Breast Cancer Epidemiology (eBook)

Foreword 6
Contents 8
Contributors 10
1 Global Burden of Breast Cancer 13
Introduction 13
Measurements of Cancer Burden 13
Sources of Cancer Incidence and Mortality Data 14
Geographical Burden and Variations Worldwide 15
Age-Specific Variations in Incidence of Breast Cancer 19
Trends in Incidence and Mortality 20
Trends in Developed Countries 20
Europe 20
North America 23
Other Developed Countries 24
Explanations for Reductions in Breast Cancer Mortality Rates in Developed Countries 24
Trends in Developing Countries 25
Asia 26
Africa 27
Latin America 27
Conclusion 28
References 29
2 Breast Cancer Biology and Clinical Characteristics 32
Introduction 32
Tumor Classification Schemes 32
Patient Characteristics 32
Age at Diagnosis/Menopausal Status 33
Family History of Breast Cancer 34
Tumor Characteristics 35
Clinical Characteristics 35
Stage 35
Grade 37
Histology 38
Molecular/Genetic Profile 40
Estrogen Receptor (ER) Status 41
Molecular Subtypes of Breast Cancer 42
Origins of Breast Cancer Subtypes 45
Conclusions 49
References 49
3 In situ Breast Cancer 58
Introduction 58
Incidence Trends 58
Natural History 61
Biological Markers 61
Survival and Recurrence 62
Prognostic Factors 64
Concern with Overtreatment 64
Summary 65
Risk Factors 65
Menstrual and Reproductive Factors 66
Age at Menarche 66
Age at Menopause 66
Age at First Birth 69
Parity 69
Lactation 69
Lifestyle Factors 70
Body Size 70
Physical Activity 71
Alcohol 71
Smoking 71
Postmenopausal Hormones 72
Oral Contraceptives 72
Diet 72
Genetics, Personal, and Family History of Breast Disease 73
BRCA1/2 73
Genetic Polymorphisms 73
Benign Breast Disease 74
Family History 74
Biomarkers of Risk 74
Endogenous Hormones 74
Mammographic Breast Density 75
Environmental Pollution 75
Summary of BCIS Risk Factors 75
Conclusion 76
References 76
4 Endogenous Hormones 84
Introduction 84
Estrogens 84
Androgens 89
Progesterone 90
Prolactin 91
Insulin-Like Growth Factors 92
Summary 95
References 95
5 Exogenous Hormones 99
Introduction 99
Menopausal Hormone Therapy 99
Patterns of Use 99
Types of Estrogen and Progesterone Used 100
Observational Studies of the Relationship Between HT Use and Breast Cancer Risk 101
Women’s Health Initiative Randomized Trials of EHT and CHT 105
Understanding Differences in EHT Findings Across Studies 106
Relationship Between HT Use and Different Breast Cancer Subtypes 107
Clinical Implications 108
Oral Contraceptives 109
Epidemiologic Evidence Assessing Oral Contraceptive Use and Breast Cancer Risk 110
Age at Diagnosis, Timing of Oral Contraceptive Use, and Duration of Use 111
Oral Contraceptive Use According to Progestin and Estrogen Content 118
Oral Contraceptive Use and Risk of Breast Cancer by Tumor Characteristics 119
Injectable Contraceptives 120
Newer Forms of Hormonal Contraceptives and Patterns of Use 121
Summary 123
References 123
6 Reproductive Factors 128
Introduction 128
Reproductive Factors 128
Age at Menarche and Menopause 128
Childbearing 129
Parity 129
Age at First Birth 130
Age at Subsequent Births and Birth Spacing 131
Pregnancy Interruption: Induced and Spontaneous Abortions 131
Breast-Feeding 132
Reproductive Factors and Risk of Different Subtypes of Breast Cancer 132
Postulated Biological Mechanisms Underlying the Observed Relationships Between Reproductive Factors and Breast Cancer Risk 133
Pregnancy Characteristics and Breast Cancer Risk 134
Birth Weight 134
Placental Weight 135
Preterm Birth 135
Preeclampsia and/or Pregnancy-Related Hypertension 135
