Evidence map›Paper›PMID 25921910›Full record

ArticleJournal of the National Cancer Institute2015

Breastfeeding, PAM50 tumor subtype, and breast cancer prognosis and survival.

Marilyn L Kwan, Philip S Bernard, Candyce H Kroenke, Rachel E Factor, Laurel A Habel, Erin K Weltzien, Adrienne Castillo, Erica P Gunderson, Kaylynn S Maxfield, Inge J Stijleman and 5 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the National Cancer Institute, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
1.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Review
  9. Article
  10. Review
  11. TP53 Pathway Function, Estrogen Receptor Status, and Breast Cancer Risk Factors in the Carolina Breast Cancer Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022
    Article
  12. Article
  13. Article
  14. Breast Cancer Risk Factors and Survival by Tumor Subtype: Pooled Analyses from the Breast Cancer Association Consortium.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021
    Article
  15. Epidemiology of Basal-like and Luminal Breast Cancers among Black Women in the AMBER Consortium.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021
    Article
  16. Review
  17. Article
  18. Can Nutrition Lower the Risk of Recurrence in Breast Cancer?Breast care (Basel, Switzerland) · 2018
    Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 1 country.

Marilyn L KwanDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML). marilyn.l.kwan@kp.org.
Philip S BernardDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Candyce H KroenkeDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Rachel E FactorDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Laurel A HabelDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Erin K WeltzienDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Adrienne CastilloDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Erica P GundersonDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Kaylynn S MaxfieldDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Inge J StijlemanDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Bryan M LangholzDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Charles P QuesenberryDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Lawrence H KushiDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Carol SweeneyDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Bette J CaanDivision of Research, Kaiser Permanente Northern California, Oakland, CA (MLK, CHK, LAH, EKW, AC, EPG, CPQJr, LHK, BJC); Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (PSB, REF, IJS, CS); Associated Regional and University Pathologist Institute for Clinical and Experimental Pathology, Salt Lake City, UT (PSB, REF); Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT (KSM, CS); Department of Preventive Medicine, University of Southern California, Los Angeles, CA (BML).
Huntsman Cancer Institute · USKaiser Permanente · USUniversity Pathologists · USUniversity of Utah · US

Funding

UTAH REGIONAL CANCER CENTERP30CA042014 · NCI · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI CORNELIA M ULRICH · 1986 to 2026
$72.6M
Prospective Study of Breast Cancer SurvivorshipR01CA105274 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI KUSHI, LAWRENCE H · 2004 to 2014
$19.9M
Molecular Profiles and Lifestyle Factors in Breast Cancer PrognosisR01CA129059 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI CAAN, BETTE J · 2009 to 2013
$3.6M
NCI NIH HHS P30 CA042014NCI NIH HHS R01 CA105274NCI NIH HHS R01 CA129059PHS HHS HHSN261201000026C
6 · The paper itself

Abstract

backgroundBreastfeeding is associated with decreased breast cancer risk, yet associations with prognosis and survival by tumor subtype are largely unknown.

methodsWe conducted a cohort study of 1636 women from two prospective breast cancer cohorts. Intrinsic tumor subtype (luminal A, luminal B, human epidermal growth factor receptor 2 [HER2]-enriched, basal-like) was determined by the PAM50 gene expression assay. Breastfeeding history was obtained from participant questionnaires. Questionnaires and medical record reviews documented 383 recurrences and 290 breast cancer deaths during a median follow-up of nine years. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between breastfeeding and tumor subtype. Cox regression was used to estimate hazard ratios (HRs) for breast cancer recurrence or death. Statistical significance tests were two-sided.

resultsBreast cancer patients with basal-like tumors were less likely to have previously breastfed than those with luminal A tumors (OR = 0.56, 95% CI = 0.39 to 0.80). Among all patients, ever breastfeeding was associated with decreased risk of recurrence (HR = 0.70, 95% CI = 0.53 to 0.93), especially breastfeeding for six months or more (HR = 0.63, 95% CI = 0.46 to 0.87, P trend = .01). Similar associations were observed for breast cancer death. Among women with luminal A subtype, ever breastfeeding was associated with decreased risks of recurrence (HR = 0.52, 95% CI = 0.31 to 0.89) and breast cancer death (HR = 0.52, 95% CI = 0.29 to 0.93), yet no statistically significant associations were observed among the other subtypes. Effects appeared to be limited to tumors with lower expression of proliferation genes.

conclusionsHistory of breastfeeding might affect prognosis and survival by establishing a luminal tumor environment with lower proliferative activity.

Indexed as

Breast FeedingGene Expression Regulation, NeoplasticAdultAgedBreast NeoplasmsCarcinoma, Ductal, BreastFemaleFollow-Up StudiesGenetic Predisposition to DiseaseHumansLogistic ModelsMiddle AgedNeoplasm Recurrence, LocalOdds RatioPredictive Value of TestsPrognosis

Identifiers

PMID25921910
PMCPMC4554253
OpenAlexW2136799978

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.