Breast cancer risk factors and survival by tumor subtype: pooled analyses from the Breast Cancer Association Consortium

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Morra, Anna ; Jung, Audrey Y. ; Behrens, Sabine ; Keeman, Renske ; Ahearn, Thomas U. ; Anton-Culver, Hoda ; Arndt, Volker ; Augustinsson, Annelie ; Auvinen, Päivi K. ; Beane Freeman, Laura E. ; Becher, Heiko ; Beckmann, Matthias W. ; Blomqvist, Carl ; Bojesen, Stig E. ; Bolla, Manjeet K. ; Brenner, Hermann ; Briceno, Ignacio ; Brucker, Sara Y. ; Camp, Nicola J. ; Campa, Daniele ; Canzian, Federico ; Castelao, Jose E. ; Chanock, Stephen J. ; Choi, Ji-Yeob ; Clarke, Christine L. ; Couch, Fergus J. ; Cox, Angela ; Cross, Simon S. ; Czene, Kamila ; Dörk, Thilo ; Dunning, Alison M. ; Dwek, Miriam ; Easton, Douglas F. ; Eccles, Diana M. ; Egan, Kathleen M. ; Evans, D. Gareth ; Fasching, Peter A. ; Flyger, Henrik ; Gago-Dominguez, Manuela ; Gapstur, Susan M. ; García-Sáenz, José A. ; Gaudet, Mia M. ; Giles, Graham G. ; Grip, Mervi ; Guénel, Pascal ; Haiman, Christopher A. ; Håkansson, Niclas ; Hall, Per ; Hamann, Ute ; Han, Sileny N. ; Hart, Steven N. ; Hartman, Mikael ; Heyworth, Jane S ; Hoppe, Reiner ; Hopper, John L. ; Hunter, David J. ; Ito, Hidemi ; Jager, Agnes ; Jakimovska, Milena ; Jakubowska, Anna ; Janni, Wolfgang ; Kaaks, Rudolf ; Kang, Daehee ; Kapoor, Pooja Middha ; Kitahara, Cari M. ; Koutros, Stella ; Kraft, Peter ; Kristensen, Vessela N. ; Lacey, James V. ; Lambrechts, Diether ; Marchand, Loic Le ; Li, Jingmei ; Lindblom, Annika ; Lubiński, Jan ; Lush, Michael ; Mannermaa, Arto ; Manoochehri, Mehdi ; Margolin, Sara ; Mariapun, Shivaani ; Matsuo, Keitaro ; Mavroudis, Dimitrios ; Milne, Roger L. ; Muranen, Taru A. ; Newman, William G. ; Noh, Dong-Young ; Nordestgaard, Børge G. ; Obi, Nadia ; Olshan, Andrew F. ; Olsson, Håkan ; Park-Simon, Tjoung-Won ; Petridis, Christos ; Pharoah, Paul D.P. ; Plaseska-Karanfilska, Dijana ; Presneau, Nadege ; Rashid, Muhammad U. ; Rennert, Gad ; Rennert, Hedy S. ; Rhenius, Valerie ; Romero, Atocha ; Saloustros, Emmanouil ; Sawyer, Elinor J. ; Schneeweiss, Andreas ; Schwentner, Lukas ; Scott, Christopher ; Shah, Mitul ; Shen, Chen-Yang ; Shu, Xiao-Ou ; Southey, Melissa C. ; Stram, Daniel O. ; Tamimi, Rulla M. ; Tapper, William ; Tollenaar, Rob A.E.M. ; Tomlinson, Ian ; Torres, Diana ; Troester, Melissa A. ; Truong, Thérèse ; Vachon, Celine M. ; Wang, Qin ; Wang, Sophia S. ; Williams, Justin A. ; Winqvist, Robert ; Wolk, Alicja ; Wu, Anna H. ; Yoo, Keun-Young ; Yu, Jyh-Cherng ; Zheng, Wei ; Ziogas, Argyrios ; Yang, Xiaohong R. ; Eliassen, A. Heather ; Holmes, Michelle D. ; García-Closas, Montserrat ; Teo, Soo Hwang ; Schmidt, Marjanka K. ; Chang-Claude, Jenny
• Corporate Authors:
  for the ABCTB Investigators ; for the NBCS Collaborators
• Description:
  Background:
  
  It is not known if modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype.
  
  Methods:
  
  We analyzed data for 121 435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16 890 deaths (8554 breast cancer-specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer-specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype.
  
  Results:
  
  There was no evidence of heterogeneous associations between risk factors and mortality by subtype (adjusted p>0.30). The strongest associations were between all-cause mortality and BMI ≥30 vs 18.5–25 kg/m2 (HR (95%CI): 1.19 (1.06,1.34)); current vs never smoking (1.37 (1.27,1.47)), high vs low physical activity (0.43 (0.21,0.86)), age ≥30 years vs <20 years at first pregnancy (0.79 (0.72,0.86)); >0 to <5 years vs ≥10 years since last full term birth (1.31 (1.11,1.55)); ever vs never use of oral contraceptives (0.91 (0.87,0.96)); ever vs never use of menopausal hormone therapy, including current estrogen-progestin therapy (0.61 (0.54,0.69)). Similar associations with breast cancer mortality were weaker; e.g. 1.11 (1.02,1.21) for current vs never smoking.
  
