Breast cancer risk factors according to joint estrogen receptor and progesterone receptor status

Jennifer A. Rusiecki*, Theodore R. Holford, Shelia H. Zahm, Tongzhang Zheng

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Background: We investigated risk factor patterns for subtypes of breast cancer characterized by joint estrogen receptor (ER) and progesterone receptor (PR) status in a hospital-based case-control study. Methods: ER and PR tumor status were determined immunohisotchemically. Risk factors of interest were entered into a multiple polychotomous logistic regression model simultaneously; odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Using this model, cases in the four tumor subtypes (ER+PR+, ER -PR-, ER+PR-, ER-PR +) were compared simultaneously to controls. A Wald test for heterogeneity across the four subtypes was conducted, as well as a case-case comparison between the two most biologically disparate subtypes, ER +PR+ and ER-PR-. Results: The receptor status distribution was as follows: 33% ER+PR+, 34% ER-PR-, 20% ER+PR-, and 13% ER-PR+. Among 317 cases and 401 controls, we found significant heterogeneity across the four tumor subtypes for older age at first full-term pregnancy (p = 0.04) and post-menopausal status (p = 0.04). For older age at first full-term pregnancy, an elevated risk was found for the ER +PR- subtype (OR = 2.5; 95% CI: 1.2-5.1). For post-menopausal status, elevated risks were found for both the ER +PR+ (OR = 2.4; 95% CI: 1.1-4.9) and ER+PR - (OR = 7.2; 95% CI: 2.4-21.7) subtypes. From the case-case comparisons, we found that cases, who had consumed alcohol for more than 1 year were 3.4 times more likely to have ER+PR+ tumors than ER-PR- tumors (95% CI: 1.4-8.4). Conclusions: Certain breast cancer risk factors may vary by ER and PR status, and joint ER/PR status should be taken into account in future studies of risk factor estimates.

Original languageEnglish
Pages (from-to)419-426
Number of pages8
JournalCancer Detection and Prevention
Issue number5
StatePublished - 2005


  • Age
  • Alcohol intake
  • BMI
  • Breast cancer
  • Estrogen receptor
  • Family history
  • Hormone
  • Lactation
  • Menarche
  • Menopausal status
  • Progesterone receptor
  • Race
  • Risk factor
  • Smoking


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