Environment and Breast Cancer: Science Review

Evidence From Humans
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Body-size indicators and risk of breast cancer according to menopause and estrogen-receptor status
Mannisto, S., Pietinen, P., Pyy, M., Palmgren, J., Eskelinen, M., Uusitupa, M. International Journal of Cancer. 1996. 68:1, 8-13.
Topic area
Body size
Study design
Population based case-control
Funding agency
Other: Academy of Finland, Yrjo Jahnsson Foundatio
Study Participants
Number of Cases
328 (132 pre) (196 post)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Control: 417 (184 pre) (233 post)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: participants in the Kuopio Breast Cancer Study who were diagnosed with a breast lump between 1990 and 1994 (cases); women in the population based register that covers the same area as the catchment area used to locate cases (controls) Ex: women who refused to participate; women who were missed by the study's enrollment system in the hospital; women who lived outside the catchment area; women with dementia; women with problems cooperating
Comment about participation selection
Stengths: population based study; anthropometric data were measured by trained staff; analyzed breast cancer risk by anthropometric indicators stratified by menopausal status; high participation rate Limitations: few premenopausal case; possible selection bias since more controls used estrogen replacement therapy than cases
Exposures investigated
Height, weight, BMI, WHR, body fat %, fat weight, lean body weight, weight gain, weight loss at age 22-44, weight loss at age 45 and older
How exposure was measured
Questionnaire, in person Anthropometric measurement, researcher-administered
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, area, age at menarche, age at first childbirth, oc use, estrogen use, family history, history of benign breast disease, education, alcohol consumption, smoking habits, leisure activity
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: menopausal status ER+, ER- measurements
Strength of associations reported
Association between post breast cancer risk and height, >169 cm vs <159cm, OR=2.3(1.1-4.6) trend p=0.12
Association between pre breast cancer risk and WHR, >0.89 vs <0.79, OR=4.6(2.0-10.7) trend p=0.01
Association between post breast cancer risk and WHR, >0.89 vs <0.79, OR=2.6(1.3-5.1) trend p=0.03
Association between post breast cancer risk and weight, >80 kg vs. <60 kg, OR=1.2(0.7-2.4) trend p=0.60
Association between post breast cancer risk and BMI, >31.3 vs. <23.4, OR=0.8(0.4-1.5) trend p=0.41