Breast Cancer Research and Treatment

, Volume 138, Issue 2, pp 601–610 | Cite as

Body size throughout the life course and mammographic density in Mexican women

  • Megan S. Rice
  • Kimberly A. Bertrand
  • Martin Lajous
  • Rulla M. Tamimi
  • Gabriela Torres-Mejía
  • Carine Biessy
  • Ruy López-Ridaura
  • Isabelle Romieu


Mammographic density (MD) is a strong risk factor for breast cancer, but the biological mechanism underlying this association is not clear. Current adult body mass index (BMI) is inversely associated with percent MD; however, few studies have included Hispanic women or evaluated associations with measures of body fatness earlier in life. ESMaestras was established in 2006, when 28,345 women ages ≥35 responded to a detailed questionnaire that assessed possible disease risk factors, including body fatness in childhood, adolescence, and young adulthood. In 2007, 2084 ESMaestras participants underwent a clinical examination, which included measurements of weight, height, and sitting height and a mammogram. We measured percent MD using a computer-assisted method. The current analysis includes 972 premenopausal and 559 postmenopausal women. We used multivariable linear regression to evaluate associations between measures of body size and MD, independent of current BMI. Among pre- and postmenopausal women, we observed no significant associations between body fatness during childhood, adolescence, or young adulthood and percent MD. Among postmenopausal women, we observed a modest positive association between body fatness immediately before first pregnancy and between ages 25 and 35 after adjustment for current BMI, with differences of 4.9 and 3.6 % points, respectively, in percent MD between the heaviest and leanest women (p-trend = 0.02). There were no significant associations between height, sitting height, and percent MD among pre- or postmenopausal women in multivariable models adjusting for BMI. In general, we found no clear associations between measures of body size in early life, current sitting height, or current height, and percent MD, after adjusting for current BMI, in this population of Mexican women. Our observation of a positive association between early adult body fatness (i.e., before first pregnancy and ages 25–35) and percent MD among postmenopausal women is inconsistent with prior research and requires confirmation in other studies.


Body size Mammographic density Breast cancer Hispanic Mexico Epidemiology 



Mammographic density


Body mass index


Benign breast disease


Postmenopausal hormone



This work was supported by the American Institute for Cancer Research (05B047), CONACYT (14429), Ministry of Health Mexico, Avon Cosmetics, Fundación Banorte, Fundación Gruma, Bicentennial Fund Traveling Fellowship, Harvard School of Public Health Department of Epidemiology, and National Institutes of Health, National Cancer Institute (T32 CA09001, R25 CA098566).

Conflict of interest

  The authors declare that they have no conflict of interest.

Supplementary material

10549_2013_2463_MOESM1_ESM.doc (86 kb)
Supplementary material 1 (DOC 85 kb)


