Advertisement

Breast Cancer

, 10:45 | Cite as

Impact of established risk factors for breast cancer in nulligravid Japanese women

  • Kaoru Hirose
  • Kazuo Tajima
  • Nobuyuki Hamajima
  • Toshiro Takezaki
  • Manami Inoue
  • Tetsuo Kuroishi
  • Shigeto Miura
Original Article

Abstract

Background

The mechanism by which pregnancy impacts breast cancer risk remains poorly understood. There is a need for detailed quantification of risk in nulliparous women. We therefore have undertaken a case-referent study of breast cancer employing data from the Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC), Japan, examining the impact of reproductive and anthropometric factors on breast cancer risk among nulligravid women compared with their parous counterparts.

Methods

In total, 2,032 breast cancer cases were included, and 17,848 women, confirmed as free of cancer, were recruited as a reference group. Odds ratios (OR) and 95% confidence intervals (95% CI) were determined by multiple logistic regression analysis.

Results

A protective effect of later age at menarche was observed among parous women, but it did not alter risk in nulligravid cases. The risk increment with a family history appeared to be most pronounced among premenopausal cases with no history of pregnancy (OR=2.68, 95% CI: 1.41-5.11). Among postmenopausal women, positive associations with height and current body mass index (BMI) in the nulligravid group were similar to those observed in the parous group. The present study indicated that age at menopause, family history in premenopausal women, and height and obesity in postmenopausal women seemed to exert more influence in nulligravid women. Formal tests for interaction between maternity status and these factors, however, did not prove statistically significant.

Conclusion

Our findings suggest that established risk factors for breast cancer have an additive impact with nulligravid status. Thus, it is implied that obesity control for all women, including nulliparous individuals, is important from a practical viewpoint for primary breast cancer prevention.

