Environment and Breast Cancer: Science Review

Evidence From Humans
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Body size indices and breast cancer risk before and after menopause
Franceschi, S., Favero, A., La Vecchia, C., Baron, A. E., Negri, E., Dal Maso, L., Giacosa, A., Montella, M., Conti, E., Amadori, D. International Journal of Cancer. 1996. 67:2, 181-6.
Topic area
Body size
Study design
Hospital based case-control
Funding agency
Other: Italian National Research Council
Study Participants
Number of Cases
2,569 (989 pre) (1,580 post)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Control: 2,588 (843 pre) (1,745 post)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: women diagnosed with histologically confirmed breast cancer between 6/1991 and 4/1994 in one of 6 Italian centers age 23-74 (cases); women admitted to the major teaching hospital and general hospitals for acute, non neoplastic, non-gynecological conditions, unrelated to hormonal or digestive tract diseases age 20-74 (controls) Ex: women with a previous diagnosis of cancer
Comment about participation selection
Strengths: large case-control study with many cases; cases were histologically confirmed; self-reported values were validated by medical records; analyzed breast cancer risk by anthropometric values stratified by menopausal status; analyzed breast cancer risk by BMI stratified by menopausal status and age; high participation rate; cases and controls were identified in the same hospitals; one of the first studies to observe that the association between post breast cancer and BMI is strengthened by age Limitations: study not population based; self-reported anthropometric data; hospital based study which might overrepresent obese women since obesity is associated with a broad spectrum of chronic conditions
Exposure Investigated
Exposures investigated
Height, weight, BMI, WHR, bra cup size, perceived body size at 12, BMI at age 30, BMI at age 50, weight gain from age 30 to diagnosis
How exposure was measured
Questionnaire, in person
Exposure assessment comment
Self-reported anthropometric data
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Adequately controlled, confounders: age, center, education, parity, total energy intake, alcohol consumption
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Effect modifiers: age, menopausal status
Strength of associations reported
Association between postmenopausal breast cancer risk and height, >168 cm vs. <158 cm, OR=0.8(0.6-1.0) trend p=0.15
Association between premenopausal breast cancer risk and weight, >75 kg vs. <57 kg, OR=0.7(0.5-1.0) trend p=0.06
Association between postmenopausal breast cancer risk and weight, >75 kg vs. <57 kg, OR=1.2(0.9-1.5) trend p=0.07
Association between postmenopausal breast cancer risk and BMI, >28.8 vs <21.7, OR=1.4(1.1-1.8) trend p=0.001
Association between premenopausal breast cancer risk and BMI, >28.8 vs <21.7, OR=0.7(0.5-0.9) trend p=0.04
Association between premenopausal breast cancer risk and WHR, >0.88 vs. <0.78, OR=0.7(0.5-1.0) trend p=0.10
Association between postmenopausal breast cancer risk and BMI in women > 70 years of age, >28.8 vs <21.7, OR=2.9(1.5-5.9) trend p=0.04