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@ARTICLE{TurzanskiFortner:143223,
      author       = {R. Turzanski-Fortner$^*$ and J. Sisti and B. Chai and L. C.
                      Collins and B. Rosner and S. E. Hankinson and R. M. Tamimi
                      and A. H. Eliassen},
      title        = {{P}arity, breastfeeding, and breast cancer risk by hormone
                      receptor status and molecular phenotype: results from the
                      {N}urses' {H}ealth {S}tudies.},
      journal      = {Breast cancer research},
      volume       = {21},
      number       = {1},
      issn         = {1465-542X},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2019-00822},
      pages        = {40},
      year         = {2019},
      abstract     = {Epidemiologic data suggest that parity increases risk of
                      hormone receptor-negative breast cancer and that
                      breastfeeding attenuates this association. Prospective data,
                      particularly on the joint effects of higher parity and
                      breastfeeding, are limited.We investigated parity,
                      breastfeeding, and breast cancer risk by hormone-receptor
                      (estrogen (ER) and progesterone receptor (PR)) and molecular
                      subtypes (luminal A, luminal B, HER2-enriched, and
                      basal-like) in the Nurses' Health Study (NHS; 1976-2012) and
                      NHSII (1989-2013). A total of 12,452 (ER+ n = 8235; ER-
                      n = 1978) breast cancers were diagnosed among 199,514
                      women. We used Cox proportional hazards models, adjusted for
                      breast cancer risk factors, to calculate hazard ratios (HR)
                      and $95\%$ confidence intervals (CI).Parous women had lower
                      risk of ER+ breast cancer (vs. nulliparous, HR = 0.82
                      [0.77-0.88]); no association was observed for ER- disease
                      (0.98 [0.84-1.13]; Phet = 0.03). Among parous women,
                      breastfeeding was associated with lower risk of ER- (vs.
                      never 0.82 [0.74-0.91]), but not ER+, disease (0.99
                      [0.94-1.05]; Phet < 0.001). Compared to nulliparous
                      women, higher parity was inversely associated with luminal B
                      breast cancer regardless of breastfeeding (≥ 3 children:
                      ever breastfed, 0.78 [0.62-0.98]; never breastfed, 0.76
                      [0.58-1.00]) and luminal A disease only among women who had
                      breastfed (≥ 3 children, 0.84 [0.71-0.99]). Basal-like
                      breast cancer risk was suggestively higher among women with
                      higher parity who never breastfed; associations were null
                      among those who ever breastfed.This study provides evidence
                      that breastfeeding is inversely associated with hormone
                      receptor-negative breast cancers, representing an accessible
                      and cost-effective risk-reduction strategy for aggressive
                      disease subtypes.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30867002},
      pmc          = {pmc:PMC6416887},
      doi          = {10.1186/s13058-019-1119-y},
      url          = {https://inrepo02.dkfz.de/record/143223},
}