of data from the African American Breast Cancer Epidemiology and Risk Consortium. The study included 1,848 women with estrogen receptor-positive (ER+) breast cancer, 1,043 with ER-negative (ER-) breast cancer (including 494 triple negative (TN) tumors, which do not have receptors for estrogen, progesterone, and human epidermal growth factor 2), and 10,044 controls. Multivariable polytomous logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for exposure categories relative to never use, controlling for potential confounding variables.

Results: OC use within the previous 5 years was associated with increased risk of ER+ (OR 1.46, 95% CI 1.18 to 1.81), ER- (OR 1.57, 95% CI 1.22 to 1.43), and TN (OR 1.78, 95% CI 1.25 to 2.53) breast cancer. The risk declined after cessation of use but was apparent for ER+ cancer for 15 to 19 years after cessation and for ER- breast cancer for an even longer interval after cessation. Long duration of use was also associated with increased risk of each subtype, particularly ER-.

Conclusions: Our results suggest that OC use, particularly recent use of long duration, is associated with an increased risk of ER+, ER-, and TN breast cancer in African American women. Research into mechanisms that explain these findings, especially the association with ER- breast cancer, is needed.

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Results from meta-analysis of oral contraceptive recency and duration in relation to breast cancer subtype. Odds ratios and 95% confidence intervals from the full model by study and from a random-effects meta-analysis for oral contraceptive (OC) recency in relation to ER+ (A) and ER– (B) breast cancer and OC duration in relation to ER+ (C) and ER– (D) breast cancer. BWHS, Black Women’s Health Study; CBCS, Carolina Breast Cancer Study; ER, estrogen receptor; WCHS, Women’s Circle of Health Study.
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Fig1: Results from meta-analysis of oral contraceptive recency and duration in relation to breast cancer subtype. Odds ratios and 95% confidence intervals from the full model by study and from a random-effects meta-analysis for oral contraceptive (OC) recency in relation to ER+ (A) and ER– (B) breast cancer and OC duration in relation to ER+ (C) and ER– (D) breast cancer. BWHS, Black Women’s Health Study; CBCS, Carolina Breast Cancer Study; ER, estrogen receptor; WCHS, Women’s Circle of Health Study.

Mentions: Figure 1 presents study-specific estimates and ORs for recent (within previous 5 years) and long-term (≥10 years) OC use in relation to ER+ and ER– breast cancer computed from a meta-analysis with a random-effects model. The P value for heterogeneity was 0.57 or greater for all comparisons, indicating no statistically significant heterogeneity.Figure 1


A case-control analysis of oral contraceptive use and breast cancer subtypes in the African American Breast Cancer Epidemiology and Risk Consortium.

Bethea TN, Rosenberg L, Hong CC, Troester MA, Lunetta KL, Bandera EV, Schedin P, Kolonel LN, Olshan AF, Ambrosone CB, Palmer JR - Breast Cancer Res. (2015)

Results from meta-analysis of oral contraceptive recency and duration in relation to breast cancer subtype. Odds ratios and 95% confidence intervals from the full model by study and from a random-effects meta-analysis for oral contraceptive (OC) recency in relation to ER+ (A) and ER– (B) breast cancer and OC duration in relation to ER+ (C) and ER– (D) breast cancer. BWHS, Black Women’s Health Study; CBCS, Carolina Breast Cancer Study; ER, estrogen receptor; WCHS, Women’s Circle of Health Study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4358874&req=5

Fig1: Results from meta-analysis of oral contraceptive recency and duration in relation to breast cancer subtype. Odds ratios and 95% confidence intervals from the full model by study and from a random-effects meta-analysis for oral contraceptive (OC) recency in relation to ER+ (A) and ER– (B) breast cancer and OC duration in relation to ER+ (C) and ER– (D) breast cancer. BWHS, Black Women’s Health Study; CBCS, Carolina Breast Cancer Study; ER, estrogen receptor; WCHS, Women’s Circle of Health Study.
Mentions: Figure 1 presents study-specific estimates and ORs for recent (within previous 5 years) and long-term (≥10 years) OC use in relation to ER+ and ER– breast cancer computed from a meta-analysis with a random-effects model. The P value for heterogeneity was 0.57 or greater for all comparisons, indicating no statistically significant heterogeneity.Figure 1

Bottom Line: Multivariable polytomous logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for exposure categories relative to never use, controlling for potential confounding variables.Long duration of use was also associated with increased risk of each subtype, particularly ER-.Our results suggest that OC use, particularly recent use of long duration, is associated with an increased risk of ER+, ER-, and TN breast cancer in African American women.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Recent oral contraceptive (OC) use has been consistently associated with increased risk of breast cancer, but evidence on specific breast cancer subtypes is sparse.

Methods: We investigated recency and duration of OC use in relation to molecular subtypes of breast cancer in a pooled analysis of data from the African American Breast Cancer Epidemiology and Risk Consortium. The study included 1,848 women with estrogen receptor-positive (ER+) breast cancer, 1,043 with ER-negative (ER-) breast cancer (including 494 triple negative (TN) tumors, which do not have receptors for estrogen, progesterone, and human epidermal growth factor 2), and 10,044 controls. Multivariable polytomous logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for exposure categories relative to never use, controlling for potential confounding variables.

Results: OC use within the previous 5 years was associated with increased risk of ER+ (OR 1.46, 95% CI 1.18 to 1.81), ER- (OR 1.57, 95% CI 1.22 to 1.43), and TN (OR 1.78, 95% CI 1.25 to 2.53) breast cancer. The risk declined after cessation of use but was apparent for ER+ cancer for 15 to 19 years after cessation and for ER- breast cancer for an even longer interval after cessation. Long duration of use was also associated with increased risk of each subtype, particularly ER-.

Conclusions: Our results suggest that OC use, particularly recent use of long duration, is associated with an increased risk of ER+, ER-, and TN breast cancer in African American women. Research into mechanisms that explain these findings, especially the association with ER- breast cancer, is needed.

Show MeSH
Related in: MedlinePlus