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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Research Articles

Risk Factors for Triple-Negative Breast Cancer in Women Under the Age of 45 Years

Jessica M. Dolle, Janet R. Daling, Emily White, Louise A. Brinton, David R. Doody, Peggy L. Porter and Kathleen E. Malone
Jessica M. Dolle
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Janet R. Daling
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Emily White
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Louise A. Brinton
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David R. Doody
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Peggy L. Porter
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Kathleen E. Malone
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DOI: 10.1158/1055-9965.EPI-08-1005 Published April 2009
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Abstract

Little is known about the etiologic profile of triple-negative breast cancer (negative for estrogen receptor/progesterone receptor/human epidermal growth factor), a breast cancer subtype associated with high mortality and inadequate therapeutic options. We undertook this study to assess the risk for triple-negative breast cancer among women 45 years of age and younger in relation to demographic/lifestyle factors, reproductive history, and oral contraceptive use. Study participants were ascertained in two previous population-based, case-control studies. Eligible cases included all primary invasive breast cancers among women ages 20 to 45 years in the Seattle–Puget Sound area, diagnosed between January 1983 and December 1992, for whom complete data was obtained for estrogen receptor, progesterone receptor, and human epidermal growth factor status (n = 897; including n = 187 triple-negative breast cancer cases). Controls were age matched and ascertained via random digit dialing. Oral contraceptive use ≥1 year was associated with a 2.5-fold increased risk for triple-negative breast cancer (95% confidence interval, 1.4-4.3) and no significantly increased risk for non-triple-negative breast cancer (Pheterogeneity = 0.008). Furthermore, the risk among oral contraceptive users conferred by longer oral contraceptive duration and by more recent use was significantly greater for triple-negative breast cancer than non-triple-negative breast cancer (Pheterogeneity = 0.02 and 0.01, respectively). Among women ≤40 years, the relative risk for triple-negative breast cancer associated with oral contraceptive use ≥1 year was 4.2 (95% confidence interval, 1.9-9.3), whereas there was no significantly increased risk with oral contraceptive use for non-triple-negative breast cancer among women ≤40 years, nor for triple-negative breast cancer or non-triple-negative breast cancer among women 41 to 45 years of age. In conclusion, significant heterogeneity exists for the association of oral contraceptive use and breast cancer risk between triple-negative breast cancer and non-triple-negative breast cancer among young women, lending support to a distinct etiology. (Cancer Epidemiol Biomarkers Prev 2009;18(4):1157–66)

  • Triple-negative breast cancer
  • oral contraceptives

Footnotes

  • Grant support: R01 CA59736, N01-CP-95671, R01 CA-41416, R01 CA0988858-03, and N01-PC35142, which supported case ascertainment through the Cancer Surveillance System.

  • Note: J.M. Dolle had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    • Accepted February 4, 2009.
    • Received October 24, 2008.
    • Revision received December 28, 2008.
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Cancer Epidemiology Biomarkers & Prevention: 18 (4)
April 2009
Volume 18, Issue 4
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Risk Factors for Triple-Negative Breast Cancer in Women Under the Age of 45 Years
Jessica M. Dolle, Janet R. Daling, Emily White, Louise A. Brinton, David R. Doody, Peggy L. Porter and Kathleen E. Malone
Cancer Epidemiol Biomarkers Prev April 1 2009 (18) (4) 1157-1166; DOI: 10.1158/1055-9965.EPI-08-1005

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Risk Factors for Triple-Negative Breast Cancer in Women Under the Age of 45 Years
Jessica M. Dolle, Janet R. Daling, Emily White, Louise A. Brinton, David R. Doody, Peggy L. Porter and Kathleen E. Malone
Cancer Epidemiol Biomarkers Prev April 1 2009 (18) (4) 1157-1166; DOI: 10.1158/1055-9965.EPI-08-1005
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