Environment and Breast Cancer: Science Review

Evidence From Humans
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Body size and breast cancer risk among women under age 45 years. [see comment]
Swanson, C. A., Coates, R. J., Schoenberg, J. B., Malone, K. E., Gammon, M. D., Stanford, J. L., Shorr, I. J., Potischman, N. A., Brinton, L. A. American Journal of Epidemiology. 1996. 143:7, 698-706.
Topic area
Body size
Study design
Population based case-control
Funding agency
Not reported
Study Participants
Number of Cases
1,588 (in situ and invasive) (1420 pre) (168 post)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Control: 1394 (1197 pre) (195 post)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: residents of Atlanta, Georgia or Seattle, Washington or central New Jersey; women diagnosed with in situ or invasive breast cancer between 5/90 and 12/92 (cases); age 20-44; women with a listed telephone number (controls) Ex: pregnant women; women less than 7 months postpartum; women without residential telephones
Comment about participation selection
Strengths: large population based case-control; many cases; anthropometric data were obtained by trained staff; one of the larger studies to analyze body size and breast cancer in a population of young women; included a 100-item dietary questionnaire; took anthropometric measurements twice (except for height, sitting height and weight); analyzed breast cancer risk by anthropometric values in young women Limitations: few postmenopausal women; did not stratify results by menopausal status; did not include confidence intervals in all of the results; possible detection bias; many of the participants had received chemotherapy prior to their interview
Exposures investigated
Height, weight, BMI, sitting-to-standing height ratio, elbow width, wrist width, WHR, subscapular skinfold, subscapular to triceps skinfold, bra cup size
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, study site, race, age at menarche, OC use, parity, height, weight and 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: BMI by bra cup size, BMI by regularity of menstrual periods, BMI by stage of diagnosis and method of detection
Strength of associations reported
Association between breast cancer risk in women under age 45 and height, >167cm vs <159cm, RR=1.46(1.2-1.8) trend p=0.004
Association between breast cancer risk in women under age 45 and weight, >77kg vs <58.6kg, RR=0.72(0.6-0.9) trend p=0.003
Association between breast cancer risk in women under age 45 and BMI, >28.8 vs <22.0, RR=0.65(0.5-0.8) trend p=0.003
Association between breast cancer risk in women under age 45 and WHR, >0.858 vs. <0.753, RR=0.95(0.8-1.2) trend p= 0.729