Table 3.

Multivariable associations^a of alpha diversity estimates with breast cancer grade and molecular subtype and in the Ghana Breast Health study (N=379 malignant cases and 414 controls)

	Grade		ER Status		Molecular Subtypeb
Alpha Diversity Metric	1 or 2	3	ER−	ER+	Triple-negative	Luminal A
N cases	81	198	135	129	82	105
Shannon Index
Tertile 1 (1.91 – 4.11)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)
Tertile 2 (4.12 – 5.02)	0.73 (0.37, 1.47)	0.56 (0.32, 0.98)	0.61 (0.33, 1.11)	0.85 (0.47, 1.55)	0.68 (0.32, 1.44)	0.82 (0.43, 1.59)
Tertile 3 (5.03 – 7.40)	0.58 (0.29, 1.14)	0.30 (0.17, 0.53)	0.35 (0.19, 0.66)	0.55 (0.30, 1.01)	0.55 (0.26, 1.16)	0.52 (0.26, 1.02)
Ptrend	0.11	<0.001	0.001	0.06	0.11	0.06
Pheterogeneity	0.05		0.11		0.95
Observed sequence variants
Tertile 1 (26 – 94)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)
Tertile 2 (95 – 139)	0.55 (0.28, 1.07)	0.38 (0.22, 0.66)	0.35 (0.19, 0.65)	0.59 (0.33, 1.06)	0.44 (0.21, 0.91)	0.47 (0.24, 0.89)
Tertile 3 (140 – 338)	0.32 (0.15, 0.67)	0.17 (0.09, 0.31)	0.21 (0.11, 0.41)	0.27 (0.14, 0.53)	0.29 (0.13, 0.65)	0.23 (0.11, 0.48)
Ptrend	0.003	<0.001	<0.001	<0.001	0.002	<0.001
Pheterogeneity	0.06		0.19		0.97
Faith’s PD
Tertile 1 (8.13 – 21.56)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)	1.00 (referent)
Tertile 2 (21.66 – 28.90)	0.50 (0.25, 0.97)	0.32 (0.18, 0.55)	0.30 (0.16, 0.56)	0.54 (0.30, 0.97)	0.38 (0.18, 0.80)	0.46 (0.24, 0.87)
Tertile 3 (28.97 – 86.36)	0.27 (0.13, 0.56)	0.17 (0.09, 0.31)	0.16 (0.08, 0.33)	0.25 (0.13, 0.49)	0.23 (0.10, 0.51)	0.22 (0.10, 0.45)
Ptrend	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001
Pheterogeneity	0.05		0.24		0.76

Abbreviations: ER, estrogen receptor

^aFully adjusted unconditional polytomous logistic regression models include age (continuous), study center (Komfo Anoyke Teaching Hospital, Korle Bu Teaching Hospital, or Peace and Love Hospital), and collection method (home or hospital), body mass index (kg/m²), education (junior secondary school or lower, senior secondary school/Some college or technical school or more, other or unknown), family history of cancer (yes, no, unknown), antibiotic use (missing, ≤ 30 days ago, and >30 days ago, this year, or never), number of full-term pregnancies (0, 1–2, 3–4, 5+ pregnancies), and current hormonal contraceptive use

^bTriple-negative breast cancers were ER−, PR−, and HER2−; luminal-like A breast cancers were ER+ or PR+ and HER2−