Gender of Offspring 136
Multiple Births 136
Implications for Prevention 137
Summary 138
References 138
7 Physical Activity and Anthropometric Factors 145
Introduction 145
Physical Activity 145
Anthropometric Factors and Breast Cancer Risk 148
Body Mass Index 149
Weight Change 150
Waist-Hip Ratio 151
Height 152
Biological Mechanisms 153
Conclusions 155
References 156
8 Diet and Nutrition 160
Introduction 160
Dietary Fat 161
Dietary Carbohydrates 163
Dietary Fiber 166
Alcohol 166
Vitamins A, C, and E 167
Folate, Vitamin B6, and Vitamin B12 169
Vitamin D and Calcium 171
Selenium 174
Coffee and Tea 174
Soy and Phytoestrogens 175
Dietary Patterns and Foods 175
Conclusions 176
References 177
9 Environmental and Occupational Exposures 189
Introduction 189
Ionizing Radiation 189
Japanese Atomic Bomb Survivors 190
Medical Exposures 190
Occupational Exposures 193
Conclusions 194
Environmental Pollutants 195
Organochlorines 195
Polychlorinated Biphenyls (PCBs) 198
Dichloro-diphenyl-trichloroethane (DDT) and Dichloro-diphenyl-dichloroethane (DDE) 203
Polycyclic Aromatic Hydrocarbons (PAHs) 207
Dioxins 209
Bisphenol A (BPA) 210
Conclusions 211
Extremely Low-Frequency (ELF) Magnetic Fields 212
Residential ELF Magnetic Field Exposure and Breast Cancer 212
Occupational ELF Magnetic Field Exposure and Breast Cancer 214
Conclusions 216
Trace Elements and Heavy Metals 216
Conclusions 217
References 218
10 Shift Work and Circadian Disruption 228
Introduction 228
Epidemiological Evidence: Breast Cancer and Night Shift Work 229
Epidemiological Evidence: Breast Cancer and Light-at-Night Exposure 233
Possible Biological Mechanisms 234
The Pineal Gland and Actions of Melatonin 234
Melatonin as a Regulator of Gonadal Function 234
Melatonin as a Direct Oncostatic Agent 235
Light-at-Night Exposure and Breast Cancer in Laboratory Animals 236
Light-at-Night Exposure and Melatonin Levels in Humans 237
Effects of Night Shift Work on Sleep 237
Night Shift Work and Breast Cancer Risk: Potential Role of Genetics 238
Summary and Future Directions 239
References 239
11 Non-Hormonal Medications and Chronic Diseases 247
Introduction 247
Statins 247
Non-steroidal Anti-inflammatory Drugs 248
Hypertension and Antihypertensive Therapy 249
Antidepressants and Depression 250
Retinoids 251
Antibiotics 251
Diabetes Mellitus Type 2 252
Autoimmune Diseases 253
Rheumatoid Arthritis and Systemic Lupus Erythematosus 253
Multiple Sclerosis 255
Primary Biliary Cirrhosis 255
Thyroid Diseases 256
Conclusion 256
References 259
12 Male Breast Cancer 265
Introduction 265
Geographic Variation in Incidence 266
Laterality of Disease 266
Genetics 267
BRCA1/2 267
Other High-Penetrance Genes 268
Low-Penetrance Genes 268
CHEK2 268
Androgen Receptor Gene 269
CYP17 Gene 269
Klinefelter’s Syndrome 270
Gynecomastia 270
Occupation 270
Endocrine Risk Factors 271
Prolactin 274
Diet 274
Alcohol 274
Ionizing Radiation 275
Conclusions 275
References 276
13 Inherited Predisposition: Familial Aggregation and High Risk Genes 281
Introduction 281
Familial Aggregation of Breast Cancer 281
Family History of Breast Cancer 281
Family History of Breast Cancer and Interaction with Other Factors 283
BRCA1 and BRCA2 Genes 284
Discovery of BRCA1 and BRCA2 284
Biology and Function of BRCA1 and BRCA2 285
Prevalence and Predictors of BRCA1/BRCA2 Mutations 285
Founder Effects and Race-Specific Results 287
Penetrance Estimates 288
Variants of Unknown Significance 288
Gene-Environment Interaction Studies of BRCA1 and BRCA2 289
