Environment and Breast Cancer: Science Review

Evidence From Humans
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Relation between obesity and breast cancer in young women.[erratum appears in Am J Epidemiol 2000 Apr 1;151(7):737]
Peacock, S. L., White, E., Daling, J. R., Voigt, L. F., Malone, K. E. American Journal of Epidemiology. 1999. 149:4, 339-46.
Topic area
Body size
Study design
Population based case-control
Study Participants
Number of Cases
Cases: 845 (invasive and in situ)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Number of Controls
Control: 961
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: white, English-speaking, born after 1944, diagnosed with invasive or in situ breast cancer between 1/1/83 and 4/30/90 (cases), and lived in three-county area surrounding Seattle, Washington Ex: women who did not own a telephone (controls)
Comment about participation selection
Strengths: study focused on younger women, fairly large case-control study, and study examined change in BMI among young women Limitations: possibility of tumors being easier to detect on thin women than on obese women might cause detection bias, possibility of obese women to have a poorer prognosis than thin women might cause a response bias since more obese women would have died before they were contacted thus eliminating them from the study cases, anthropometric data self-reported, few confounders, and poor recall may have lead to inaccurate data and misclassification
Exposure Investigated
Exposures investigated
Height, weight, BMI at reference, max BMI, BMI at 18 years, and annual average change in BMI from 18 years to reference
How exposure was measured
Questionnaire, in person
Exposure assessment comment
Anthropometric data self-reported
Breast cancer outcome investigated
Primary breast cancer (Invasive and In Situ)
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Nonhispanic Americans
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 and age at menarche
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
Strength of associations reported
Association between breast cancer and height, >5'7" vs. <5'3", OR=0.96(0.72-1.27) trend p=0.314
Association between breast cancer and weight, >160 pounds vs. < 119, OR=0.65(0.48-0.89) trend p=0.004
Association between breast cancer and BMI, >27.1 vs. <19.9, OR=0.67(0.49-0.91) trend p=0.003
Association between breast cancer and maximum lifetime BMI, >29.3 vs. <21.5, OR=0.69(0.51-0.94) trend p=0.003
Association between breast cancer and BMI among participants age 21-35 years old, >27.1 vs. <19.9 , OR=0.41(0.21-0.79)
Author address
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
Controls participation rate
Greater than 70% (77.6%)