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      Reproductive factors and molecular subtypes of breast cancer among premenopausal women in Latin America: the PRECAMA study

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          Abstract

          Etiological differences among breast cancer (BC) subtypes have not been clearly established, especially among young women in Latin America. This study examined the relationship between reproductive factors and BC subtypes among 288 BC cases (20–45 years) and population-based matched controls in four Latin American countries. Immunohistochemistry was determined centrally. Associations between BC and reproductive factors were determined. Older age at first full-term pregnancy (FFTP) (Odds Ratio (OR) = 1.11; 95% Confidence Interval (CI), 1.04–1.19 per year), longer time between menarche and FFTP (OR = 1.12; 95%CI: 1.04–1.20 per year), and older age at last pregnancy (OR = 1.10; 95%CI, 1.02–1.19 per year) were associated with an increased risk of estrogen receptor positive (ER+) tumors (n = 122). Ever pregnant (OR = 0.35; 95%CI, 0.13–0.96), number of childbirths (OR = 0.64; 95%CI, 0.47–0.87 per child), time since last birth (OR = 0.92; 95%CI, 0.85–0.99 per year), and history of breastfeeding (OR = 0.23; 95%CI, 0.09–0.58) were inversely associated with the risk of ER+ tumor. Older age at menarche (OR = 0.63; 95%CI, 0.45–0.89 per year) and longer duration of breastfeeding (OR = 0.97; 95%CI, 0.94–1.01 per month) were inversely associated with estrogen receptor negative (ER-) tumors (n = 48). Reproductive factors may be differentially associated with BC subtypes in young Latin American women.

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          Etiology of hormone receptor-defined breast cancer: a systematic review of the literature.

          Breast cancers classified by estrogen receptor (ER) and/or progesterone receptor (PR) expression have different clinical, pathologic, and molecular features. We examined existing evidence from the epidemiologic literature as to whether breast cancers stratified by hormone receptor status are also etiologically distinct diseases. Despite limited statistical power and nonstandardized receptor assays, in aggregate, the critically evaluated studies (n = 31) suggest that the etiology of hormone receptor-defined breast cancers may be heterogeneous. Reproduction-related exposures tended to be associated with increased risk of ER-positive but not ER-negative tumors. Nulliparity and delayed childbearing were more consistently associated with increased cancer risk for ER-positive than ER-negative tumors, and early menarche was more consistently associated with ER-positive/PR-positive than ER-negative/PR-negative tumors. Postmenopausal obesity was also more consistently associated with increased risk of hormone receptor-positive than hormone receptor-negative tumors, possibly reflecting increased estrogen synthesis in adipose stores and greater bioavailability. Published data are insufficient to suggest that exogenous estrogen use (oral contraceptives or hormone replacement therapy) increase risk of hormone-sensitive tumors. Risks associated with breast-feeding, alcohol consumption, cigarette smoking, family history of breast cancer, or premenopausal obesity did not differ by receptor status. Large population-based studies of determinants of hormone receptor-defined breast cancers defined using state-of-the-art quantitative immunostaining methods are needed to clarify the role of ER/PR expression in breast cancer etiology.
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            Reproductive behaviors and risk of developing breast cancer according to tumor subtype: A systematic review and meta-analysis of epidemiological studies.

            Breast cancer is composed of distinct subtypes defined mainly based on the expression of hormone receptors (HR) and HER2. For years, reproductive factors were shown to impact breast cancer risk but it is unclear whether this differs according to tumor subtype. In this meta-analysis we evaluated the association between parity, age at first birth, breastfeeding and the risk of developing breast cancer according to tumor subtype.
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              Contemporary nutritional transition: determinants of diet and its impact on body composition.