Prevention, Treatment, and Outcomes in Mutation Carriers 292
Tumor Features of BRCA1- and BRCA2-Associated Breast Cancers 292
Prevention of First Primary Breast Cancer 292
Breast Cancer Treatments for BRCA1 and BRCA2 Mutation Carriers 292
Ipsilateral and Contralateral Breast Cancer 293
Breast Cancer Mortality 293
Remaining Unexplained Heritable Component 294
Summary 295
References 296
14 Common Genetic Susceptibility Loci 304
Introduction 304
The Search for Common Susceptibility Variants 305
Commmon susceptibility variants 307
Heterogeneity in Risk of Common Susceptibility Variants 310
Functional Insight into Susceptibility 312
Polygenic Architecture of Susceptibility 313
What Does Polygenic Imply? 313
Combined Effect of Susceptibility Loci 314
Population Distribution of Genetic Risk 317
Future 319
Bibliography 320
15 Mammographic Density as a Potential Surrogate Marker for Breast Cancer 324
Introduction 324
Mammographic Density and Breast Cancer Risk 326
Mammographic Density and Breast Tissue Composition 327
Age, Mammographic Density, and the Incidence of Breast Cancer 327
Factors Associated with Variation and Change in Mammographic Density 329
Breast Cancer Risk Factors 329
Parity 329
Menopause 329
Body Mass Index 330
Family History 332
Race/Ethnicity 332
Endogenous Hormones and Growth Factors 332
Exogenous Hormones 333
Change in Mammographic Density and Breast Cancer Risk 336
Mammographic Density as a Potential Surrogate Marker of Breast Cancer 337
Summary 340
References 341
16 Breast Cancer Screening 345
Introduction 345
Goal of Screening 345
Efficacy and Accuracy of Screening Mammography 346
Efficacy by Age 346
Women Aged 40-49 Years 346
Women Aged 50-69 Years 348
Women Aged 70 Years and Older 349
Efficacy According to Length of Screening Interval and Whether CBE is Performed 350
Screening Interval 350
Clinical Breast Exam 350
Efficacy According to Family History of Breast Cancer 351
Efficacy According to Menopausal Status or Postmenopausal Hormone Therapy 351
Accuracy of Screening Mammography 352
Film Screening Mammography 352
Digital Screen Mammography 354
Harms and Limitations of Screening Mammography 354
Diagnostic Evaluations and Associated Morbidity and Anxiety 354
Increased Detection of Ductal Carcinoma In Situ (DCIS) 356
False Reassurance 357
Mammography Facilities 358
Interpreting Mammographic Results 358
Efficacy and Accuracy of Clinical Breast Exam 359
Efficacy and Accuracy of Breast Self-Exam (BSE) 360
Accuracy of MRI 361
Breast Cancer Screening Recommendations 362
Informed Decision Making for Screening 364
Future Directions 364
Summary 365
References 365
17 Principles of Breast Cancer Therapy 372
Introduction 372
Prognostic and Predictive Factors 372
Loco-regional Therapy for Early-Stage Breast Cancer 374
Determinants of Systemic Therapy for Early Breast Cancer 376
Adjuvant Endocrine Therapy 377
Adjuvant Chemotherapy 379
Adjuvant Biologic Therapy 380
Principles of Treating Metastatic Breast Cancer 381
Endocrine Therapy for Metastatic Breast Cancer 382
Chemotherapy for Metastatic Breast Cancer 383
Biologic and Other Systemic Therapies for Metastatic Breast Cancer 384
Summary 385
References 385
18 Breast Cancer Outcomes 390
Introduction 390
Survival 390
Rates of Recurrence 393
Modifiers of Risk of Mortality, Recurrence, and Second Primary Breast Cancer 394
Diet 394
Weight Control 395
Physical Activity 396
Quality of Life 398
Emotional Well-Being 398
Fatigue 398
Physical Health 399
Summary 399
References 400
Index 403