Environment and Breast Cancer: Science Review

Evidence From Humans
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Body size and risk of breast cancer
Trentham-Dietz, A., Newcomb, P. A., Storer, B. E., Longnecker, M. P., Baron, J., Greenberg, E. R., Willett, W. C. American Journal of Epidemiology. 1997. 145:11, 1011-9.
Topic area
Body size
Study design
Population based case-control
Study Participants
Number of Cases
6,548 (1,627 pre) (4,921 post) (invasive only)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Control: 9,057 (2739 pre) (6317 post)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: female residents age 20-74 of Wisconsin, Massachusetts, Maine and New Hampshire; diagnosed with invasive breast cancer between 4/88 and 12/91 (cases); had a listed telephone number or drivers license (20-65 years); received Medicare benefits (65-74 years) Ex: prior history of breast cancer; no listed telephone number or did not have a drivers license
Comment about participation selection
Strengths: large population based case-control; large number of cases; interviewers were unaware of the participant's case-control status until the end of the interview for the great majority of interviews; analyzed pre and post menopausal breast cancer according to body size measurements Limitations: conducted telephone interviews; self-reported anthropometric data; many more post cases than pre cases; possible detection bias in women with a greater BMI
Exposure Investigated
Exposures investigated
Height, BMI, Weight, weight at age 18, and weight at age 35 years
How exposure was measured
Questionnaire, by telephone
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: parity, age at first birth, age at menarche, family history of breast cancer, alcohol consumption, education, age at menopause, weight, height and BMI
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 and menopausal status
Strength of associations reported
Association between premenopausal breast cancer risk and women with a height of 1.70-1.98m vs 1.40-1.56m, OR=1.36(1.05-1.76) trend p<0.001
Inverse association between premenopausal breast cancer risk and women with a weight at 18 years of 61.2-138kg vs 35.8-49.8kg. OR=0.75(0.60-0.94) trend p<0.001
Association between premenopausal breast cancer risk and height, >1.68m vs. <1.57m, OR=1.27(1.11-1.45) trend p<0.001
Association between postmenopausal breast cancer risk and women with a BMI of 27.6-57.1 vs 12.9-21.2, OR=1.41(1.25-1.60) trend p<0.001
Association between postmenopausal breast cancer risk and women with a weight of 74.8-151kg vs 34.5-56.6kg, OR=1.57(1.37-1.79) trend p<0.001