  Conclusions:
  
  We confirm associations between modifiable lifestyle factors and 10-year all-cause mortality. There was no strong evidence that associations differed by ER status or intrinsic-like subtype.
  
  Impact:
  
  Given the large dataset and lack of evidence that associations between modifiable risk factors and 10-year mortality differed by subtype, these associations could be cautiously used in prognostication models to inform patient-centered care.
  
  
• Subjects:
  Adult Aged Breast Neoplasms Cause Of Death Female Humans Life Style Middle Aged Neoplasm Invasiveness Neoplasm Staging Prospective Studies Risk Factors Survival Analysis

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• Source:
  Cancer Epidemiol Biomarkers Prev. 30(4):623-642
• Pubmed ID:
  33500318
• Pubmed Central ID:
  PMC8026532
• Document Type:
  Journal Article
• Funding:
  R01 CA176785/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; MR/N003284/1/MRC_/Medical Research CouncilUnited Kingdom/ ; G1000143/MRC_/Medical Research CouncilUnited Kingdom/ ; P50 CA058223/CA/NCI NIH HHSUnited States/ ; U01 CA116167/CA/NCI NIH HHSUnited States/ ; R01 CA064277/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/ ; MR/M012190/1/MRC_/Medical Research CouncilUnited Kingdom/ ; R01 CA163353/CA/NCI NIH HHSUnited States/ ; R01 CA050385/CA/NCI NIH HHSUnited States/ ; UM1 CA164917/CA/NCI NIH HHSUnited States/ ; U01 CA199277/CA/NCI NIH HHSUnited States/ ; U01 CA179715/CA/NCI NIH HHSUnited States/ ; R01 CA128931/CA/NCI NIH HHSUnited States/ ; HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; U54 CA156733/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; Z01 CP010119/ImNIH/Intramural NIH HHSUnited States/ ; UM1 CA164973/CA/NCI NIH HHSUnited States/ ; P01 CA087969/CA/NCI NIH HHSUnited States/ ; UM1 CA164920/CA/NCI NIH HHSUnited States/ ; G0500300/MRC_/Medical Research CouncilUnited Kingdom/ ; R01 CA097396/CA/NCI NIH HHSUnited States/ ; R37 CA070867/CA/NCI NIH HHSUnited States/ ; U01 CA176726/CA/NCI NIH HHSUnited States/ ; Z01 ES049030/ImNIH/Intramural NIH HHSUnited States/ ; R01 CA058860/CA/NCI NIH HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; P30 CA016086/CA/NCI NIH HHSUnited States/ ; K07 CA092044/CA/NCI NIH HHSUnited States/ ; HHSN261201800016C/CA/NCI NIH HHSUnited States/ ; R01 CA047147/CA/NCI NIH HHSUnited States/ ; 14136/CRUK_/Cancer Research UKUnited Kingdom/ ; R01 CA116167/CA/NCI NIH HHSUnited States/ ; R01 CA148667/CA/NCI NIH HHSUnited States/ ; R01 CA177150/CA/NCI NIH HHSUnited States/ ; P50 CA116201/CA/NCI NIH HHSUnited States/ ; G0401527/MRC_/Medical Research CouncilUnited Kingdom/ ; R01 CA063464/CA/NCI NIH HHSUnited States/ ; UM1 CA186107/CA/NCI NIH HHSUnited States/ ; P30 CA023100/CA/NCI NIH HHSUnited States/ ; U01 CA063464/CA/NCI NIH HHSUnited States/ ; R01 CA077398/CA/NCI NIH HHSUnited States/ ; R01 CA054281/CA/NCI NIH HHSUnited States/ ; R01 CA132839/CA/NCI NIH HHSUnited States/ ; P30 CA068485/CA/NCI NIH HHSUnited States/ ; U01 CA058860/CA/NCI NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; U01 CA098758/CA/NCI NIH HHSUnited States/ ; N01 CN025403/CA/NCI NIH HHSUnited States/ ; U19 CA148065/CA/NCI NIH HHSUnited States/ ; P30 CA033572/CA/NCI NIH HHSUnited States/ ; R01 CA069664/CA/NCI NIH HHSUnited States/ ; UM1 CA182910/CA/NCI NIH HHSUnited States/ ; 10118/CRUK_/Cancer Research UKUnited Kingdom/ ; R01 CA192393/CA/NCI NIH HHSUnited States/ ; R37 CA054281/CA/NCI NIH HHSUnited States/ ; U01 CA164973/CA/NCI NIH HHSUnited States/ ; R01 CA140286/CA/NCI NIH HHSUnited States/ ; R01 CA047305/CA/NCI NIH HHSUnited States/ ; P30 CA042014/CA/NCI NIH HHSUnited States/
• Volume:
  30
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:baa43c2552f584110f864e95dc6dd7b9e5e089d1de3c9708289dd9a86972408c
• Download URL:
  https://stacks.cdc.gov/view/cdc/105003/cdc_105003_DS1.pdf
• File Type:
  [PDF - 293.50 KB ]