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. 2016 Mar;27(3):359-66.
doi: 10.1007/s10552-015-0712-3. Epub 2016 Jan 21.

Epidemiological risk factors associated with inflammatory breast cancer subtypes

Rachel L Atkinson  1   2 , Randa El-Zein  2   3 , Vicente Valero  2   4 , Anthony Lucci  2   5 , Therese B Bevers  1 , Tamer Fouad  2   4 , Weiqin Liao  1 , Naoto T Ueno  2   4 , Wendy A Woodward  2   6 , Abenaa M Brewster  7
Affiliations

Epidemiological risk factors associated with inflammatory breast cancer subtypes

Rachel L Atkinson et al. Cancer Causes Control. 2016 Mar.

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/m(2)) 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.

Keywords: Cancer epidemiology; Inflammatory breast cancer; Lifestyle factors; Obesity; Reproductive factors.

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