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Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study
BACKGROUND: Breast cancer (BC) is the most prevalent cancer in women and the leading cause of women's cancer-related deaths and morbidity worldwide. In Rwanda, BC incidence is increasing with an unacceptably high mortality rate in premenopausal women. OBJECTIVES: The purpose was to identify mod...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Hindawi
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519716/ https://www.ncbi.nlm.nih.gov/pubmed/34659834 http://dx.doi.org/10.1155/2021/5560559 |
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author | Ntirenganya, Faustin Twagirumukiza, Jean Damascene Bucyibaruta, Georges Rugwizangoga, Belson Rulisa, Stephen |
author_facet | Ntirenganya, Faustin Twagirumukiza, Jean Damascene Bucyibaruta, Georges Rugwizangoga, Belson Rulisa, Stephen |
author_sort | Ntirenganya, Faustin |
collection | PubMed |
description | BACKGROUND: Breast cancer (BC) is the most prevalent cancer in women and the leading cause of women's cancer-related deaths and morbidity worldwide. In Rwanda, BC incidence is increasing with an unacceptably high mortality rate in premenopausal women. OBJECTIVES: The purpose was to identify modifiable BC risk factors and assess associations between common breast cancer risks factors and molecular subtypes in premenopausal women in Rwanda. METHODS: This was a case-control study. Premenopausal women with histological confirmation of BC and frequency-matched for age controls were recruited. A preestablished questionnaire was administered to both cases and controls for sociodemographics, BC probable risk factors, and clinical and pathological characteristics. BC was classified into luminal A, luminal B, HER2-type, basal-like (triple negative), and unclassified molecular subtypes by immunohistochemistry (IHC). Odds ratio (OR) and 95% confidence interval (CI) were estimated using multivariate logistic regression analysis. RESULTS: 340 participants were recruited into the study (170 cases vs. 170 controls). The median age was 39 years. The majority of cases presented at advanced stages of the disease (51.2% in stages III and IV) and had invasive ductal carcinoma (98.2%). 60.6% had subtypes of poor prognosis (HER2 enriched 14.7%, triple negative 12.9%, and unclassified 32.9%). Alcohol intake (AOR = 3.73, 95%CI 2.19 − 6.32, p < 0.001), obesity/overweight in adolescence or early adulthood (AOR = 10.86, 95%CI 4.82 − 24.4, p < 0.001), history of primary infertility (AOR = 33.8, 95%CI 3.5 − 321.5, p = 0.002), nulliparity (AOR = 3.75, 95%CI 1.61 − 8.75, p = 0.002), and a history of benign breast disease (AOR = 6.06, 95%CI 1.19 − 30.73, p = 0.03) were associated with the occurrence of premenopausal breast cancer. There was no significant difference between risk factor stratification per molecular subtype. CONCLUSION: Several reproductive, environmental, and lifestyle risk factors have been identified to be associated with premenopausal BC. Among them, alcohol intake and obesity/overweight during adolescence/early adulthood can be modified. Interventions targeting alcohol consumption and obesity/overweight in adolescents and young adults may decrease the incidence of premenopausal breast cancer. |
format | Online Article Text |
id | pubmed-8519716 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-85197162021-10-16 Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study Ntirenganya, Faustin Twagirumukiza, Jean Damascene Bucyibaruta, Georges Rugwizangoga, Belson Rulisa, Stephen Int J Breast Cancer Research Article BACKGROUND: Breast cancer (BC) is the most prevalent cancer in women and the leading cause of women's cancer-related deaths and morbidity worldwide. In Rwanda, BC incidence is increasing with an unacceptably high mortality rate in premenopausal women. OBJECTIVES: The purpose was to identify modifiable BC risk factors and assess associations between common breast cancer risks factors and molecular subtypes in premenopausal women in Rwanda. METHODS: This was a case-control study. Premenopausal women with histological confirmation of BC and frequency-matched for age controls were recruited. A preestablished questionnaire was administered to both cases and controls for sociodemographics, BC probable risk factors, and clinical and pathological characteristics. BC was classified into luminal A, luminal B, HER2-type, basal-like (triple negative), and unclassified molecular subtypes by immunohistochemistry (IHC). Odds ratio (OR) and 95% confidence interval (CI) were estimated using multivariate logistic regression analysis. RESULTS: 340 participants were recruited into the study (170 cases vs. 170 controls). The median age was 39 years. The majority of cases presented at advanced stages of the disease (51.2% in stages III and IV) and had invasive ductal carcinoma (98.2%). 60.6% had subtypes of poor prognosis (HER2 enriched 14.7%, triple negative 12.9%, and unclassified 32.9%). Alcohol intake (AOR = 3.73, 95%CI 2.19 − 6.32, p < 0.001), obesity/overweight in adolescence or early adulthood (AOR = 10.86, 95%CI 4.82 − 24.4, p < 0.001), history of primary infertility (AOR = 33.8, 95%CI 3.5 − 321.5, p = 0.002), nulliparity (AOR = 3.75, 95%CI 1.61 − 8.75, p = 0.002), and a history of benign breast disease (AOR = 6.06, 95%CI 1.19 − 30.73, p = 0.03) were associated with the occurrence of premenopausal breast cancer. There was no significant difference between risk factor stratification per molecular subtype. CONCLUSION: Several reproductive, environmental, and lifestyle risk factors have been identified to be associated with premenopausal BC. Among them, alcohol intake and obesity/overweight during adolescence/early adulthood can be modified. Interventions targeting alcohol consumption and obesity/overweight in adolescents and young adults may decrease the incidence of premenopausal breast cancer. Hindawi 2021-10-08 /pmc/articles/PMC8519716/ /pubmed/34659834 http://dx.doi.org/10.1155/2021/5560559 Text en Copyright © 2021 Faustin Ntirenganya et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Ntirenganya, Faustin Twagirumukiza, Jean Damascene Bucyibaruta, Georges Rugwizangoga, Belson Rulisa, Stephen Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study |
title | Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study |
title_full | Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study |
title_fullStr | Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study |
title_full_unstemmed | Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study |
title_short | Premenopausal Breast Cancer Risk Factors and Associations with Molecular Subtypes: A Case-Control Study |
title_sort | premenopausal breast cancer risk factors and associations with molecular subtypes: a case-control study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519716/ https://www.ncbi.nlm.nih.gov/pubmed/34659834 http://dx.doi.org/10.1155/2021/5560559 |
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