Environment and Breast Cancer: Science Review

Evidence From Humans
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Insulin-like growth factor binding proteins 1 and 3 and breast cancer outcomes
Goodwin, P. J., Ennis, M., Pritchard, K. I., Trudeau, M. E., Koo, J., Hartwick, W., Hoffma, B., Hood, N. Breast Cancer Research & Treatment. 2002. 74:1, 65-76.
Topic area
Body size
Study design
Other: consecutive cohort
Funding agency
Other: Canadian Breast Cancer Research Initiative
Study Participants
Number of Cases
512 (289 pre) (26 peri) (197 post) (invasive only)
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number in Cohort
Cohort: 512
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: women with operable breast cancer that presented to one of three University of Toronto hospitals between July 1989 and June 1996; younger than 75 years; undergone complete resection with axillary node dissection for a T1-3, NO-1, MO invasive breast cancer Ex: undergone preoperative systematic therapy; prior malignancy; prior surgical treatment for breast cancer; serious underlying medical conditions that could influence survival; used medications that could influence lipids or insulin; inability to speak English; refused to provide informed consent
Comment about participation selection
Strengths: anthropometric data measured by trained staff; blood was centrifuged immediately after collection; analyzed insulin-like growth factor levels (IGF) by BMI; stratified results by menopausal status; looked at breast cancer recurrence and survival Limitations: looked only at BMI exposure; did not include hazard ratios for the association between breast cancer recurrence or mortality and IGFB levels stratified by BMI
How exposure was measured
Questionnaire, self-administered Anthropometric measurement, researcher-administered
Breast cancer outcome investigated
Breast cancer recurrence or progression
Mortality from breast cancer
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:insulin levels, IGFBP 1 & 3, tumor grade, tumor stage, receptor status
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
Follow up: 7 years
Results Comments
Insulin levels were moderately inversely correlated with BMI. BMI was an inverse predictor of IGFBP-1 levels when included with Insulin in the model. IGFBP-3 was not strongly correlated with BMI.
Author address
Department of Medicine, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Ontario, Canada. pgoodwin@mtsinai.on.ca