Environment and Breast Cancer: Science Review

Prenatal and perinatal risk factors for breast cancer in young women
Weiss, H. A., Potischman, N. A., Brinton, L. A., Brogan, D., Coates, R. J., Gammon, M. D., Malone, K. E., Schoenberg, J. B. Epidemiology. 1997. 8:2, 181-7.

Topic area
Early life exposures
Early life exposures
Study design
Population based case-control
Population based case-control
Funding agency
Not reported
Not reported

Study Participants
Number of Cases
Twin: 2150, Maternal age: 2106, DES: 534
Twin: 2150, Maternal age: 2106, DES: 534
Number of Controls
Controls: Twin: 1961, Maternal age: 1926, DES: 497
Controls: Twin: 1961, Maternal age: 1926, DES: 497
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Women's Interview Study of Health (WISH), Case-Control Study of Breast Cancer Among Younger Women
In: Cases: all women age 20-44 years in Seattle and New Jersey and age 20-54 years in Atlanta who were newly diagnosed with breast cancer during the period May 1, 1990, through December 31, 1992. For DES cases were restricted to women enrolled before April 30, 1992 and under age 45 years at diagnosis
In: Controls: women chosen through random-digit-dialing, matched by geographical area and age to the expected distribution of cases. For DES controls were restricted to women enrolled before April 30, 1992 and under age 45 years at dialing
Ex: women without residential telephone, women previously diagnosed with breast cancer, women who were adopted
Comment about participation selection
Adjustment for a variety of potential confounders.
Adjustment for a variety of potential confounders.

Exposure Investigated
Exposures investigated
Twinning, maternal age, DES in utero
Twinning, maternal age, DES in utero
How exposure was measured
Questionnaire, by telephone for subjects, self-administered for mother of subjects
Questionnaire, by telephone for subjects, self-administered for mother of subjects
Exposure assessment comment
Self-reported, recall bias, mother reporting DES consumption during pregnancy is small for analysis
Self-reported, recall bias, mother reporting DES consumption during pregnancy is small for analysis
Breast cancer outcome investigated
Primary incident breast cancer
Primary incident breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
White, African-American for maternal age and twin, only White for DES
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
No
Description of major analysis
Logistic regression model adjusted for age at reference date, race, study site, family history, previous breast biopsy, a combination variable including number of full-term births and age at first full-term birth, age at menarche, menopausal status, BMI,
Logistic regression model adjusted for age at reference date, race, study site, family history, previous breast biopsy, a combination variable including number of full-term births and age at first full-term birth, age at menarche, menopausal status, BMI,
Strength of associations reported
Maternal age: 0.93 (0.7-1.3), twin: 1.62 (1.0-2.7); DES: 0.75 (0.4-1.6)
Maternal age: 0.93 (0.7-1.3), twin: 1.62 (1.0-2.7); DES: 0.75 (0.4-1.6)
Results Comments
There is only a little association between breast cancer risk and maternal age, however breast cancer risk in a twin was greater than a singleton, and the association was slightly stronger among women with a twin brother. Exposure to DES in utero showed little evidence of an altered breast cancer risk.
There is only a little association between breast cancer risk and maternal age, however breast cancer risk in a twin was greater than a singleton, and the association was slightly stronger among women with a twin brother. Exposure to DES in utero showed little evidence of an altered breast cancer risk.

Author address
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
Controls participation rate
More than 70 % for subjects, Less than 70% for mot
More than 70 % for subjects, Less than 70% for mot