title: Postmenopausal Female Hormone Use and Estrogen Receptor-Positive and -Negative Breast Cancer in African American Women.
abstract: BACKGROUND
  Use of estrogen with progestin (combination therapy) is associated with increased incidence of estrogen receptor-positive (ER+) breast cancer in observational studies and randomized trials among postmenopausal white women. Whether this is also the case among African American women is not established.
  
  
  METHODS
  Using data from the AMBER consortium collected from 1993 to 2013, we assessed use of estrogen alone and of combination therapy in relation to ER+ and ER-negative (ER-) breast cancer risk in postmenopausal African American women, based on 1132 ER+ case patients, 512 ER- case patients, and 6693 control patients. Odds ratios (ORs) and confidence intervals (CIs) were estimated using multinomial logistic regression with control for breast cancer risk factors.
  
  
  RESULTS
  Forty-seven percent of control patients had used estrogen alone, combination therapy, or both. The odds ratio for ER+ breast cancer associated with combination use, relative to never use of either estrogen alone or combination therapy, was 1.50 (95% CI = 1.25 to 1.79). The increase was greater for recent (OR = 1.55, 95% CI = 1.21 to 1.99) and long-term use (OR = 1.75, 95% CI = 1.13 to 2.73) and among nonobese women (OR = 1.91, 95% CI = 1.29 to 2.83). Breast cancer risk was increased regardless of the interval between onset of menopause and initiation of combination use (OR = 1.43, 95% CI = 1.11 to 1.85, for <5 year interval; OR = 1.78, 95% CI = 1.34 to 2.37, for ≥5 year interval). Combination use was not associated with risk of ER- breast cancer, and use of estrogen alone was not associated with risk of either ER+ or ER- breast cancer.
  
  
  CONCLUSIONS
  Use of estrogen with progestin increases risk of ER+ breast cancer in African American women. A decrease in use would be expected to reduce the number of ER+ cancers.
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK). lrosenbe@bu.edu.
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Traci N
authors.initials: TN
authors.lastname: Bethea
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Emma
authors.initials: E
authors.lastname: Viscidi
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Hong
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Troester
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Elisa V
authors.initials: EV
authors.lastname: Bandera
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Haiman
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Laurence N
authors.initials: LN
authors.lastname: Kolonel
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Olshan
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Christine B
authors.initials: CB
authors.lastname: Ambrosone
authors.affiliation: Slone Epidemiology Center at Boston University, Boston, MA (LR, TNB, EV, JRP); Roswell Park Cancer Institute, Buffalo, NY (CCH, CBA); University of North Carolina Lineberger Cancer Center, Chapel Hill, NC (MAT, AFO); Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (EVB); Department of Preventive Medicine and Norris Comprehensive Cancer Cencer, University of Southern California Keck School of Medicine, Los Angeles, CA (CAH); Department of Public Health Sciences, University of Hawaii School of Medicine, Honolulu, HI (LNK).
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D001943:Breast Neoplasms / Q000139:chemically induced* / Q000737:chemistry* / Q000453:epidemiology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects* / Q000379:methods; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D017698:Postmenopause; D011372:Progestins / Q000008:administration & dosage; D011960:Receptors, Estrogen / Q000032:analysis*; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D004967:Estrogens; D011372:Progestins; D011960:Receptors, Estrogen