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Important Role of Menarche in Development of Estrogen Receptor-Negative Breast Cancer in African American Women


Ambrosone, Christine B.; Zirpoli, Gary R.; Hong, Chi-Chen; Yao, Song; Troester, Melissa A.; Bandera, Elisa V.; Schedin, Pepper J.; Bethea, Traci N.; Borges, Virginia F.; & Park, Song-Yi, et al. (2015). Important Role of Menarche in Development of Estrogen Receptor-Negative Breast Cancer in African American Women. Journal of the National Cancer Institute, 107(9), djv172. PMCID: PMC4836800


BACKGROUND: Menarche is a critical time point for diverging fates of mammary cells of origin. African American women have young age at menarche, which could be associated with their high rates of estrogen receptor-negative (ER-) breast cancer.
METHODS: In the AMBER Consortium, using harmonized data from 4426 African American women with breast cancer and 17 474 controls, we used polytomous logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for ages at menarche and first live birth (FLB), and the interval between, in relation to ER+ and ER- breast cancer. All statistical tests were two-sided.
RESULTS: Risk of ER- breast cancer was reduced with later age at menarche among both parous and nulliparous women (>/=15 vs <11 years OR = 0.62, 95% CI = 0.48 to 0.81 and OR = 0.56, 95% CI = 0.29 to 1.10, respectively), with no effect of age at FLB. For ER+ breast cancer, the inverse association was weaker among nulliparous women. While longer intervals between menarche and FLB were associated with increased risk of ER+ breast cancer in a dose-response fashion (OR for 20 year interval = 1.39, 95% CI = 1.08 to 1.79, P trend = .003), ER- risk was only increased for intervals up to 14 years and not beyond (P trend = .33).
CONCLUSIONS: While ER- breast cancer risk was markedly reduced in women with a late age at menarche, there was not a clear pattern of increased risk with longer interval between menarche and FLB, as was observed for ER+ breast cancer. These findings indicate that etiologic pathways involving adolescence and pregnancy may differ for ER- and ER+ breast cancer.


Reference Type

Journal Article

Year Published


Journal Title

Journal of the National Cancer Institute


Ambrosone, Christine B.
Zirpoli, Gary R.
Hong, Chi-Chen
Yao, Song
Troester, Melissa A.
Bandera, Elisa V.
Schedin, Pepper J.
Bethea, Traci N.
Borges, Virginia F.
Park, Song-Yi
Chandra, Dhyan
Rosenberg, Lynn A.
Kolonel, Laurence N.
Olshan, Andrew F.
Palmer, Julie R.