Postmenopausal Female Hormone Use and Estrogen Receptor-Positive and -Negative Breast Cancer in African American Women

Citation

Rosenberg, Lynn A.; Bethea, Traci N.; Viscidi, Emma W.; Hong, Chi-Chen; Troester, Melissa A.; Bandera, Elisa V.; Haiman, Christopher A.; Kolonel, Laurence N.; Olshan, Andrew F.; & Ambrosone, Christine B., et al. (2016). Postmenopausal Female Hormone Use and Estrogen Receptor-Positive and -Negative Breast Cancer in African American Women. Journal of the National Cancer Institute, 108(4), djv361. PMCID: PMC4857155

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.
CONCLUSION: 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.

URL

http://dx.doi.org/10.1093/jnci/djv361

Reference Type

Journal Article

Year Published

2016

Journal Title

Journal of the National Cancer Institute

Author(s)

Rosenberg, Lynn A.
Bethea, Traci N.
Viscidi, Emma W.
Hong, Chi-Chen
Troester, Melissa A.
Bandera, Elisa V.
Haiman, Christopher A.
Kolonel, Laurence N.
Olshan, Andrew F.
Ambrosone, Christine B.
Palmer, Julie R.

PMCID

PMC4857155

ORCiD

Olshan - 0000-0001-9115-5128