Authors' Affiliations: Moores Cancer Center; Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California; Arizona Cancer Center, University of Arizona, Tucson; Department of Surgery, Maricopa Medical Center, Phoenix, Arizona; Department of Pediatrics, Dan L. Duncan Cancer Center, Baylor College of Medicine; University of Texas M.D. Anderson Cancer Center, Houston, Texas; Universidad of Guadalajara, Guadalajara; Instituto Tecnológico de Sonora, Ciudad Obregón; and Universidad of Sonora, Hermosillo, Mexico.
Cancer Epidemiol Biomarkers Prev. 2013 Oct;22(10):1853-61. doi: 10.1158/1055-9965.EPI-13-0560. Epub 2013 Aug 15.
Published data support the presence of etiologic heterogeneity by breast tumor subtype, but few studies have assessed this in Hispanic populations.
We assessed tumor subtype prevalence and associations between reproductive factors and tumor subtypes in 1,041 women of Mexican descent enrolled in a case-only, binational breast cancer study. Multinomial logistic regression comparing HER2(+) tumors and triple-negative breast cancer (TNBC) to luminal A tumors was conducted.
Compared with women with luminal A tumors, those with a later age at first pregnancy were less likely to have TNBC [OR, 0.61; 95% confidence interval (CI), 0.39-0.95], whereas those with three or more full-term pregnancies were more likely to have TNBC (OR, 1.68; 95% CI, 1.10-2.55). A lower odds of TNBC was shown for longer menstruation duration, whether before first pregnancy (OR, 0.78; 95% CI, 0.65-0.93 per 10 years) or menopause (OR, 0.79; 95% CI, 0.69-0.91 per 10 years). Patients who reported breastfeeding for more than 12 months were over twice as likely to have TNBC than luminal A tumors (OR, 2.14; 95% CI, 1.24-3.68). Associations comparing HER2(+) with luminal A tumors were weak or nonexistent except for the interval between last full-term pregnancy and breast cancer diagnosis.
Findings show etiologic heterogeneity by tumor subtype in a population of Hispanic women with unique reproductive profiles.
Identification of etiologically distinct breast tumor subtypes can further improve our understanding of the disease and help provide personalized prevention and treatment regimens.
已有研究数据支持乳腺癌根据肿瘤亚型存在病因异质性，但很少有研究评估过西班牙裔人群中的这种情况。
我们评估了墨西哥裔 1041 名女性病例中的肿瘤亚型流行率以及生殖因素与肿瘤亚型之间的关系，这些女性参与了一项双边乳腺癌病例对照研究。采用多变量逻辑回归比较了 HER2(+)肿瘤和三阴性乳腺癌（TNBC）与 luminal A 肿瘤。
与 luminal A 肿瘤患者相比，初产年龄较晚的患者发生 TNBC 的可能性较小[比值比（OR），0.61；95%置信区间（CI），0.39-0.95]，而生育 3 次或更多足月产的患者发生 TNBC 的可能性较大（OR，1.68；95% CI，1.10-2.55）。初潮前（OR，每 10 年 0.78；95% CI，0.65-0.93）或绝经前（OR，每 10 年 0.79；95% CI，0.69-0.91）较长的经期时间与 TNBC 的发生几率降低有关。报告母乳喂养超过 12 个月的患者发生 TNBC 的几率是 luminal A 肿瘤的两倍多（OR，2.14；95% CI，1.24-3.68）。与 luminal A 肿瘤相比，HER2(+)的比较结果为弱相关或不相关，只有末次足月妊娠与乳腺癌诊断之间的间隔除外。
在具有独特生殖特征的西班牙裔女性人群中，研究结果表明肿瘤亚型存在病因异质性。
确定病因学上不同的乳腺癌肿瘤亚型可以进一步加深我们对该疾病的理解，并有助于提供个性化的预防和治疗方案。
