Modern reproductive patterns associated with estrogen receptor positive but not negative breast cancer susceptibility

C. Athena Aktipis, Bruce J Ellis, Katherine K. Nishimura, Robert A. Hiatt

Research output: Contribution to journalArticle

14 Scopus citations


It has long been accepted that modern reproductive patterns are likely contributors to breast cancer susceptibility because of their influence on hormones such as estrogen and the importance of these hormones in breast cancer. We conducted a meta-analysis to assess whether this 'evolutionary mismatch hypothesis' can explain susceptibility to both estrogen receptor positive (ER-positive) and estrogen receptor negative (ER-negative) cancer. Our meta-analysis includes a total of 33 studies and examines parity, age of first birth and age of menarche broken down by estrogen receptor status. We found that modern reproductive patterns are more closely linked to ER-positive than ER-negative breast cancer. Thus, the evolutionary mismatch hypothesis for breast cancer can account for ER-positive breast cancer susceptibility but not ER-negative breast cancer.

Original languageEnglish (US)
Article numbereou028
Pages (from-to)52-74
Number of pages23
JournalEvolution, Medicine and Public Health
Issue number1
Publication statusPublished - Jan 1 2015



  • Age of first birth
  • Breast cancer heterogeneity
  • Cancer evolution
  • Evolutionary mismatch
  • Hormoneassociated breast cancer
  • Parity

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics
  • Health, Toxicology and Mutagenesis
  • Medicine (miscellaneous)

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