Breast cancer risk after full‐term pregnancies among <scp>A</scp>frican women from <scp>N</scp>igeria, <scp>C</scp>ameroon, and <scp>U</scp>ganda

Sighoko, Dominique; Ogundiran, Temidayo O.; Ademola, Adeyinka; Adebamowo, Clement; Chen, Lin; Odedina, Stella; Anetor, Imaria; Ndom, Paul; Gakwaya, Antony; Ojengbede, Oladosu; Huo, Dezheng; Olopade, Olufunmilayo I.

doi:10.1002/cncr.29305

Cited by 14 publications

(17 citation statements)

References 37 publications

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“…We extended prior ndings by evaluating etiologic heterogeneity for risk factors thought to be most relevant for subsequent risk among BBD patients. Consistent with multiple studies of women diagnosed with sporadic breast cancer [7][8][9][10] and with the Mayo Clinic BBD cohort [6], we observed that parity/age at rst birth was signi cantly associated with future breast cancer risk. Also consistent with limited data from other BBD cohorts [6], we found that history of bilateral oophorectomy was associated with reduced breast cancer risk, whereas positive family history of breast cancer in a 1st degree relative tended to be associated with increased breast cancer risk.…”

Section: Patient Characteristics and Breast Cancer Risksupporting

confidence: 89%

“…We were able to further evaluate potential etiologic heterogeneity in risk associations, because our BBD study is nested within a single, large, well-de ned population with access to healthcare and with a long-standing tumor tissue registry that has collected data since 1960's. Although the number of ER-negative tumors was limited, we con rmed patterns of association by ER status that have also been observed among women diagnosed with sporadic breast cancers [7][8][9][10]. For example, early age at rst birth showed an inverse association with ER-positive tumors, which was not evident among ER-negative tumors and suggested that reproductive risk factor associations among BBD patients may be similar to those observed in the general population.…”

Section: Patient Characteristics and Breast Cancer Risksupporting

confidence: 69%

“…Breast cancer is a heterogeneous disease, with data strongly supporting different associations of risk factors such as parity and genetic susceptibility loci by tumor subtypes de ned by hormone receptor status and other clinical/pathologic features [7][8][9][10]. Whether similar etiologic heterogeneity exists for breast cancer arising in BBD patients is unknown, and to date very few cohort studies can assess this hypothesis [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for breast cancer development by tumor characteristics among women with benign breast disease

Figueroa

Gierach²,

Duggan

et al. 2020

Preprint

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Background: Among women diagnosed with invasive breast cancer, 30% have a prior diagnosis of benign breast disease (BBD). Thus, it is important to identify factors among BBD patients that elevate invasive cancer risk. In the general population, risk factors differ in their associations by clinical pathologic features; however, whether women with BBD show etiologic heterogeneity in the types of breast cancers they develop remains unknown. Methods: Using a nested case-control study of BBD and breast cancer risk conducted in a community healthcare plan (Kaiser Permanente Northwest), we assessed relationships of histologic features in BBD biopsies and patient characteristics with subsequent breast cancer risk, and tested for heterogeneity of associations by estrogen receptor (ER) status, tumor grade and size. The study included 514 invasive breast cancer cases (median follow-up of 9 years post-BBD diagnosis) and 514 matched controls, diagnosed with proliferative or non-proliferative BBD between 1971-2006, with follow-up through mid-2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using multivariable polytomous logistic regression models.Results: Breast cancers were predominantly ER-positive (86%), well- or moderately-differentiated (73%), small (74% <20mm) and stage I/II (91%). Having had an age at first birth <30 years was associated with reduced risk of ER-positive breast cancer (OR=0.69, 95%CI=0.49-0.98), but not of ER-negative disease (OR=1.08, 95%CI=0.51-2.30) p-heterogeneity=0.24. Compared to patients with non-proliferative BBD, proliferative BBD with atypia conferred higher risk for ER-positive (OR=5.48, 95%CI=2.14-14.01) than ER-negative disease (OR=1.52, 95%CI=0.18-13.05, with only one ER-negative case); p-heterogeneity=0.45. Presence of columnar cell lesions (CCLs) at BBD diagnosis was associated with 1.5-fold risk for both ER-positive and ER-negative tumors, with a 2-fold risk (95%CI=1.21-3.58) observed among postmenopausal women (56%), independent of proliferative BBD status with and without atypia. We did not identify statistically significant differences in risk factor associations by tumor grade or size.Conclusion: Most tumors that developed after a BBD diagnosis in this cohort were highly treatable low-stage ER-positive tumors. CCL in BBD biopsies may be associated with moderate increased risk, independent of BBD histology, and irrespective of ER status.

