Recent Use of Oral Contraceptives and Risk of Luminal B, Triple-Negative, and HER2-Overexpressing Breast Cancer

Abstract

Introduction: Oral contraceptive use is a well-established risk factor for breast cancer and is common among reproductive-aged women in the United States. Its relationship with less common, more aggressive, molecular subtypes is less clear. Methods: A population-based case-case analysis was conducted comparing three less common molecular subtypes to luminal A breast cancer among 1701 premenopausal cases aged 21-49 diagnosed with a first primary invasive breast cancer between 2004 and 2015. Medical record reviews and structured interviewer administered questionnaires were used to collect data on oral contraceptive use. Multinomial logistic regression was used to estimate odds ratios (OR) and corresponding 95% confidence intervals (95% CI) for recency of oral contraceptive use for each subtype of breast cancer. Results: Current use of oral contraceptives and use within five years before diagnosis was associated with lower odds of H2E tumors compared to luminal A tumors [odds ratio (OR)=0.5, 95% confidence interval (CI): 0.3, 0.9 and OR=0.5, 95% CI: 0.4, 0.8, respectively] with increasing duration associated with decreasing odds (p for trend<0.05). Oral contraceptive use was not associated with risks of TN or luminal B breast cancer.

Long non-coding RNAs affecting cell metabolism in cancer

“…Classically, breast cancer complies with the expression of hormone receptor for estrogen (ER+) and/or for progesterone (PR+) and for the expression of the human epidermal growth factor receptor (HER2) [24][25][26][27]. Therefore, breast cancer has been conventionally classified in five subtypes; luminal A (ER+ /PR+ /HER2−), luminal B, HER2 positive and triple negative (ER−/PR−/HER2−) [28][29][30]. This conventional classification of breast cancer has improved the diagnosis and the targeted therapy in patients, resulting in a better clinical outcome.…”

Identification of Tumor Microenvironment-Related Prognostic Biomarkers in Luminal Breast Cancer

“…BC is a heterogeneous disease in terms of cellular composition, molecular alterations, and clinical outcomes within different tumor subtypes and within a single tumor. BC is commonly categorized by gene expression profiling into four main subtypes: luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)-enriched, and triple-negative (TN; Lorona et al, 2019 ). More than 70% of the diagnosed BC cases are the luminal subtype and positive for estrogen receptor and/or progesterone receptor (ER+ and PR+, respectively; Polyak and Metzger Filho, 2012 ).…”

The Impact of Exogenous Estrogen Exposure on the Characteristics and Outcome of Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Early-Stage Breast Cancer

“…While the associations between HRT and OCT and breast cancer risk are well established [2][3][4][5][6][7], data regarding the effects of exogenous estrogen treatments on breast cancer characteristics and outcomes are limited. Most existing data focus on the associations of these exposures to receptor expression, suggesting stronger association with HRT or OCT and ER-positive disease [17][18][19]22]. In order to better understand the impact of these exposures, we focused on women with early ER-positive, HER2-negative disease.…”

“…Data on the impact of OCT on breast cancer characteristics are inconsistent. A population-based case-case analysis found OCT is associated with luminal (i.e., ER-positive, human epidermal growth factor receptor 2 [HER2]-negative disease) or tri-ple-negative disease, but not with HER2-positive disease [22]. A large, prospective cohort study has shown that women with breast cancer and prior use of OCT had comparable survival to women with breast cancer who never used OCT [23].…”