Key words

Breast cancer Menopausal status Nulligravid women Parous women Risk factor 

Abbreviations

BMI

Body mass index

OR

Odds ratio

CI

Confidence interval

References

  1. 1).
    Hirose K, Tajima K, Hamajima N,et al: A large-scale, hospital-based case-control study of risk factors of breast cancer according to menopausal status.Jpn J Cancer Res 86: 146–154, 1995.PubMedGoogle Scholar
  2. 2).
    Hirose K, Tajima K, Hamajima N,et al: Effect of body size on breast-cancer risk among Japanese women.Int J Cancer 80: 349–355, 1999.PubMedCrossRefGoogle Scholar
  3. 3).
    Hirose K, Tajima K, Hamajima N,et al: Association of family history and other risk factors with breast cancer risk among Japanese premenopausal and postmenopausal women.Cancer Causes and Control 12: 349–358, 2001.PubMedCrossRefGoogle Scholar
  4. 4).
    Kelsey JL, Gammon MD, John EM: Reproductive factors and breast cancer.Epidemiol Rev 15: 36–47, 1993.PubMedGoogle Scholar
  5. 5).
    Yoo K-Y, Tajima K, Kuroishi T,et al: Independent protective effect of lactation against breast cancer: a case-control study in Japan.Am J Epidemiol 135: 726–733, 1992.PubMedGoogle Scholar
  6. 6).
    Hamajima N, Hirose K, Inoue M,et al: Age-specific risk factors of breast cancer estimated by a case-control study in Japan.J Epidemiol 5: 99–105, 1995.Google Scholar
  7. 7).
    Inoue M, Tajima K, Hirose K,et al: Epidemiological features of first-visit outpatients in Japan: comparison with general population and variation by sex, age, and season.J Clin Epidemiol 50: 69–77, 1997.PubMedCrossRefGoogle Scholar
  8. 8).
    Hirose K, Tajima K, Hamajima N,et al: Impact of family history on the risk of breast cancer among the Japanese.Jpn J Cancer Res 88: 1130–1136, 1997.PubMedGoogle Scholar
  9. 9).
    Tominaga S, Kuroishi T: High-risk group for breast cancer: recent results.J Jpn Assoc Breast Cancer Screen 7: 187–195, 1998 (in Japanese).Google Scholar
  10. 10).
    Hamajima N, Hirose K, Inoue M,et al: Case-control studies: matched controls or all available controls?J Clin Epidemiol 47: 971–975, 1994.PubMedCrossRefGoogle Scholar
  11. 11).
    Weiss HA, Troisi R, Rossing MA,et al: Fertility problems and breast cancer risk in young women: a casecontrol study in the United States.Cancer Causes Control 9: 331–339, 1998.PubMedCrossRefGoogle Scholar
  12. 12).
    Daling JR, Malone KE, Voigt LF,et al: Risk of breast cancer among young women: relationship to induced abortion.J Natl Cancer Inst 86: 1584–1592, 1994.PubMedCrossRefGoogle Scholar
  13. 13).
    Brind J, Chinchilli VM, Severs WB,et al: Induced abortion as an independent risk factor for breast cancer: a comprehensive review and meta-analysis.J Epidemiol Community Health 50: 481–496, 1996.PubMedCrossRefGoogle Scholar
  14. 14).
    Newcomb PA, Storer BE, Longnecker MP,et al: Pregnancy termination in relation to risk of breast cancer.JAMA 275: 283–287, 1996.PubMedCrossRefGoogle Scholar
  15. 15).
    Rookus MA, vanLeeuwen FE: Induced abortion and risk for breast cancer: reporting (recall) bias in a Dutch case-control study.J Natl Cancer Inst 88: 1759–1764, 1996.PubMedCrossRefGoogle Scholar
  16. 16).
    Peeters PHM, Verbeek ALM, Krol A,et al: Age at menarche and breast cancer risk in nulliparous women.Breast Cancer Res Treat 33: 55–61, 1994.CrossRefGoogle Scholar
  17. 17).
    Fioretti F, Tavani A, Bosetti C,et al: factors for breast cancer in nulliparous women.Brit J Cancer 79: 1923–1928, 1999.PubMedCrossRefGoogle Scholar
  18. 18).
    MacMahon B, Trichopoulos D, Brown J,et al: Age at menarche, urine estrogens and breast cancer risk.Int J Cancer 30: 427–431, 1982.PubMedCrossRefGoogle Scholar
  19. 19).
    Apter D, Reinila M, Vihko R: Some endocrine characteristics of early menarche, a risk factor for breast cancer, are preserved into adulthood.Int J Cancer 44: 737–787, 1989.CrossRefGoogle Scholar
  20. 20).
    Andriew N, Demenais F: Interactions between genetic and reproductive factors in breast cancer risk in a French family sample.Am J Hum Genet 61: 678–690, 1997.CrossRefGoogle Scholar
  21. 21).
    Willett WC, Browne ML, Bain C,et al: Relative weight and risk of breast cancer among pre-menopausal women.Am J Epidemiol 122: 731–740, 1985.PubMedGoogle Scholar
  22. 22).
    Le Marchand L, Kolonel LN, Earle ME,et al: Body size at different periods of life and breast-cancer risk.Am J Epidemiol 128: 137–152, 1988.PubMedGoogle Scholar
  23. 23).
    Vatten LJ, Kvinnsland S: Body-mass index and risk of breast cancer. A prospective study of 23,826 Norwegian women.Int J Cancer 45: 440–444, 1990.Google Scholar
  24. 24).
    Kirschner MA, Ertel N, Schneider G: Obesity, hormones and cancer.Cancer Res 41: 3711–3717, 1981.PubMedGoogle Scholar
  25. 25).
    Zumoff B: Relationship of obesity to blood estrogen.Cancer Res 42: 3289s-3294s, 1982.PubMedGoogle Scholar
  26. 26).
    Bruning PF: Endogenous estrogens and breast cancer; a possible relationship between body-fat distribution and estrogen availability.J Steroid Biochem 27: 487–492, 1987.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 2003

Authors and Affiliations

  • Kaoru Hirose
    • 1
  • Kazuo Tajima
    • 1
  • Nobuyuki Hamajima
    • 1
  • Toshiro Takezaki
    • 1
  • Manami Inoue
    • 1
  • Tetsuo Kuroishi
    • 1
  • Shigeto Miura
    • 2
  1. 1.Division of Epidemiology and PreventionAichi Cancer Center Research InstituteJapan
  2. 2.Department of Breast SurgeryAichi Cancer Center HospitalJapan

Personalised recommendations