title: Risk factors for specific histopathological types of postmenopausal breast cancer in the NIH-AARP Diet and Health Study.
abstract: Risk factor associations for rare breast cancer variants are often imprecise, obscuring differences between tumor types. To clarify differences, we examined risk factors for 5 histological types of breast cancer in the National Institutes of Health-AARP Diet and Health Study. Risk factor information was self-reported. We followed 192,076 postmenopausal women aged 50-71 years from 1995-1996 through 2006. During that time period, 5,334 ductal, 836 lobular, 639 mixed ductal-lobular, 216 mucinous, and 132 tubular breast cancers were diagnosed. Hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards regression. Heterogeneity was evaluated using case-only logistic regression. The strongest differences were for menopausal hormone therapy (Pheterogeneity < 0.01) and age at first birth (Pheterogeneity < 0.01). Risk of tubular cancer in relation to current menopausal hormone therapy (for current use vs. never use, hazard ratio (HR) = 4.39, 95% confidence interval (CI): 2.77, 6.96) was several times stronger than risk of other histological types (range of HRs, 1.39-1.75). Older age at first birth was unassociated with risk of mucinous (for ≥30 years vs. 20-24 years, HR = 0.62, 95% CI: 0.27, 1.42) or tubular (HR = 1.08, 95% CI: 0.51, 2.29) tumors, in contrast to clear positive associations with lobular (HR = 1.82, 95% CI: 1.39, 2.37) and mixed ductal-lobular (HR = 1.87, 95% CI: 1.39, 2.51) tumors. Differing associations for hormonal factors and mucinous and tubular cancers suggest etiologies distinct from those of common breast cancers.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 7-E236, MSC 9774, Bethesda, MD 20892-9774, USA. sarah.nyante@nih.gov
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Nyante
authors.forename: Cher M
authors.initials: CM
authors.lastname: Dallal
authors.forename: Gretchen L
authors.initials: GL
authors.lastname: Gierach
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Albert R
authors.initials: AR
authors.lastname: Hollenbeck
authors.forename: Louise A
authors.initials: LA
authors.lastname: Brinton
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000473:pathology; D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology* / Q000473:pathology; D000368:Aged; D000886:Anthropometry; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D016001:Confidence Intervals; D003276:Contraceptives, Oral; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D060787:Neoplasm Grading; D009367:Neoplasm Staging; D017698:Postmenopause / Q000502:physiology; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D003276:Contraceptives, Oral; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
keywords: breast neoplasms; cohort studies; histology; risk factors
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