Osteoprotegerin and breast cancer risk by hormone receptor subtype: A nested case-control study in the EPIC cohort

Renée T. Fortner, Danja Sarink, Helena Schock, Theron Johnson, Anne Tjønneland, Anja Olsen, Kim Overvad, Aurélie Affret, Mathilde His, Marie Christine Boutron-Ruault, Heiner Boeing, Antonia Trichopoulou, Androniki Naska, Philippos Orfanos, Domenico Palli, Sabina Sieri, Amalia Mattiello, Rosario Tumino, Fulvio Ricceri, H. Bas Bueno-de-MesquitaPetra H.M. Peeters, Carla H. Van Gils, Elisabete Weiderpass, Eiliv Lund, J. Ramón Quirós, Antonio Agudo, Maria José Sánchez, María Dolores Chirlaque, Eva Ardanaz, Miren Dorronsoro, Tim Key, Kay Tee Khaw, Sabina Rinaldi, Laure Dossus, Marc Gunter, Melissa A. Merritt, Elio Riboli, Rudolf Kaaks

Research output: Contribution to journalArticle

Abstract

Background: Circulating osteoprotegerin (OPG), a member of the receptor activator of nuclear factor kappa-B (RANK) axis, may influence breast cancer risk via its role as the decoy receptor for both the RANK ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Circulating OPG and breast cancer risk has been examined in only one prior study. Methods: A case-control study was nested in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 2008 incident invasive breast cancer cases (estrogen receptor (ER)+, n = 1622; ER-, n = 386), matched 1:1 to controls, were included in the analysis. Women were predominantly postmenopausal at blood collection (77%); postmenopausal women included users and non-users of postmenopausal hormone therapy (HT). Serum OPG was quantified with an electrochemiluminescence assay. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression. Results: The associations between OPG and ER+ and ER- breast cancer differed significantly. Higher concentrations of OPG were associated with increased risk of ER- breast cancer (top vs. bottom tertile RR = 1.93 [95% CI 1.24-3.02]; p trend = 0.03). We observed a suggestive inverse association for ER+ disease overall and among women premenopausal at blood collection. Results for ER- disease did not differ by menopausal status at blood collection (p het = 0.97), and we observed no heterogeneity by HT use at blood collection (p het ≥ 0.43) or age at breast cancer diagnosis (p het ≥ 0.30). Conclusions: This study provides the first prospective data on OPG and breast cancer risk by hormone receptor subtype. High circulating OPG may represent a novel risk factor for ER- breast cancer.

Original languageEnglish
Article number26
JournalBMC Medicine
Volume15
Issue number1
DOIs
Publication statusPublished - Feb 8 2017

Keywords

  • Breast cancer
  • Estrogen receptor
  • Hormone receptor
  • Osteoprotegerin
  • Progesterone receptor
  • RANK axis

ASJC Scopus subject areas

  • Medicine(all)

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    Fortner, R. T., Sarink, D., Schock, H., Johnson, T., Tjønneland, A., Olsen, A., Overvad, K., Affret, A., His, M., Boutron-Ruault, M. C., Boeing, H., Trichopoulou, A., Naska, A., Orfanos, P., Palli, D., Sieri, S., Mattiello, A., Tumino, R., Ricceri, F., ... Kaaks, R. (2017). Osteoprotegerin and breast cancer risk by hormone receptor subtype: A nested case-control study in the EPIC cohort. BMC Medicine, 15(1), [26]. https://doi.org/10.1186/s12916-017-0786-8