Hurson Amber N, Ahearn Thomas U, Koka Hela, Jenkins Brittany D, Harris Alexandra R, Roberts Sylvia, Fan Sharon, Franklin Jamirra, Butera Gisela, Keeman Renske, Jung Audrey Y, Middha Pooja, Gierach Gretchen L, Yang Xiaohong R, Chang-Claude Jenny, Tamimi Rulla M, Troester Melissa A, Bandera Elisa V, Abubakar Mustapha, Schmidt Marjanka K, Garcia-Closas Montserrat
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
Department of Biochemistry and Molecular Biology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
medRxiv. 2024 Mar 19:2024.03.18.24304210. doi: 10.1101/2024.03.18.24304210.
Breast cancer is comprised of distinct molecular subtypes. Studies have reported differences in risk factor associations with breast cancer subtypes, especially by tumor estrogen receptor (ER) status, but their consistency across racial and ethnic populations has not been comprehensively evaluated.
We conducted a qualitative, scoping literature review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis, extension for Scoping Reviews to investigate consistencies in associations between 18 breast cancer risk factors (reproductive, anthropometric, lifestyle, and medical history) and risk of ER-defined subtypes in women who self-identify as Asian, Black or African American, Hispanic or Latina, or White. We reviewed publications between January 1, 1990 and July 1, 2022. Etiologic heterogeneity evidence (convincing, suggestive, none, or inconclusive) was determined by expert consensus.
Publications per risk factor ranged from 14 (benign breast disease history) to 66 (parity). Publications were most abundant for White women, followed by Asian, Black or African American, and Hispanic or Latina women. Etiologic heterogeneity evidence was strongest for parity, followed by age at first birth, post-menopausal BMI, oral contraceptive use, and estrogen-only and combined menopausal hormone therapy. Evidence was limited for other risk factors. Findings were consistent across racial and ethnic groups, although the strength of evidence varied.
The literature supports etiologic heterogeneity by ER for some established risk factors that are consistent across race and ethnicity groups. However, in non-White populations evidence is limited. Larger, more comparable data in diverse populations is needed to better characterize breast cancer etiologic heterogeneity.
乳腺癌由不同的分子亚型组成。研究报告了风险因素与乳腺癌亚型之间的差异，尤其是按肿瘤雌激素受体（ER）状态划分，但尚未全面评估其在不同种族和族裔人群中的一致性。
我们使用系统评价和Meta分析的首选报告项目（PRISMA）扩展版进行了一项定性的范围综述，以调查18种乳腺癌风险因素（生殖、人体测量、生活方式和病史）与自我认定为亚洲、黑人或非裔美国人、西班牙裔或拉丁裔或白人的女性中ER定义的亚型风险之间关联的一致性。我们回顾了1990年1月1日至2022年7月1日期间的出版物。病因异质性证据（令人信服、提示性、无或不确定）由专家共识确定。
每个风险因素的出版物数量从14篇（良性乳腺疾病史）到66篇（生育史）不等。白人女性的出版物最多，其次是亚洲、黑人或非裔美国人和西班牙裔或拉丁裔女性。生育史的病因异质性证据最强，其次是初产年龄、绝经后体重指数、口服避孕药使用以及仅使用雌激素和联合使用绝经激素治疗。其他风险因素的证据有限。尽管证据强度有所不同，但研究结果在不同种族和族裔群体中是一致的。
文献支持某些既定风险因素按ER分类的病因异质性，这些因素在不同种族和族裔群体中是一致的。然而，在非白人人群中证据有限。需要在不同人群中获取更大、更具可比性的数据，以更好地描述乳腺癌的病因异质性。
