Association between breast cancer risk factors and molecular type in postmenopausal patients with hormone receptor-positive early breast cancer

• Published in: Breast cancer research and treatment Vol. 174; no. 2; pp. 453 - 461
• Main Authors: Wunderle, Marius, Pretscher, Jutta, Brucker, Sara Y., Volz, Bernhard, Hartmann, Arndt, Fiessler, Cornelia, Hein, Alexander, Häberle, Lothar, Jud, Sebastian M., Lux, Michael P., Janni, Wolfgang, Loehberg, Christian R., Hartkopf, Andreas D., Walter, Christina B., Baake, Gerold, Fridman, Alexander, Malter, Wolfram, Wuerstlein, Rachel, Harbeck, Nadia, Hoffmann, Oliver, Kümmel, Sherko, Martin, Bernhard, Thomssen, Christoph, Graf, Heiko, Wolf, Christopher, Bayer, Christian M., Hack, Carolin C., Almstedt, Katrin, Gass, Paul, Heindl, Felix, Brodkorb, Tobias F., Nabieva, Naiba, Lindner, Christoph, Kolberg, Hans-Christian, Krabisch, Petra, Weigel, Michael, Steinfeld-Birg, Dieter, Kohls, Andreas, Brucker, Cosima, Schulz, Volker, Fischer, Gunnar, Pelzer, Volker, Wallwiener, Diethelm, Rack, Brigitte, Fehm, Tanja, Rody, Achim, Maass, Nicolai, Beckmann, Matthias W., Fasching, Peter A., Rauh, Claudia
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-04-2019; Springer; Springer Nature B.V
• Subjects: Age; Aromatase; Body mass index; Breast cancer; Breast feeding; Cancer research; Clinical Trial; Data processing; Diagnosis; Epidemiology; ErbB-2 protein; Estrogens; Genetic aspects; Health risk assessment; Hormone replacement therapy; Medical research; Medical schools; Medicine; Medicine & Public Health; Menopause; Oncology; Phenols (Class of compounds); Post-menopause; Postmenopausal women; Progesterone; Regression analysis; Risk factors; Sex hormones; Smoking; Steroid hormones; Breast cancer; Hormone replacement therapy; Prognosis; Molecular subtype; Risk factors
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-018-05115-6

Purpose
Evidence shows that genetic and non-genetic risk factors for breast cancer (BC) differ relative to the molecular subtype. This analysis aimed to investigate associations between epidemiological risk factors and immunohistochemical subtypes in a cohort of postmenopausal, hormone receptor-positive BC patients.
Methods
The prospective, single-arm, multicenter phase IV PreFace study (Evaluation of Predictive Factors Regarding the Effectivity of Aromatase Inhibitor Therapy) included 3529 postmenopausal patients with hormone receptor-positive early BC. Data on their epidemiological risk factors were obtained from patients’ diaries and their medical histories. Data on estrogen receptor, progesterone receptor, and HER2 receptor status were obtained from pathology reports. Patients with incomplete information were excluded. Data were analyzed using conditional inference regression analysis, analysis of variance, and the chi-squared test.
Results
In a cohort of 3392 patients, the strongest association with the molecular subtypes of BC was found for hormone replacement therapy (HRT) before diagnosis of early BC. The analysis showed that patients who took HRT at diagnosis had luminal A-like BC more often (83.7%) than those who had never taken HRT or had stopped taking it (75.5%). Luminal B-like BC and HER2-positive BC were diagnosed more often in women who had never taken HRT or had stopped taking it (13.3% and 11.2%, respectively) than in women who were taking HRT at diagnosis of BC (8.3% and 8.0%, respectively).
Conclusions
This analysis shows an association between HRT and the distribution of molecular subtypes of BC. However, no associations between other factors (e.g., age at diagnosis, body mass index, smoking status, age at menopause, number of deliveries, age at first delivery, breastfeeding history, or family history) were noted.