Environment and Breast Cancer: Science Review

Evidence From Humans
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Hormonal and other factors in relation to survival among breast cancer patients
Reeves, G. K., Patterson, J., Vessey, M. P., Yeates, D., Jones, L. International Journal of Cancer. 2000. 89:3, 293-9.
Topic area
Body size
Study design
Prospective cohort
Funding agency
Not reported
Study Participants
Number of Cases
608 all-cause mortalities of women diagnosed with breast cancer
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number in Cohort
Cohort: 1,208 women diagnosed with breast cancer (74% pre) (26% post)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: participants of one of two case-control studies between 1969 and 1984; age 24-69 at diagnosis; underwent primary treatment for newly diagnosed and histologically proven breast cancer between 1969 and 1984 in one of 6 London hospitals Ex: women whose staging information could not be obtained
Comment about participation selection
Strengths: clinical stage and nodal status were obtained at the time of surgery; primary treatment was obtained from hospital records; lengthy follow-up; high participation rate; analyzed all cause mortality by anthropometric values stratified by stage and nodal status; findings based largely on premenopausal women Limitations: anthropometric data were self-reported; deaths in the study are not limited to breast cancer; findings not stratified by menopausal status
Exposure Investigated
Exposures investigated
Weight, height and BMI
How exposure was measured
Questionnaire, in person Anthropometric measurement, self-administered
Exposure assessment comment
Anthropometric data self-reported
Statistical Analysis
Breast cancer outcome investigated
Mortality from breast cancer in a cohort of breast cancer patients
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: stage, nodal status, age at diagnosis, year of diagnosis, hospital and weight
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: breast cancer stage and nodal status Follow-up: 1968-1984 to 1/1/1994
Strength of associations reported
Women in the cohort with a BMI >27 compared to women with a BMI of less than 25 had an increased risk of mortality, RR=1.49(1.18-1.86)
Women in the cohort with a weight of 75+ km compared to women with a weight of less than 65 km had an increased risk of mortality, RR=1.56(1.21-2.01)
Results Comments
Height did not appear to be related to survival either before or after adjustment for weight.
Author address
Cancer Epidemiology Unit, Imperial Cancer Research Fund, Radcliffe Infirmary, Oxford, UK. reeves@icrf.icnet.uk