Open Access Open Badges Research article

The association of polymorphisms in hormone metabolism pathway genes, menopausal hormone therapy, and breast cancer risk: a nested case-control study in the California Teachers Study cohort

Eunjung Lee1, Fredrick Schumacher1, Juan Pablo Lewinger1, Susan L Neuhausen2, Hoda Anton-Culver3, Pamela L Horn-Ross4, Katherine D Henderson2, Argyrios Ziogas3, David Van Den Berg1, Leslie Bernstein2 and Giske Ursin156*

Author Affiliations

1 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1441 Eastlake Avenue, Los Angeles, CA 90089, USA

2 Department of Population Sciences, Beckman Research Institute, City of Hope, 1500 Duarte Road, Duarte, CA 91010, USA

3 Department of Epidemiology, School of Medicine, University of California, 224 Irvine Hall, Irvine, CA 92697-7550, USA

4 Cancer Prevention Institute of California, 2201 Walnut Avenue, Fremont, CA 94538, USA

5 Department of Nutrition, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway

6 Cancer Registry of Norway, PB 5313, Majorstuen, 0304 Oslo, Norway

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Breast Cancer Research 2011, 13:R37  doi:10.1186/bcr2859

Published: 1 April 2011



The female sex steroids estrogen and progesterone are important in breast cancer etiology. It therefore seems plausible that variation in genes involved in metabolism of these hormones may affect breast cancer risk, and that these associations may vary depending on menopausal status and use of hormone therapy.


We conducted a nested case-control study of breast cancer in the California Teachers Study cohort. We analyzed 317 tagging single nucleotide polymorphisms (SNPs) in 24 hormone pathway genes in 2746 non-Hispanic white women: 1351 cases and 1395 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by fitting conditional logistic regression models using all women or subgroups of women defined by menopausal status and hormone therapy use. P values were adjusted for multiple correlated tests (PACT).


The strongest associations were observed for SNPs in SLCO1B1, a solute carrier organic anion transporter gene, which transports estradiol-17β-glucuronide and estrone-3-sulfate from the blood into hepatocytes. Ten of 38 tagging SNPs of SLCO1B1 showed significant associations with postmenopausal breast cancer risk; 5 SNPs (rs11045777, rs11045773, rs16923519, rs4149057, rs11045884) remained statistically significant after adjusting for multiple testing within this gene (PACT = 0.019-0.046). In postmenopausal women who were using combined estrogen-progestin therapy (EPT) at cohort enrollment, the OR of breast cancer was 2.31 (95% CI = 1.47-3.62) per minor allele of rs4149013 in SLCO1B1 (P = 0.0003; within-gene PACT = 0.002; overall PACT = 0.023). SNPs in other hormone pathway genes evaluated in this study were not associated with breast cancer risk in premenopausal or postmenopausal women.


We found evidence that genetic variation in SLCO1B1 is associated with breast cancer risk in postmenopausal women, particularly among those using EPT.