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Epidemiological risk factors associated with inflammatory breast cancer subtypes

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Abstract

Background

In this single-institution case–control study, we identified risk factors associated with inflammatory breast cancer (IBC) subtypes based on staining of estrogen receptor (ER), progesterone receptor (PR) and expression of human epidermal growth factor 2 (HER2neu) to determine distinct etiologic pathways.

Methods

We identified 224 women with IBC and 396 cancer-free women seen at the MD Anderson Cancer Center. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for associations between breast cancer risk factors and the IBC tumor subtypes: luminal (ER+ and/or PR+/HER2neu−), HER2neu+ (any ER and PR, HER2neu+), and triple-negative (ER−/PR−/HER2neu−).

Results

In multivariable analysis, compared with women age ≥26 at first pregnancy, women age <26 had a higher risk of triple-negative IBC (OR 3.32, 95% CI 1.37–8.05). Women with a history of breast-feeding had a lower risk of triple-negative (OR 0.30; 95% CI 0.15–0.62) and luminal IBC (OR 0.35, 95% CI 0.18–0.68). A history of smoking was associated with an increased risk of luminal IBC (OR 2.37; 95% CI 1.24–4.52). Compared with normal-weight women, those who were overweight or obese (body mass index ≥25 kg/m2) had a higher risk of all three tumor subtypes (p < 0.01 for all subtypes).

Conclusion

Overweight or obese status is important modifiable risk factor for IBC of any subtype. Modifiable risk factors, age at first pregnancy (≥26), breast-feeding, and smoking may be associated with specific IBC subtypes. These results highlight the importance of evaluating epidemiologic risk factors for IBC for the identification of subtype-specific prevention strategies.

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Acknowledgments

This work was supported in part by National Institutes of Health (1R01CA180061-01 (WW), R25T CA057730 (RA), Cancer Center Support Grant CA016672) and the State of Texas Grant for Rare and Aggressive Breast Cancer.

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Authors and Affiliations

  1. Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 1155 Pressler St., Unit 1360, P.O. Box 301439, Houston, TX, 77230, USA

    Rachel L. Atkinson, Therese B. Bevers, Weiqin Liao & Abenaa M. Brewster

  2. MD Anderson Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, Houston, TX, USA

    Rachel L. Atkinson, Randa El-Zein, Vicente Valero, Anthony Lucci, Tamer Fouad, Naoto T. Ueno & Wendy A. Woodward

  3. Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Randa El-Zein

  4. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Vicente Valero, Tamer Fouad & Naoto T. Ueno

  5. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Anthony Lucci

  6. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Wendy A. Woodward

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  1. Rachel L. Atkinson
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Correspondence to Abenaa M. Brewster.

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Atkinson, R.L., El-Zein, R., Valero, V. et al. Epidemiological risk factors associated with inflammatory breast cancer subtypes. Cancer Causes Control 27, 359–366 (2016). https://doi.org/10.1007/s10552-015-0712-3

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  • DOI: https://doi.org/10.1007/s10552-015-0712-3

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