DOI QR코드

DOI QR Code

Risk Factors for Premenopausal Breast Cancer: A Case-control Study in Uruguay

  • Ronco, Alvaro L. (Depto. De Epidemiologia, Facultad de Medicina, IUCLAEH) ;
  • Stefani, Eduardo De (Grupo de Epidemiologia, Depto. De Patologia, Hospital de Clinicas, Facultad de Medicina (UDELAR)) ;
  • Deneo-Pellegrini, Hugo (Grupo de Epidemiologia, Depto. De Patologia, Hospital de Clinicas, Facultad de Medicina (UDELAR))
  • Published : 2012.06.30

Abstract

In order to thoroughly analyze risk factors of breast cancer (BC) in premenopausal Uruguayan women, a case-control study was carried out at the Pereira Rossell Women's Hospital, Montevideo, where 253 incident BC cases and 497 frequency-matched healthy controls were interviewed on menstrual and reproductive story, were administered a short food frequency questionnaire and undertook a series of body measurements necessary to calculate body composition and somatotype. Odds ratio (OR) coefficients were taken as estimates of relative risk derived from unconditional logistic regression. Among the classical risk factors, only the family history of BC in first degree relatives was significantly associated with risk of premenopausal BC (OR=2.20, 95% CI 1.33-3.62). Interestingly, this risk factor was found to be stronger in women of ages >40 (OR=4.05, 95% CI 2.10-7.81), late menarche (OR= 2.39, 95% CI 1.18-4.85), early age for their first delivery (OR=3.02, 95% CI 1.26-7.22), short time between menarche and first delivery (OR=3.22, 95% CI 1.29-8.07), and with high parity (OR=4.10, 95% CI 1.79-9.36), although heterogeneity was detected only for age and parity. High consumption of red meat was positively associated with the disease risk (OR=2.20, 95% CI 1.35-3.60), in the same way as fried foods (OR=1.79, 95% CI 1.12-2.84). Conversely, a high intake of plant foods displayed a protective effect (OR=0.41, 95% CI 0.26-0.65). Except for hypertension (OR=1.55, 95% CI 1.03-2.35), none of the analyzed components of metabolic syndrome were associated to BC risk. Particular increases of risk for premenopausal BC were found for family history in first degree relatives in certain subsets derived from the menstrual-reproductive history. Preventive strategies could broaden their scope if new studies confirm the present results, in view of the limited prevention measures that premenopausal BC currently has.

