Triple-negative breast cancer risk in women is defined by the defect of estrogen signaling: preventive and therapeutic implications

Figures & data

Figure 1 Graphic representation of age-related increases in overall ER+ and ER− BC incidences.

Notes: Raw numbers show a close to twofold increase in ER− tumors and a much higher – almost fourfold – increase in ER+ tumors with aging, while the percentage of ER− cancers exhibits a decreasing trend. Data derived from Hartley et al.⁷
Abbreviations: BC, breast cancer; ER, estrogen receptor.

Table 1 Lifelong changes in the levels of sex hormones and insulin resistance in women and their correlations with overall and TN breast cancer risk

Hormonal changes in the life periods of women	Estrogen level	Androgen level	Insulin resistance	Overall and TNa breast cancer risk		References
Adolescence
Menstrual disorder	↓	↑	↑	↑↑	↑	^Citation33
Anovulatory cycles	↓	↑	↑	↑↑	↑	^Citation33
Phytoestrogen use	↑	↓	↓	↓↓	↓	^Citation134
Premenopausal women
Anovulatory infertility	↓	↑	↑	↑↑	↑	^Citation33,Citation145
Nulliparity	↓	↑	↑	↑↑	↑	^Citation155,Citation156
PCOS	↓	↑	↑	↑↑	↑	^Citation69
Contraceptive use	↑	↓	↓	↓↓	↓	^Citation50,Citation51
Parity	↑	↓	↓	↓↓	↓	^Citation139,Citation144
In vitro fertilization	↑	↓	↓	↓↓	↓	^Citation145
High-dose estrogen	↑	↓	↓	↓↓	↓	^Citation157
Postmenopausal women
HRT use	↑	↓	↓	↓↓	↓	^Citation55,Citation76
Non-HRT use	↓	↑	↑	↑↑	↑	^Citation33,Citation55
Hysterectomy	↓	↑	↑	↑↑	↑	^Citation55

Notes:

a Changes in overall and TN breast cancer risk exhibit similar trends under hormonal alterations; however, the extent of this change is lower among TN tumors, due to the lack of estrogen receptors. Reprinted with permission from Bentham Science Publisher. Copyright © 2013. Suba Z. Circulatory estrogen level protects against breast cancer in obese women. Recent Pat Anticancer Drug Discov. 2013;8(2):154–167.³³

Abbreviations: HRT, hormone replacement therapy; PCOS, polycystic ovarian syndrome; TN, triple-negative.

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