Environment and Breast Cancer: Science Review

Interaction of adolescent anthropometric characteristics and family history on breast cancer risk in a Historical Cohort Study of 426 families (USA)
Cerhan, J. R., Grabrick, D. M., Vierkant, R. A., Janney, C. A., Vachon, C. M., Olson, J. E., Kushi, L. H., Sellers, T. A. Cancer Causes & Control. 2004. 15:1, 1-9.

Topic area
Body size
Body size
Study design
Prospective cohort
Prospective cohort
Funding agency
NCI
NCI

Study Participants
Number of Cases
175 family members of breast cancer patients who were later diagnosed with their own breast cancers
175 family members of breast cancer patients who were later diagnosed with their own breast cancers
Menopausal Status
Post menopausal
The menopausal status of women included in this study is listed here.
Pre menopausalPost menopausal
Number in Cohort
Cohort: 4,632
Cohort: 4,632
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: family members of 426 breast cancer patients seen at the Tumor Clinic of the University of Minnesota Hospital from 1944-1952; completed telephone interview on breast cancer risk factors and mailed survey on anthropometric data; 18 years or older
Ex: family members whose proband was diagnosed before 1940; family members in which most or all of the relatives were deceased at the time of follow-up; lost to follow-up; refused participation; women who did not complete a telephone interview; women with missing anthropometric data
Comment about participation selection
Strengths: evaluated whether the degree of relationship to the proband modified the effect of the adolescent anthropometric variables on breast cancer risk; large number of participants Limitations: anthropometric data self-reported; not strictly population based; breast cancer cases were self-reported; potential selection bias through exclusion criteria, unable to stratify results by menopausal status due to a lack of cases
Strengths: evaluated whether the degree of relationship to the proband modified the effect of the adolescent anthropometric variables on breast cancer risk; large number of participants Limitations: anthropometric data self-reported; not strictly population based; breast cancer cases were self-reported; potential selection bias through exclusion criteria, unable to stratify results by menopausal status due to a lack of cases

Exposure Investigated
Exposures investigated
Relative weight at age 12, height, weight at age 18 and BMI at age 18
Relative weight at age 12, height, weight at age 18 and BMI at age 18
How exposure was measured
Questionnaire, self-administered
Questionnaire, self-administered
Exposure assessment comment
Anthropometric data self-reported
Anthropometric data self-reported
Early life exposures considered
BMI at age 12
BMI at age 12

Statistical Analysis
Breast cancer outcome investigated
Primary breast cancer
Primary breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
No
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, birth cohort, adult BMI and non-independence of observations within a family
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
Follow-up: 1991-1996 Effect modifiers: family history of breast cancer
Follow-up: 1991-1996 Effect modifiers: family history of breast cancer
Strength of associations reported
Association between breast cancer risk in sisters and daughters of probands and above average weight at age 12 of those sisters and daughters, above average vs. below average, RR=4.25(1.71-10.5) trend p=0.29
Association between breast cancer risk in sisters and daughters of probands and height of those sisters and daughters, >1.65 m vs. <1.60 m, RR=1.41(0.59-3.34) trend p=0.43
Association between breast cancer risk in sisters and daughters of probands and weight at age 18 of those sisters and daughters, >56.8 kg vs. <52.3 RR=1.09(0.45-2.62) trend p=0.88
Association between breast cancer risk in sisters and daughters of probands and BMI at age 18 of those sisters and daughters, >21.8 vs. <19.7, RR=1.60(0.65-3.91) trend p=0.31
Association between breast cancer risk in sisters and daughters of probands and above average weight at age 12 of those sisters and daughters, above average vs. below average, RR=4.25(1.71-10.5) trend p=0.29
Association between breast cancer risk in sisters and daughters of probands and height of those sisters and daughters, >1.65 m vs. <1.60 m, RR=1.41(0.59-3.34) trend p=0.43
Association between breast cancer risk in sisters and daughters of probands and weight at age 18 of those sisters and daughters, >56.8 kg vs. <52.3 RR=1.09(0.45-2.62) trend p=0.88
Association between breast cancer risk in sisters and daughters of probands and BMI at age 18 of those sisters and daughters, >21.8 vs. <19.7, RR=1.60(0.65-3.91) trend p=0.31
Results Comments
Trend of increasing breast cancer risk among sisters and daughters of probands in women with increasing height and BMI at age 18 although findings are not significant. No significant association between breast cancer risk among granddaughters and nieces of probands.
Trend of increasing breast cancer risk among sisters and daughters of probands in women with increasing height and BMI at age 18 although findings are not significant. No significant association between breast cancer risk among granddaughters and nieces of probands.

Author address
Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. cerhan.james@mayo.edu
Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. cerhan.james@mayo.edu