              The world has experienced a marked shift in the global BMI distribution towards reduced undernutrition and increased obesity. The collision between human biology, shaped over the millennia and modern technology, globalization, government policies and food industry practices have worked to create far-reaching energy imbalance across the globe. A prime example is the clash between our drinking habits and our biology. The shift from water and breast milk as the only beverages available, to a vast array of caloric beverages was very rapid, shaped both by our tastes and aggressive marketing of the beverage industry. Our biology, shaped over millennia by daily consumption of water and seasonal availability of food, was not ready to compensate for the liquid energies. Other dietary changes were similarly significant, particularly the shift towards increased frequency of eating and larger portions. The roles of the food and beverage production, distribution and marketing sectors in not only shaping our diet but also accelerating these changes must be understood. Apart from the role of beverages, there is much less consensus about the role of various components of our diet in energy imbalance. Understanding the determinants of change in the key components of our diet through an array of research provides insights into some of the options we face in attempting to attain a great balance between energy intake and expenditures while creating an overall healthier dietary pattern. A few countries are systematically addressing the causes of poor dietary and physical activity patterns and high energy imbalance.
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                Author and article information

                Contributors
                rinaldis@iarc.fr
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                30 August 2018
                30 August 2018
                2018
                : 8
                : 13109
                Affiliations
                [1 ]ISNI 0000000405980095, GRID grid.17703.32, Section of Nutrition and Metabolism, , International Agency for Research on Cancer, ; Lyon, France
                [2 ]Val D’Aurelle Montpellier Cancer Institute (ICM), Montpellier, France
                [3 ]ISNI 0000 0004 1773 4764, GRID grid.415771.1, Centre for Population Health Research, , National Institute of Public Health, ; Cuernavaca, Mexico
                [4 ]ISNI 0000 0000 8882 5269, GRID grid.412881.6, Group Infection and Cancer, , School of Medicine, University of Antioquia, ; Medellín, Colombia
                [5 ]Hemato Oncologos, Cali, Colombia
                [6 ]ISNI 0000 0004 0486 8632, GRID grid.412188.6, Grupo Proyecto UNI-Barranquilla, , Universidad del Norte, ; Barranquilla, Colombia
                [7 ]ISNI 0000 0000 9019 2157, GRID grid.421610.0, Agencia Costarricense de Investigaciones Biomédicas (ACIB)-Fundación INCIENSA, ; San José, Costa Rica
                [8 ]Instituto de Nutrición y de Tecnología de los Alimentos, Santiago, Chile
                [9 ]Instituto Oncológico Fundación Arturo López Pérez, Providencia, Santiago, Chile
                [10 ]ISNI 0000000405980095, GRID grid.17703.32, Molecular Mechanisms and Biomarkers Group, , International Agency for Research on Cancer, ; Lyon, France
                [11 ]ISNI 0000 0001 2180 1622, GRID grid.270240.3, Divisions of Human Biology and Public Health Sciences, , Fred Hutchinson Cancer Research Center, ; Seattle, USA
                [12 ]Hospital Santiago Oriente Dr. Luis Tisné Brousse, Santiago, Chile
                [13 ]National Institute of Cancer, Santiago, Chile
                [14 ]Torre Médica Las Américas, Medellín, Colombia
                [15 ]ISNI 0000 0000 8882 5269, GRID grid.412881.6, GENMOL Group, Natural and Basic Sciences Faculty, , University of Antioquia, ; Medellín, Colombia
                [16 ]Clínica Vida Fundacion, Medellín, Colombia
                [17 ]Instituto de Cancerología Las Américas, Medellín, Colombia
                [18 ]Imágenes Diagnósticas y Biotecnología Reproductiva, Cediul S.A., Barranquilla, Colombia
                [19 ]Clínica Bonnadona Prevenir, Barranquilla, Colombia
                [20 ]Torre Médica El Tesoro, Medellín, Colombia
                Article
                31393
                10.1038/s41598-018-31393-7
                6117299
                30166604
                ddfec080-b691-4d41-abaf-bff952c72392
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 13 March 2018
                : 30 July 2018
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