Pre- and perinatal factors and incidence of breast cancer in the Black Women’s Health Study
The purpose of the study was to investigate the association between pre- or perinatal factors and breast cancer risk among African American women.
Participants in the Black Women’s Health Study, a prospective cohort of 59,000 African American women, reported birth weight, preterm birth, twin or triplet status, maternal age at birth, birth order, and having been breastfed during infancy at various times during follow-up from 1997 to 2015. Numbers of incident cases ranged from 312 for breastfed analyses to 1,583 for twin or triplet analyses. Using multivariable Cox proportional hazards regression, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between each factor and breast cancer risk overall and by estrogen receptor (ER) status.
Compared to birth weights of 5 lbs. 8 oz.–8 lbs. 13 oz., low (< 5 lbs. 8 oz.) and high (> 8 lbs. 13 oz.) birth weights were associated with increased breast cancer risk; HRs (95% CI) were 1.19 (0.98–1.44) and 1.26 (0.97–1.63), respectively. Associations were similar by ER status. Having been born to a mother aged ≥ 35 years versus < 20 years was associated with risk of ER+ (HR 1.59, 95% CI 1.10–2.29), but not ER− breast cancer. Other perinatal factors were not associated with breast cancer.
African American women with a low or high birth weight or born to older mothers may have increased breast cancer risk. Trends towards delayed child birth and higher birth weights, coupled with disproportionately high rates of low birth weight among African Americans, may contribute to increases in breast cancer incidence.
KeywordsPrenatal factors Perinatal factors Breast cancer African American women
Data on breast cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, the National Institutes of Health or the state cancer registries. The authors thank participants and staff of the Black Women’s Health Study for their contributions.
This study, along with LR and JRP, was funded by the National Cancer Institute/National Institutes of Health (NCI/NIH, R01CA058420, UM1CA164974, and U01CA164974). LEB and TAB were supported by the Susan G. Komen foundation (GTDR15331228). KAB was supported in part by the Dahod Breast Cancer Research Program of the Boston University School of Medicine.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Research involving human and animal participants
This article does not contain any studies with animals performed by any of the authors.
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