Breast cancer risk factor associations differ for pure versus invasive carcinoma with an in situ component in case-control and case-case analyses

Details

• Alternative Title:
  Cancer Causes Control
• Personal Author:
  Ruszczyk, Melanie ; Zirpoli, Gary ; Kumar, Shicha ; Bandera, Elisa V. ; Bovbjerg, Dana H. ; Jandorf, Lina ; Khoury, Thaer ; Hwang, Helena ; Ciupak, Gregory ; Pawlish, Karen ; Schedin, Pepper ; Masso-Welch, Patricia ; Ambrosone, Christine B. ; Hong, Chi-Chen
• Description:
  Purpose
  
  Invasive ductal carcinoma (IDC) is diagnosed with or without a ductal carcinoma in situ (DCIS) component. Previous analyses have found significant differences in tumor characteristics between pure IDC lacking DCIS and mixed IDC with DCIS. We will test our hypothesis that pure IDC represents a form of breast cancer with etiology and risk factors distinct from mixed IDC/DCIS.
  
  Methods
  
  We compared reproductive risk factors for breast cancer risk, as well as family and smoking history between 831 women with mixed IDC/DCIS (n=650) or pure IDC (n=181), and 1,620 controls, in the context of the Women's Circle of Health Study (WCHS), a case-control study of breast cancer in African-American and European-American women. Data on reproductive and lifestyle factors were collected during interviews, and tumor characteristics were abstracted from pathology reports. Case-control and case-case analyses were conducted using unconditional logistic regression.
  
  Results
  
  Most risk factors were similarly associated with pure IDC and mixed IDC/DCIS. However, among postmenopausal women, risk for pure IDC was lower in women with body mass index (BMI) 25 to <30 kg/m2 (Odds Ratio (OR)=0.66; 95% confidence interval (CI), 0.35-1.23) and BMI≥30 kg/m2 (OR=0.33; 95% CI, 0.18-0.67) compared to women with BMI<25 kg/m2, with no associations with mixed IDC/DCIS. In case-case analyses, women who breastfed up to 12 months (OR=0.55; 95% CI, 0.32-0.94) or longer (OR=0.47; 95% CI, 0.26-0.87) showed decreased odds of pure IDC than mixed IDC/DCIS compared to those who did not breastfeed.
  
  Conclusions
  
  Associations with some breast cancer risk factors differed between mixed IDC/DCIS and pure IDC, potentially suggesting differential developmental pathways. These findings, if confirmed in a larger study, will provide a better understanding of the development patterns of breast cancer and the influence of modifiable risk factors, which in turn could lead to better preventive measures for pure IDC, which have worse disease prognosis compared to mixed IDC/DCIS.
  
  
• Subjects:
  Adult Article Breast Cancer Breast Feeding Breast Neoplasms Cancer Etiology Cancer Pathology Carcinoma, Ductal, Breast Carcinoma, Intraductal, Noninfiltrating Case-Control Studies Ductal Carcinoma In Situ Component Female Humans Logistic Models Middle Aged Multivariate Analysis Obesity Odds Ratio Overweight Reproductive History Risk Factors

  More +
• Source:
  Cancer Causes Control. 27(2):183-198.
• Pubmed ID:
  26621543
• Pubmed Central ID:
  PMC4724280
• Document Type:
  Journal Article
• Funding:
  U58 DP003931/DP/NCCDPHP CDC HHS/United States ; P30 CA016056/CA/NCI NIH HHS/United States ; 5U58DP003931-02/DP/NCCDPHP CDC HHS/United States ; P30 CA072720/CA/NCI NIH HHS/United States ; R01 CA169175/CA/NCI NIH HHS/United States ; P01 CA151135/CA/NCI NIH HHS/United States ; K22 CA138563/CA/NCI NIH HHS/United States ; N01PC-2013-00021/PC/NCI NIH HHS/United States ; R03 CA17106/CA/NCI NIH HHS/United States ; R03 CA171061/CA/NCI NIH HHS/United States ; R01 CA100598/CA/NCI NIH HHS/United States
• Volume:
  27
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7895d087d601f663e800dae585045167e694f3299066259ca075bafad8453877
• Download URL:
  https://stacks.cdc.gov/view/cdc/39483/cdc_39483_DS1.pdf
• File Type:
  [PDF - 525.64 KB ]