Associations between estrogen receptor-negative breast cancer and timing of reproductive events differ between African American and European American women

Abstract

The effects of reproductive factors on breast cancer risk seem to differ by estrogen receptor (ER) status. Menarche and first live birth (FLB) tend to occur at younger ages in African Americans (AA) than European Americans (EA), and could play a role in breast cancer disparities. In the Women's Circle of Health Study, a case-control study of breast cancer in EA and AA women, in-person interviews were conducted to collect epidemiologic data, including reproductive histories. Data on ER status, abstracted from pathology reports, were available for 814 AA and 538 EA breast cancer cases, and were analyzed with 1015 AA and 715 EA controls, to evaluate associations between subgroups and age at menarche, age at FLB, and the interval between those ages. Among AA women, later age at menarche (≥14 years) was associated with reduced risk of both ER(+) and ER(-) breast cancer, with ORs strongest for ER(-) disease [OR = 0.57; 95% confidence interval (CI), 0.37-0.88]; associations were weaker and nonsignificant for EA women. There were no significant associations with age at FLB, but AA women with a FLB within 15 years of menarche had increased risk of ER(-) disease (OR = 2.26; 95% CI, 1.29-3.95), with no significant associations among EAs. In our data, earlier age at menarche and shorter intervals until FLB are associated with ER(-) breast cancer in AA women; differential distributions by race of these and other reproductive risk factors could contribute to the higher prevalence of ER(-) breast cancer in AA women. Cancer Epidemiol Biomarkers Prev; 23(6); 1115-20. ©2014 AACR.