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Breast cancer risk factors and survival by tumor subtype: pooled analyses from the Breast Cancer Association Consortium

Breast cancer risk factors and survival by tumor subtype: pooled analyses from the Breast Cancer Association Consortium
Breast cancer risk factors and survival by tumor subtype: pooled analyses from the Breast Cancer Association Consortium
Background: It is not known if modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype. Methods: We analyzed data for 121,435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16,890 deaths (8,554 breast cancer-specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer-specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype. Results: There was no evidence of heterogeneous associations between risk factors and mortality by subtype (adjusted p>0.30). The strongest associations were between all-cause mortality and BMI ≥30 vs 18.5-25 kg/m2 (HR (95%CI): 1.19 (1.06,1.34)); current vs never smoking (1.37 (1.27,1.47)), high vs low physical activity (0.43 (0.21,0.86)), age ≥30 years vs <20 years at first pregnancy (0.79 (0.72,0.86)); >0 to <5 years vs ≥10 years since last full term birth (1.31 (1.11,1.55)); ever vs never use of oral contraceptives (0.91 (0.87,0.96)); ever vs never use of menopausal hormone therapy, including current estrogen-progestin therapy (0.61 (0.54,0.69)). Similar associations with breast cancer mortality were weaker; e.g. 1.11 (1.02,1.21) for current vs never smoking. Conclusions: We confirm associations between modifiable lifestyle factors and 10-year all-cause mortality. There was no strong evidence that associations differed by ER status or intrinsic-like subtype. Impact: Given the large dataset and lack of evidence that associations between modifiable risk factors and 10-year mortality differed by subtype, these associations could be cautiously used in prognostication models to inform patient-centered care.
1055-9965
Morra, Anna
b866cd70-d637-40ab-8fce-fa78a04a9417
Jung, Audrey Y.
74465ea8-5494-4474-b290-acf6631095ed
Eccles, Diana
5b59bc73-11c9-4cf0-a9d5-7a8e523eee23
et al.
Morra, Anna
b866cd70-d637-40ab-8fce-fa78a04a9417
Jung, Audrey Y.
74465ea8-5494-4474-b290-acf6631095ed
Eccles, Diana
5b59bc73-11c9-4cf0-a9d5-7a8e523eee23

Morra, Anna , et al. (2020) Breast cancer risk factors and survival by tumor subtype: pooled analyses from the Breast Cancer Association Consortium. Cancer Epidemiology, Biomarkers & Prevention. (In Press)

Record type: Article

Abstract

Background: It is not known if modifiable lifestyle factors that predict survival after invasive breast cancer differ by subtype. Methods: We analyzed data for 121,435 women diagnosed with breast cancer from 67 studies in the Breast Cancer Association Consortium with 16,890 deaths (8,554 breast cancer-specific) over 10 years. Cox regression was used to estimate associations between risk factors and 10-year all-cause mortality and breast cancer-specific mortality overall, by estrogen receptor (ER) status, and by intrinsic-like subtype. Results: There was no evidence of heterogeneous associations between risk factors and mortality by subtype (adjusted p>0.30). The strongest associations were between all-cause mortality and BMI ≥30 vs 18.5-25 kg/m2 (HR (95%CI): 1.19 (1.06,1.34)); current vs never smoking (1.37 (1.27,1.47)), high vs low physical activity (0.43 (0.21,0.86)), age ≥30 years vs <20 years at first pregnancy (0.79 (0.72,0.86)); >0 to <5 years vs ≥10 years since last full term birth (1.31 (1.11,1.55)); ever vs never use of oral contraceptives (0.91 (0.87,0.96)); ever vs never use of menopausal hormone therapy, including current estrogen-progestin therapy (0.61 (0.54,0.69)). Similar associations with breast cancer mortality were weaker; e.g. 1.11 (1.02,1.21) for current vs never smoking. Conclusions: We confirm associations between modifiable lifestyle factors and 10-year all-cause mortality. There was no strong evidence that associations differed by ER status or intrinsic-like subtype. Impact: Given the large dataset and lack of evidence that associations between modifiable risk factors and 10-year mortality differed by subtype, these associations could be cautiously used in prognostication models to inform patient-centered care.

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Morra_Jung_BCAC_riskfactors_survival_by_subtype_R3_marked_CEBP_accepted - Accepted Manuscript
Restricted to Repository staff only until 9 December 2021.
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Accepted/In Press date: 9 December 2020

Identifiers

Local EPrints ID: 445646
URI: http://eprints.soton.ac.uk/id/eprint/445646
ISSN: 1055-9965
PURE UUID: 9bb4967b-077d-4301-a534-4f85676fece5
ORCID for Diana Eccles: ORCID iD orcid.org/0000-0002-9935-3169

Catalogue record

Date deposited: 05 Jan 2021 17:31
Last modified: 22 Oct 2021 01:33

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Contributors

Author: Anna Morra
Author: Audrey Y. Jung
Author: Diana Eccles ORCID iD
Corporate Author: et al.

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