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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Epidemiology of Basal-like and Luminal Breast Cancers among Black Women in the AMBER Consortium

Halei C. Benefield, Gary R. Zirpoli, Emma H. Allott, Yue Shan, Amber N. Hurson, Angela R. Omilian, Thaer Khoury, Chi-Chen Hong, Andrew F. Olshan, Traci N. Bethea, Elisa V. Bandera, Julie R. Palmer, Christine B. Ambrosone and Melissa A. Troester
Halei C. Benefield
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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  • ORCID record for Halei C. Benefield
Gary R. Zirpoli
2Slone Epidemiology Center at Boston University, Boston, Massachusetts.
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Emma H. Allott
3Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
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Yue Shan
4Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Amber N. Hurson
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Angela R. Omilian
5Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
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Thaer Khoury
6Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York.
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Chi-Chen Hong
5Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
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Andrew F. Olshan
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Traci N. Bethea
2Slone Epidemiology Center at Boston University, Boston, Massachusetts.
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Elisa V. Bandera
7Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
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Julie R. Palmer
2Slone Epidemiology Center at Boston University, Boston, Massachusetts.
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Christine B. Ambrosone
5Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York.
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  • ORCID record for Christine B. Ambrosone
Melissa A. Troester
1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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  • For correspondence: troester@unc.edu
DOI: 10.1158/1055-9965.EPI-20-0556 Published January 2021
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Abstract

Background: Evidence suggests etiologic heterogeneity among breast cancer subtypes. Previous studies with six-marker IHC classification of intrinsic subtypes included small numbers of black women.

Methods: Using centralized laboratory results for estrogen receptor (ER), progesterone receptor, HER2, proliferation marker, Ki-67, EGFR, and cytokeratin (CK)5/6, we estimated case-only and case–control ORs for established breast cancer risk factors among cases (n = 2,354) and controls (n = 2,932) in the African American Breast Cancer Epidemiology and Risk (AMBER) consortium. ORs were estimated by ER status and intrinsic subtype using adjusted logistic regression.

Results: Case-only analyses by ER status showed etiologic heterogeneity by age at menarche, parity (vs. nulliparity), and age at first birth. In case–control analyses for intrinsic subtype, increased body mass index and waist-to-hip ratio (WHR) were associated with increased risk of luminal A subtype, whereas older age at menarche and parity, regardless of breastfeeding, were associated with reduced risk. For basal-like cancers, parity without breastfeeding and increasing WHR were associated with increased risk, whereas breastfeeding and age ≥25 years at first birth were associated with reduced risk among parous women. Basal-like and ER−/HER2+ subtypes had earlier age-at-incidence distribution relative to luminal subtypes.

Conclusions: Breast cancer subtypes showed distinct etiologic profiles in the AMBER consortium, a study of more than 5,000 black women with centrally assessed tumor biospecimens.

Impact: Among black women, high WHR and parity without breastfeeding are emerging as important intervention points to reduce the incidence of basal-like breast cancer.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2021;30:71–9

  • Received April 14, 2020.
  • Revision received June 7, 2020.
  • Accepted October 16, 2020.
  • Published first October 23, 2020.
  • ©2020 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 30 (1)
January 2021
Volume 30, Issue 1
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Epidemiology of Basal-like and Luminal Breast Cancers among Black Women in the AMBER Consortium
Halei C. Benefield, Gary R. Zirpoli, Emma H. Allott, Yue Shan, Amber N. Hurson, Angela R. Omilian, Thaer Khoury, Chi-Chen Hong, Andrew F. Olshan, Traci N. Bethea, Elisa V. Bandera, Julie R. Palmer, Christine B. Ambrosone and Melissa A. Troester
Cancer Epidemiol Biomarkers Prev January 1 2021 (30) (1) 71-79; DOI: 10.1158/1055-9965.EPI-20-0556

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Epidemiology of Basal-like and Luminal Breast Cancers among Black Women in the AMBER Consortium
Halei C. Benefield, Gary R. Zirpoli, Emma H. Allott, Yue Shan, Amber N. Hurson, Angela R. Omilian, Thaer Khoury, Chi-Chen Hong, Andrew F. Olshan, Traci N. Bethea, Elisa V. Bandera, Julie R. Palmer, Christine B. Ambrosone and Melissa A. Troester
Cancer Epidemiol Biomarkers Prev January 1 2021 (30) (1) 71-79; DOI: 10.1158/1055-9965.EPI-20-0556
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