Breast cancer incidence by estrogen receptor status in Denmark from 1996 to 2007
During the past 50 years, breast cancer incidence has increased by 2–3 % annually. Despite many years of testing for estrogen receptors (ER), evidence is scarce on breast cancer incidence by ER status. The aim of this paper was to investigate the increase in breast cancer incidence by ER status. Data were obtained from the clinical database of the Danish Breast Cancer Cooperative Group which holds nationwide data on diagnosis, including pathology, treatment, and follow-up on primary breast cancers since 1977. All Danish women <80 years diagnosed with primary breast cancer 1996–2007 were identified in this prospective register based study. ER status was evaluated using immunohistochemical staining by standardized laboratory methods in the Danish Pathology Departments and reported to the database. From 1996 to 2007, breast cancer incidence increased overall with a tendency to level off after 2002. In all women a significant decrease was found in ER unknown tumors. However, in both pre- and postmenopausal women, significant increases were seen in incidence of ER+ tumors; though the increase levelled off for premenopausal women after 2002. In postmenopausal women, the incidence of ER− breast cancer decreased significantly throughout the period. In women <35 years, we found a minor non-significant increase in both ER+ and ER− tumors. ER unknown decreased in all women and was the most distinct in premenopausal women aged 35+. We found a significant increase in ER+ breast cancer incidence in postmenopausal women whereas the incidence in premenopausal women (aged 35+) levelled off after 2002.
KeywordsBreast cancer incidence Estrogen receptor status Epidemiology
Danish Breast Cancer Group
Hormone replacement therapy
Annual percentage rate change
Conflict of interest
These authors declare that they have no conflict of interest.
This study was performed in agreement with the Ethical Committees on Human Studies.
- 10.Collaborative Group on Hormonal Factors in Breast Cancer (1997) Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Lancet 350(9084):1047–1059CrossRefGoogle Scholar
- 11.Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford AA, Howard BV, Johnson KC, Katchen JM (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA 288(3):321–333PubMedCrossRefGoogle Scholar
- 17.Lambe M, Wigertz A, Holmqvist M, Adolfsson J, Bardage C, Fornander T, Karlsson P, Odlind V, Persson I, Ahlgren J, Bergkvist L (2010) Reductions in use of hormone replacement therapy: effects on Swedish breast cancer incidence trends only seen after several years. Breast Cancer Res Treat 121(3):679–683PubMedCrossRefGoogle Scholar
- 24.Moller S, Jensen MB, Ejlertsen B, Bjerre KD, Larsen M, Hansen HB, Christiansen P, Mouridsen HT (2008) The clinical database and the treatment guidelines of the Danish Breast Cancer Cooperative Group (DBCG); its 30-years experience and future promise. Acta Oncol 47(4):506–524PubMedCrossRefGoogle Scholar
- 28.Lahmann PH, Hoffmann K, Allen N, van Gils CH, Khaw KT, Tehard B, Berrino F, Tjonneland A, Bigaard J, Olsen A, Overvad K, Clavel-Chapelon F et al (2004) Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer 111(5):762–771PubMedCrossRefGoogle Scholar
- 29.Schutze M, Boeing H, Pischon T, Rehm J, Kehoe T, Gmel G, Olsen A, Tjonneland A-M, Dahm CC, Overvad K, Clavel-Chapelon F, Boutron-Ruault MC et al (2011) Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ 342:d1584PubMedCrossRefGoogle Scholar
- 30.Yang XR, Chang-Claude J, Goode EL, Couch FJ, Nevanlinna H, Milne RL, Goudet M, Schmidt MK, Broeks A, Cox A, Fasching PA, Hein R et al (2011) Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies. J Natl Cancer Inst 103(3):250–263PubMedCrossRefGoogle Scholar