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Hormonal Factors and the Risk of Breast Cancer According to Estrogen- and Progesterone-Receptor Subgroup¹

Division of Preventive Oncology, Cancer Care Ontario, Toronto, Ontario, M5G 2L7 Canada [M. C., N. K., B. T., M. S., S. B.], and Departments of Public Health Sciences [M. C., N. K., S. B.] and Nutritional Sciences [N. K.], University of Toronto, Toronto, Ontario, Canada

Evidence suggests hormonal factors may be more strongly associated with estrogen receptor+progesterone receptor+ (ER+PR+) than ER-PR- breast cancer risk. This study evaluated risk factors according to ERPR tumor status among pre- and postmenopausal women participating in two recent population-based case-control studies. Breast cancer cases, ages 25–74 years, and diagnosed 1995–1998 were sampled from the Ontario Cancer Registry. Controls were a random sample of women identified using the Ontario Ministry of Finance rolls and were frequency-matched to cases within 5-year age groups. Epidemiological data were collected from breast cancer cases and controls using two self-administered questionnaires. ERPR data were obtained for 87% of the breast cancer cases (3276 of 3748). Multivariate polytomous logistic regression was used to obtain odds ratios estimates and 95% confidence intervals. The following significant differences were observed in the risk factor profiles for ER+PR+ and ER-PR- breast cancer: among premenopausal women, late age at menarche was only associated with a reduction in ER+PR+ breast cancer risk; obesity was associated with an increased ER-PR- and decreased ER+PR+ cancer risk; and the association between alcohol intake and breast cancer risk was heterogeneous across ERPR subgroups, although the direction varied across the levels of alcohol intake. Among postmenopausal women, there were no statistically significant differences observed in the risk factor profiles for ER+PR+ and ER-PR- breast cancer. Some heterogeneity exists in the risk factor profiles of ER+PR+ and ER-PR- premenopausal breast cancer; however, risk factor profiles did not differ markedly for postmenopausal breast cancer.

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