Limited epidemiological evidence suggests that the etiology of hormone receptor positive (HR+) breast cancer may differ by levels of histologic grade and proliferation. We pooled risk factor and pathology data on 5,905 HR+ breast cancer cases and 26,281 controls from 11 epidemiological studies. Proliferation was determined by centralized automated measures of KI67 in tissue microarrays. Odds ratios (OR), 95% confidence intervals (CI) and p-values for case-case and case-control comparisons for risk factors in relation to levels of grade and quartiles (Q1-Q4) of KI67 were estimated using polytomous logistic regression models. Case-case comparisons showed associations between nulliparity and high KI67 [OR (95% CI) for Q4 vs Q1 = 1.54 (1.22, 1.95)]; obesity and high grade [grade 3 vs 1 = 1.68 (1.31, 2.16)]; and current use of combined hormone therapy (HT) and low grade [grade 3 vs 1 = 0.27 (0.16, 0.44)] tumors. In case-control comparisons, nulliparity was associated with elevated risk of tumors with high but not low levels of proliferation [1.43 (1.14, 1.81) for KI67 Q4 vs 0.83 (0.60, 1.14) for KI67 Q1]; obesity among women ≥50 years with high but not low grade tumors [1.55 (1.17, 2.06) for grade 3 vs 0.88 (0.66, 1.16) for grade 1]; and HT with low but not high grade tumors [3.07 (2.22, 4.23) for grade 1 vs 0.85 (0.55, 1.30) for grade 3]. Menarcheal age and family history were similarly associated with HR+ tumors of different grade or KI67 levels. These findings provide insights into the etiologic heterogeneity of HR+ tumors. This article is protected by copyright. All rights reserved.
Pharmacology, Toxicology and Pharmaceutical Science
2
3%
Biochemistry, Genetics and Molecular Biology
2
3%
Other
3
4%
Unknown
37
54%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 April 2018.
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#16,597,003
of 24,417,958 outputs
Outputs from International Journal of Cancer
#10,009
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Outputs of similar age
#215,781
of 335,033 outputs
Outputs of similar age from International Journal of Cancer
#82
of 131 outputs
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