Keywords

References

  1. Ambrosone CB, Freudenheim JL, Thompson PA, et al (1999). Manganese superoxide dismutase (MnSOD) genetic polymorphisms, dietary antioxidants, and risk of breast cancer. Cancer Res, 59, 602.
  2. American College of Radiology (1998). Breast imaging reporting and data system (BI-RADS). 3rd ed., American College of Radiology, Reston, VA.
  3. Breslow NE, Day NE (1980). Statistical methods in cancer research. Vol. 1. The analysis of case-control studies. IARC Sci Publ. 32. IARC, Lyon.
  4. Carter JEL (2002). The Heath-Carter anthropometric somatotype-Instruction Manual. Surrey, Canada, TeP and Rosscraft.
  5. Carter JEL, Heath BH (1990). Somatotyping: Development and Applications. Cambridge, Cambridge University Press.
  6. Chauhan A, Subba SH, Menezes RG, et al (2011). Younger women are affected by breast cancer in South India - a hospital-based descriptive study. Asian Pac J Cancer Prev, 12, 709-11.
  7. Chow LW, Lui KL, Chan JC et al (2005). Association between body mass index and risk of formation of breast cancer in Chinese women. Asian J Surg, 28, 179-84. https://doi.org/10.1016/S1015-9584(09)60338-9
  8. Colditz GA, Rosner BA, Speizer FE (1996). Risk Factors for Breast Cancer According to Family History of Breast Cancer. J Natl Cancer Inst, 88, 365-71. https://doi.org/10.1093/jnci/88.6.365
  9. Colditz GA , Rosner B (2000). Cumulative risk of breast cancer to age 70 years according to risk factor status: data from the Nurses' Health Study. Am J Epidemiol, 152, 950-64. https://doi.org/10.1093/aje/152.10.950
  10. De Rose EH, Pigatto E, Celi R (1984). Kinanthropometry, physical education and sport training. SEED, Brasilia. (in Portuguese)
  11. Dettenborn L, James GD, Britton JA, Bovbjerg DH (2008). Higher levels of central adiposity in healthy premenopausal women with family histories of premenopausal breast cancer. Am J Hum Biol, 20, 355-8. https://doi.org/10.1002/ajhb.20700
  12. Egan KM, Stampfer MJ, Rosner BA, et al (1998). Risk factors for breast cancer in women with a breast cancer family history. Cancer Epidemiol Biomarkers Prev, 7, 359.
  13. Faulkner J (1968). Physiology of swimming and diving. In Falls H: Exercise Physiology. Academic Press, Baltimore.
  14. Fung TT, Hu FB, Holmes MD, et al (2005). Dietary patterns and the risk of postmenopausal breast cancer. Int J Cancer, 116, 116-21. https://doi.org/10.1002/ijc.20999
  15. Heymsfield SB, Wang Z, Baumgartner RN, Ross R (1997). Human body composition: advances in models and methods. Ann Rev Nutr, 17, 527-58. https://doi.org/10.1146/annurev.nutr.17.1.527
  16. Hines LM, Risendal B, Slattery ML, et al (2010). Comparative analysis of breast cancer risk factors among Hispanic and non-Hispanic white women. Cancer, 116, 3215-23. https://doi.org/10.1002/cncr.25154
  17. Hirose K, Tajima K, Hamajima N et al (2001). Association of family history and other risk factors with breast cancer risk among Japanese premenopausal and postmenopausal women. Cancer Causes Control, 12, 349-58. https://doi.org/10.1023/A:1011232602348
  18. Hall IJ, Newman B, Millikan RC, Moorman PG (2000). Body size and breast cancer risk in black women and white women: the Carolina Breast Cancer Study. Am J Epidemiol, 151, 754-64. https://doi.org/10.1093/oxfordjournals.aje.a010275
  19. Jackson AS and Pollack ML (1985). Practical Assessment of body composition. Physician Sport Med, 13, 76-90.
  20. Kruk J (2007). Association of lifestyle and other risk factors with breast cancer according to menopausal status: a case-control study in the Region of Western Pomerania (Poland). Asian Pac J Cancer Prev, 8, 513-24.
  21. Kushi LH, Potter JD, Bostick RM, et al (1995). Dietary fat and risk of breast cancer according to hormone receptor status. Cancer Epidemiol Biomarkers Prev, 4, 11-9.
  22. Lahmann PH, Hoffmann K, Allen N et al (2004). Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer, 111, 762-71. https://doi.org/10.1002/ijc.20315
  23. Lee RC, Wang Z, Heo M, et al (2000). Total-body skeletal muscle mass: development and cross-validation of anthropometric prediction models. Am J Clin Nutr, 72, 796-803.
  24. Linos E, Spanos D , Rosner BA, et al (2008) . Effects of Reproductive and Demographic Changes on Breast Cancer Incidence in China: A Modeling Analysis. J Natl Cancer Inst, 100, 1352-60. https://doi.org/10.1093/jnci/djn305
  25. Mc Tiernan A, Thomas DB (1986). Evidence for a protective effect of lactation on risk of breast cancer in young women. Am J Epidemiol, 124, 353-8.
  26. Michels KB, Mohllajee AP, Roset-Bahmanyar E, Beehler GP, Moysich KB (2007). Diet and Breast Cancer. A Review of the Prospective Observational Studies. Cancer Suppl, 109, 2712-48. https://doi.org/10.1002/cncr.22654
  27. Okobia MN, Bunker CH, Zmuda JM et al (2006). Anthropometry and breast cancer risk in Nigerian women. Breast J, 12, 462-6. https://doi.org/10.1111/j.1075-122X.2006.00304.x
  28. Oldenburg RA, Meijers-Heijboer H, Cornelisse CJ, Devilee P (2007). Genetic susceptibility for breast cancer: How many more genes to be found? Critical Rev Oncol/Hematol, 63, 125-49. https://doi.org/10.1016/j.critrevonc.2006.12.004
  29. Olsen A, Tjonneland A, Thomsen BL, et al (2003). Fruits and vegetables intake differentially affects estrogen receptor negative and positive breast cancer incidence rates. J Nutr, 133, 2342-7.
  30. Pathak DR, Whittemore AS (1992). Combined effects of body size, parity, and menstrual events on breast cancer incidence in seven countries. Am JEpidemiol, 135, 153-68.
  31. Pike MC , Kolonel LN , Henderson BE, et al (2002). Breast cancer in a multiethnic cohort in Hawaii and Los Angeles: risk factor-adjusted incidence in Japanese equals and in Hawaiians exceeds that in whites. Cancer Epidemiol Biomarkers Prev, 11, 795-800.
  32. Ronco AL, De Stefani E, Mendilaharsu M, Deneo-Pellegrini H (1996). Meat, fat and the risk of breast cancer: a case-control study from Uruguay. Int J Cancer, 65, 328-31. https://doi.org/10.1002/(SICI)1097-0215(19960126)65:3<328::AID-IJC9>3.0.CO;2-1
  33. Ronco AL, De Stefani E, Boffetta P, et al (1999). Vegetables, fruits, and related nutrients and risk of breast cancer: a case control study in Uruguay. Nutr Cancer, 35, 111-9. https://doi.org/10.1207/S15327914NC352_3
  34. Ronco A, De Stefani E, Deneo-Pellegrini H (2006a). Polyunsaturated fatty acids intake and risk of breast cancer: a case-control study. XIV World Congress on Breast Diseases, Zagreb, Croatia, May 18-21st.
  35. Ronco AL, De Stefani E, Boffetta P, et al (2006b). Food patterns and risk of breast cancer: A factor analysis study in Uruguay. Int J Cancer, 19, 1672-8.
  36. Ronco AL, Mendoza B, Varas X, et al (2008). Somatotype and risk of breast cancer: a case-control study in Uruguay. Braz J Epidemiol, 11, 215-27. https://doi.org/10.1590/S1415-790X2008000200004
  37. Ronco AL, Boeing H, De Stéfani E, et al (2009). A case-control study on fat to muscle ratio and risk of breast cancer. Nutr Cancer, 61, 466-74. https://doi.org/10.1080/01635580902725995
  38. Ronco AL, De Stefani E, Stoll M (2010). Hormonal and metabolic modulation through nutrition: towards a primary prevention of breast cancer. The Breast, 19, 322-32. https://doi.org/10.1016/j.breast.2010.05.005
  39. Ronco AL, De Stefani E (2011). Interrelationships between body composition and somatotype and the risk of breast cancer. Proceedings of the II International Symposium on Breast Cancer Prevention, Rennes, France, October 9-11th, p.59.
  40. Ronco AL, De Stefani E (eds) (2012a). Nutritional epidemiology of breast cancer. Springer Verlag, Dordrecht.
  41. Ronco AL, De Stefani E, Deneo-Pellegrini H, Quarneti A (2012b). Diabetes, overweight and risk of postmenopausal breast cancer: a case-control study in Uruguay. Asian Pac J Cancer Prev, 13, 455-63.
  42. Shu XO, Jin F, Dai Q, et al (2001). Association of body size and fat distribution with risk of breast cancer among Chinese women. Int J Cancer, 94, 449-55. https://doi.org/10.1002/ijc.1487
  43. Stuebe AM, Willett WC, Xue F, Michels KB (2009). Lactation and incidence of premenopausal breast cancer: a longitudinal study. Arch Intern Med, 169, 1364-71. https://doi.org/10.1001/archinternmed.2009.231
  44. Taylor VH, Misra M, Mukherjee SD (2009). Is red meat intake a risk factor for breast cancer among premenopausal women? Breast Cancer Res Treat, 117, 1-8. https://doi.org/10.1007/s10549-009-0441-y
  45. Varas X, Leborgne F, Leborgne JH (1992). Non palpable, probably benign lesions: role of follow-up mammography. Radiology, 184, 1409-14.
  46. World Cancer Research Fund / American Institute for Cancer Research (2007). Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC, American Institute for Cancer Research.
  47. Wu AH, Yu MC, Tseng CC, Pike MC (2007). Body size, hormone therapy and risk of breast cancer in Asian-American women. Int J Cancer, 120, 844-52. https://doi.org/10.1002/ijc.22387

