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American Journal of Epidemiology Advance Access originally published online on October 21, 2009
American Journal of Epidemiology 2009 170(10):1241-1249; doi:10.1093/aje/kwp298
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American Journal of Epidemiology © The Author 2009. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Genetic Variation in the Progesterone Receptor and Metabolism Pathways and Hormone Therapy in Relation to Breast Cancer Risk

Kerryn W. Reding*, Christopher I. Li, Noel S. Weiss, Chu Chen, Christopher S. Carlson, David Duggan, Kenneth E. Thummel, Janet R. Daling and Kathleen E. Malone

* Correspondence to Dr. Kerryn W. Reding, Department of Epidemiology, School of Public Health, University of Washington, 1100 Fairview Avenue North, Mailstop M4-B874, Seattle, WA 98109 (e-mail: kreding{at}u.washington.edu).

Received for publication April 27, 2009. Accepted for publication August 17, 2009.

The relevance of progesterone to breast carcinogenesis is highlighted by evidence indicating that use of combined estrogen-progesterone therapy (EPT) is more strongly related to breast cancer risk than is use of unopposed estrogen therapy. However, few investigators have assessed how genetic variation in progesterone-related genes modifies the effect of EPT on risk. In an analysis combining data from 2 population-based case-control studies of postmenopausal breast cancer (1,296 cases and 1,055 controls) conducted in Washington State in 1997–1999 and 2000–2004, the authors evaluated how 51 single nucleotide polymorphisms in 7 progesterone-related genes (AKR1C1, AKR1C2, AKR1C3, CYP3A4, SRD5A1, SRD5A2, and PGR) influenced breast cancer risk. There was no appreciable association with breast cancer risk overall for any single nucleotide polymorphism. For rs2854482 in AKR1C2, carrying 1 or 2 A alleles was associated with a 2.0-fold increased breast cancer risk in EPT users (95% confidence interval: 1.0, 4.0) but not in never users (Pheterogeneity = 0.03). For rs12387 in AKR1C3, the presence of 1 or 2 G alleles was associated with a 1.5-fold increased risk among EPT users (95% confidence interval: 1.1, 2.2) but not in never users (Pheterogeneity = 0.02). Interpretation of these subgroup associations must await the results of similar studies conducted in other populations.

breast neoplasms; hormone replacement therapy; progesterone; receptors, progesterone

Abbreviations: CI, confidence interval; EPT, estrogen-progesterone therapy; OR, odds ratio; PACE, Puget Sound Area Breast Cancer Evaluation; PGR, progesterone receptor; SHARE, Seattle Area Hormone and Reproductive Epidemiology; SNP, single nucleotide polymorphism


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