Breast cancer risk factors defined by estrogen and progesterone receptor status: the multiethnic cohort study

Am J Epidemiol. 2009 May 15;169(10):1251-9. doi: 10.1093/aje/kwp036. Epub 2009 Mar 24.

Abstract

Prospective data on ethnic differences in hormone receptor-defined subtypes of breast cancer and their risk factor profiles are scarce. The authors examined the joint distributions of estrogen receptor (ER) and progesterone receptor (PR) status across 5 ethnic groups and the associations of established risk factors with ER/PR status in the Multiethnic Cohort Study (Hawaii and Los Angeles, California). During an average of 10.4 years of follow-up of 84,427 women between 1993-1996 and 2004/2005, 2,543 breast cancer cases with data on ER/PR status were identified: 1,672 estrogen receptor-positive (ER+)/progesterone receptor-positive (PR+); 303 ER+/progesterone receptor-negative (PR-); 77 estrogen receptor-negative (ER-)/PR+; and 491 ER-/PR-. ER/PR status varied significantly across racial/ethnic groups even within the same tumor stage (for localized tumors, P < 0.0001; for advanced tumors, P = 0.01). The highest fraction of ER-/PR- tumors was observed in African Americans (31%), followed by Latinas (25%), Whites (18%), Japanese (14%), and Native Hawaiians (14%). Associations differed between ER+/PR+ and ER-/PR- cases for postmenopausal obesity (P = 0.02), age at menarche (P = 0.05), age at first birth (P = 0.04), and postmenopausal hormone use (P < 0.0001). African Americans are more likely to be diagnosed with ER-/PR- tumors independently of stage at diagnosis, and there are disparate risk factor profiles across the ER/PR subtypes of breast cancer.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / physiopathology
  • California / epidemiology
  • Confidence Intervals
  • Ethnicity
  • Female
  • Hawaii / epidemiology
  • Health Status
  • Humans
  • Incidence
  • Middle Aged
  • Population Surveillance
  • Prospective Studies
  • Receptors, Estrogen*
  • Receptors, Progesterone*
  • Risk Factors
  • Surveys and Questionnaires

Substances

  • Receptors, Estrogen
  • Receptors, Progesterone