Environment and Breast Cancer: Science Review

Evidence From Humans
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Stage of breast cancer in relation to body mass index and bra cup size
Hall, H. I., Coates, R. J., Uhler, R. J., Brinton, L. A., Gammon, M. D., Brogan, D., Potischman, N., Malone, K. E., Swanson, C. A. International Journal of Cancer. 1999. 82:1, 23-7.
Topic area
Body size
Study design
Other: case-case comparison from a case-control study
Funding agency
Not reported
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Number in Cohort
Cohort: 1,361 women diagnosed with breast cancer
Cohort participation rate
Retention/participation exceeded 70% for exposed a
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: cases from a population based case-control study on breast cancer etiology conducted in Atlanta, GA and Seattle-Puget Sound, WA and 5 counties of central New Jersey; age 20-44 years at diagnosis; diagnosed with breast cancer between May 1, 1990 and December 31, 1992 Ex: women with a prior diagnosis of breast cancer; women in which no breast cancer stage information was available; in situ cases; women with missing anthropometric data
Comment about participation selection
Strengths: anthropometric data obtained by trained staff; stage of the cancers at diagnosis were obtained from the SEER program cancer registry records; analyzed the relationship between breast cancer stage at diagnosis and both BMI and bra cup size stratified by method of detection in a sample of breast cancer cases; large sample size; population-based study Limitations: sample size was small for some stratified analyses; may have been lower study participation among women with later-stage breast cancers; weight was measured after women were diagnosed with breast cancer, which may have had an influence on the results
Exposures investigated
BMI, bra cup size
How exposure was measured
Questionnaire, in person Anthropometric measurement, researcher-administered
Breast cancer outcome investigated
Breast cancer recurrence or progression
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, race, height, number of full-term births, number of mammograms and method of detection
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Strength of associations reported
The analysis included an examination of the effect modifiers:method of detection.
Association between regional/distant stage vs local stage of breast cancer diagnosis and height, >166.9 cm vs. <161.1 cm, OR=1.26(0.97-1.64) trend p=0.08
Association between regional/distant stage vs local stage of breast cancer diagnosis and BMI, (BMI >26.7 vs <22.5), OR=1.46(1.10-1.93) trend p=0.01
Association between regional/distant stage vs local stage of breast cancer diagnosis and bra cup size, (D cup vs A cup), OR=1.61(1.04-2.48) trend p=0.01
Author address
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. ixh1@cdc.gov