Cited by

  1. Hypertension and the Risk of Breast Cancer in Chilean Women: a Case-control Study vol.13, pp.11, 2012, https://doi.org/10.7314/APJCP.2012.13.11.5829
  2. Vascular Endothelial Growth Factor (VEGF) Gene Polymorphisms and Breast Cancer Risk in a Chinese Population vol.14, pp.4, 2013, https://doi.org/10.7314/APJCP.2013.14.4.2433
  3. Metabolic syndrome and postmenopausal breast cancer vol.20, pp.12, 2013, https://doi.org/10.1097/GME.0b013e31828ce95d
  4. A nationwide population-based cohort study on tonsillectomy and subsequent cancer incidence vol.125, pp.1, 2015, https://doi.org/10.1002/lary.24864
  5. Vascular endothelial growth factor (VEGF) gene polymorphisms and breast cancer risk in Punjabi population from North West India vol.35, pp.11, 2014, https://doi.org/10.1007/s13277-014-2404-0
  6. Vascular endothelial growth factor gene polymorphism (-634G/C) and breast cancer risk vol.35, pp.8, 2014, https://doi.org/10.1007/s13277-014-1997-7
  7. Metabolic Syndrome and Breast Cancer Risk: A Case-Cohort Study Nested in a Multicentre Italian Cohort vol.10, pp.6, 2015, https://doi.org/10.1371/journal.pone.0128891
  8. Lifestyle Components and Primary Breast Cancer Prevention vol.15, pp.24, 2014, https://doi.org/10.7314/APJCP.2014.15.24.10543
  9. Mate Intake and Risk of Breast Cancer in Uruguay: a Case-Control Study vol.17, pp.3, 2016, https://doi.org/10.7314/APJCP.2016.17.3.1453
  10. Risk factors of breast cancer and knowledge about the disease: an integrative revision of Latin American studies vol.22, pp.1, 2017, https://doi.org/10.1590/1413-81232017221.09272015
  11. Hypertension and Subsequent Genitourinary and Gynecologic Cancers Risk vol.94, pp.16, 2015, https://doi.org/10.1097/MD.0000000000000753
  12. Hypertension and breast cancer risk: a systematic review and meta-analysis vol.7, pp.1, 2017, https://doi.org/10.1038/srep44877