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Associations of reproductive breast cancer risk factors with breast tissue composition

Authors
Yaghjyan, LusineAustin-Datta, Rebecca J.Oh, HannahHeng, Yujing J.Vellal, Adithya D.Sirinukunwattana, KorsukBaker, Gabrielle M.Collins, Laura C.Murthy, DivyaRosner, BernardTamimi, Rulla M.
Issue Date
5-Jul-2021
Publisher
BMC
Keywords
Benign breast disease; Parity; Breastfeeding; Age at first child; Breast cancer risk
Citation
BREAST CANCER RESEARCH, v.23, no.1
Indexed
SCIE
SCOPUS
Journal Title
BREAST CANCER RESEARCH
Volume
23
Number
1
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/137152
DOI
10.1186/s13058-021-01447-2
ISSN
1465-5411
1465-542X
Abstract
Background We investigated the associations of reproductive factors with the percentage of epithelium, stroma, and fat tissue in benign breast biopsy samples. Methods This study included 983 cancer-free women with biopsy-confirmed benign breast disease (BBD) within the Nurses' Health Study and Nurses' Health Study II cohorts. The percentage of each tissue type (epithelium, stroma, and fat) was measured on whole-section images with a deep-learning technique. All tissue measures were log-transformed in all the analyses to improve normality. The data on reproductive variables and other breast cancer risk factors were obtained from biennial questionnaires. Generalized linear regression was used to examine the associations of reproductive factors with the percentage of tissue types, while adjusting for known breast cancer risk factors. Results As compared to parous women, nulliparous women had a smaller percentage of epithelium (beta = - 0.26, 95% confidence interval [CI] - 0.41, - 0.11) and fat (beta = - 0.34, 95% CI - 0.54, - 0.13) and a greater percentage of stroma (beta = 0.04, 95% CI 0.01, 0.08). Among parous women, the number of children was inversely associated with the percentage of stroma (beta per child = - 0.01, 95% CI - 0.02, - 0.00). The duration of breastfeeding of >= 24 months was associated with a reduced proportion of fat (beta = - 0.30, 95% CI - 0.54, - 0.06; p-trend = 0.04). In a separate analysis restricted to premenopausal women, older age at first birth was associated with a greater proportion of epithelium and a smaller proportion of stroma. Conclusions Our findings suggest that being nulliparous as well as having a fewer number of children (both positively associated with breast cancer risk) is associated with a smaller proportion of epithelium and a greater proportion of stroma, potentially suggesting the importance of epithelial-stromal interactions. Future studies are warranted to confirm our findings and to elucidate the underlying biological mechanisms.
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