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Section: Patient Characteristics and Breast Cancer Risksupporting

confidence: 89%

Section: Patient Characteristics and Breast Cancer Risksupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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Risk factors for breast cancer development by tumor characteristics among women with benign breast disease

Figueroa

Gierach²,

Duggan

et al. 2020

Preprint

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“…The Ibo and other ethnic group participants were recruited from Aleshiloye market, a major market in Ibadan. The recruitment methods and study design have been documented in detail elsewhere [22,23]. All subjects were informed about the research and gave consent.…”

Section: Subjectsmentioning

confidence: 99%

Traditional medicine usage among adult women in Ibadan, Nigeria: a cross-sectional study

Odedina

Agwai

et al. 2020

BMC Complement Med Ther

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Background: Previous research has revealed high rates of traditional medicine usage in Nigeria. Reports of widespread contamination of herbal medicine products and higher rates of noncompliance with Western medications among traditional medicine users have raised concerns about the safety of traditional medicine use. Few studies have explored how demographic factors predict rates of traditional medicine use in the general population. Methods: We conducted interviews of 748 adult women recruited from the communities in the city of Ibadan, Nigeria from 2013 to 2015. A structured questionnaire was created to collect data on rates of traditional medicine use and demographic factors such as age, education, ethnicity, and occupation. Multivariate logistic regressions were run to examine factors related to traditional medicine use, and the effects were measured with odds ratios (OR) along with 95% confidence interval (95%CI). Results: The overall proportion of traditional medicine use was 81.6%. Women from the Ibo and Hausa ethnic groups were significantly less likely to use traditional medicine than the majority Yoruba group (OR 0.25, 95%CI 0.10-0.63;, OR 0.43, 95%CI 0.24-0.76) respectively). In addition, educated women were less likely than their noneducated counterparts to have used traditional medicine, with the biggest effect seen in women with a secondary education (OR 0.42, 95%CI 0.21-0.85). Conclusions: We found a high rate of traditional medicine usage, consistent with that found in prior research. A novel finding was the significance of ethnicity as a predictor for usage rates.

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“…Traditionally within these communities, girls usually get married before the age of 20 years. As prior studies have suggested, a full-term pregnancy before the age of 20 years may have a transient cancer promoting effect as each pregnancy, including the first one, may increase the risk of early-onset breast cancer [24][25][26], so early marriages and subsequent early pregnancies could contribute to the higher proportion of early onset pre-menopausal breast cancers seen in the Cushites vs. the other two ethnic groups, although the cross-sectional nature of the study design along with the small number of Cushite cases limits our ability to draw conclusions.…”

Section: Discussionmentioning

confidence: 99%

Ethnicity and breast cancer characteristics in Kenya

Sayed

Moloo

Wasike

et al. 2017

Breast Cancer Res Treat

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Purpose There are no published data from specific regions of sub-Saharan Africa describing the clinical and pathological characteristics and molecular subtypes of invasive breast cancer by ethnic group. The purpose of this study was to investigate these characteristics among the three major ethno-cultural groupings in Kenya. Methods The study included women with pathologically-confirmed breast cancer seen between March 2012 and May 2015 at 11 hospitals throughout Kenya. Socio-demographic, clinical, and reproductive data were collected by questionnaire, and pathology review and immunohistochemistry were performed centrally. Results The 846 cases included 661 Bantus (78.1%), 143 Nilotes (16.9%), 19 Cushites (2.3%), and 23 patients of mixed ethnicity (2.7%). In analyses comparing the two major ethnic groups, Bantus were more educated, more overweight, had an older age at first birth and had a younger age at menopause than Nilotes (p<0.05 for all comparisons). In analyses restricted to definitive surgery specimens, there were no statistically significant differences in tumour characteristics or molecular subtypes, although the Nilote tumours tended to be larger (OR for ≥ 5 cm vs. < 2 cm: 3.86, 95%CI: 0.77, 19.30) and were somewhat more likely to be HER2-enriched (OR for HER2-enriched vs. Luminal A/B: 1.41, 95%CI: 0.79, 2.49). Conclusion This case series showed no significant differences in breast cancer tumour characteristics or molecular subtypes, but significant differences in socio-demographic characteristics and reproductive factors, among the three major ethnic groups in Kenya. We suggest further evaluation of ethnic differences in breast cancer throughout the genetically and culturally diverse populations of sub-Saharan Africa.

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Breast cancer risk after full‐term pregnancies among African women from Nigeria, Cameroon, and Uganda

Cited by 14 publications

References 37 publications

Risk factors for breast cancer development by tumor characteristics among women with benign breast disease

Risk factors for breast cancer development by tumor characteristics among women with benign breast disease

Traditional medicine usage among adult women in Ibadan, Nigeria: a cross-sectional study

Ethnicity and breast cancer characteristics in Kenya

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