Reproductive Risk Factors Associated with Breast Cancer Molecular Subtypes among Young Women in Northern China

Abstract

Purpose. Accumulated evidence suggests that reproductive factors are related to different breast cancer subtypes, but most studies on these relationships are mainly focused on middle-aged and older patients, and it remains unclear how reproductive factors impact different subtypes of breast cancer in young women. Methods. We assessed the relationships between fertility factors and luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)-enriched, and triple-negative breast cancer (TNBC) subtypes in 3792 patients and 4182 controls aged 20–70 years. Data on the reproductive history of the study participants were acquired through face-to-face interviews and questionnaires. We conducted case-control comparisons among tumor subtypes based on estrogen receptor (ER), progesterone receptor (PR), and HER2 statuses using unconditional polychotomous multivariate logistic regression models to compute odds ratios (ORs) and 95% confidence intervals (CIs). Results. Parity was inversely related to both luminal A and luminal B subtypes in young women and older women (all Ptrend<0.05). Later age at first full-term birth was inversely related to the luminal A subtype (Ptrend<0.05) in young women but correlated with an increased risk of the luminal A subtype (Ptrend<0.05) in older women. Parous Chinese women 40 years old or younger who breastfed for 12 months or longer had a lower risk of luminal B and TNBC subtypes than women who never breastfed (OR=0.55, 95% CI 0.36-0.84 and OR=0.52, 95% CI 0.28-0.99, respectively). Conclusions. Our results implied that parity exerted a strong protective effect against luminal A and luminal B subtype breast cancer in young Chinese women, and long-term breastfeeding obviously decreased the risk of luminal B and TNBC subtypes in this population.