  1. 1.
    McCormack VA, dos Santos Silva I (2006) Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 15(6):1159–1169. doi: 10.1158/1055-9965.EPI-06-0034 PubMedCrossRefGoogle Scholar
  2. 2.
    Yaffe MJ (2008) Measurement of mammographic density. Breast Cancer Res 10(3):209. doi: 10.1186/bcr2102 PubMedCrossRefGoogle Scholar
  3. 3.
    Martin LJ, Boyd NF (2008) Mammographic density. Potential mechanisms of breast cancer risk associated with mammographic density: hypotheses based on epidemiological evidence. Breast Cancer Res 10(1):201. doi: 10.1186/bcr1831 PubMedCrossRefGoogle Scholar
  4. 4.
    World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. American Institute for Cancer Research, WashingtonGoogle Scholar
  5. 5.
    Palmer JR, Adams-Campbell LL, Boggs DA, Wise LA, Rosenberg L (2007) A prospective study of body size and breast cancer in black women. Cancer Epidemiol Biomarkers Prev 16(9):1795–1802. doi: 10.1158/1055-9965.epi-07-0336 PubMedCrossRefGoogle Scholar
  6. 6.
    Michels KB, Terry KL, Willett WC (2006) Longitudinal study on the role of body size in premenopausal breast cancer. Arch Intern Med 166(21):2395–2402. doi: 10.1001/archinte.166.21.2395 PubMedCrossRefGoogle Scholar
  7. 7.
    Magnusson CM, Roddam AW, Pike MC, Chilvers C, Crossley B, Hermon C, McPherson K, Peto J, Vessey M, Beral V (2005) Body fatness and physical activity at young ages and the risk of breast cancer in premenopausal women. Br J Cancer 93(7):817–824. doi: 10.1038/sj.bjc.6602758 PubMedCrossRefGoogle Scholar
  8. 8.
    Baer HJ, Colditz GA, Rosner B, Michels KB, Rich-Edwards JW, Hunter DJ, Willett WC (2005) Body fatness during childhood and adolescence and incidence of breast cancer in premenopausal women: a prospective cohort study. Breast Cancer Res 7(3):R314–R325. doi: 10.1186/bcr998 PubMedCrossRefGoogle Scholar
  9. 9.
    Weiderpass E, Braaten T, Magnusson C, Kumle M, Vainio H, Lund E, Adami HO (2004) A prospective study of body size in different periods of life and risk of premenopausal breast cancer. Cancer Epidemiol Biomarkers Prev 13(7):1121–1127PubMedGoogle Scholar
  10. 10.
    Magnusson C, Baron J, Persson I, Wolk A, Bergstrom R, Trichopoulos D, Adami HO (1998) Body size in different periods of life and breast cancer risk in post-menopausal women. Int J Cancer 76(1):29–34PubMedCrossRefGoogle Scholar
  11. 11.
    London SJ, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Speizer FE (1989) Prospective study of relative weight, height, and risk of breast cancer. JAMA 262(20):2853–2858PubMedCrossRefGoogle Scholar
  12. 12.
    Le Marchand L, Kolonel LN, Earle ME, Mi MP (1988) Body size at different periods of life and breast cancer risk. Am J Epidemiol 28(1):137–152Google Scholar
  13. 13.
    Berkey CS, Frazier AL, Gardner JD, Colditz GA (1999) Adolescence and breast carcinoma risk. Cancer 85(11):2400–2409. doi: 10.1002/(SICI)1097-0142(19990601)85:11<2400:AID-CNCR15>3.0.CO;2-O PubMedCrossRefGoogle Scholar
  14. 14.
    Samimi G, Colditz GA, Baer HJ, Tamimi RM (2008) Measures of energy balance and mammographic density in the Nurses’ Health Study. Breast Cancer Res Treat 109(1):113–122. doi: 10.1007/s10549-007-9631-7 PubMedCrossRefGoogle Scholar
  15. 15.
    Sellers TA, Vachon CM, Pankratz VS, Janney CA, Fredericksen Z, Brandt KR, Huang Y, Couch FJ, Kushi LH, Cerhan JR (2007) Association of childhood and adolescent anthropometric factors, physical activity, and diet with adult mammographic breast density. Am J Epidemiol 166(4):456–464. doi: 10.1093/aje/kwm112 PubMedCrossRefGoogle Scholar
  16. 16.
    Harris HR, Tamimi RM, Willett WC, Hankinson SE, Michels KB (2011) Body size across the life course, mammographic density, and risk of breast cancer. Am J Epidemiol 174(8):909–918. doi: 10.1093/aje/kwr225 PubMedCrossRefGoogle Scholar
  17. 17.
    Boyd NF, Lockwood GA, Byng JW, Little LE, Yaffe MJ, Tritchler DL (1998) The relationship of anthropometric measures to radiological features of the breast in premenopausal women. Br J Cancer 78(9):1233–1238PubMedCrossRefGoogle Scholar
  18. 18.
    Vachon CM, Kuni CC, Anderson K, Anderson VE, Sellers TA (2000) Association of mammographically defined percent breast density with epidemiologic risk factors for breast cancer (United States). Cancer Causes Control 11(7):653–662PubMedCrossRefGoogle Scholar
  19. 19.
    McCormack VA, dos Santos Silva I, De Stavola BL, Perry N, Vinnicombe S, Swerdlow AJ, Hardy R, Kuh D (2003) Life-course body size and perimenopausal mammographic parenchymal patterns in the MRC 1946 British birth cohort. Br J Cancer 89(5):852–859. doi: 10.1038/sj.bjc.6601207 PubMedCrossRefGoogle Scholar
  20. 20.
    Jeffreys M, Warren R, Gunnell D, McCarron P, Smith GD (2004) Life course breast cancer risk factors and adult breast density (United Kingdom). Cancer Causes Control 15(9):947–955. doi: 10.1007/s10522-004-2473-3 PubMedGoogle Scholar
  21. 21.
    Lope V, Perez-Gomez B, Moreno MP, Vidal C, Salas-Trejo D, Ascunce N, Roman IG, Sanchez-Contador C, Santamarina MC, Carrete JA, Collado-Garcia F, Pedraz-Pingarron C, Ederra M, Ruiz-Perales F, Peris M, Abad S, Cabanes A, Pollan M (2011) Childhood factors associated with mammographic density in adult women. Breast Cancer Res Treat. doi: 10.1007/s10549-011-1664-2 PubMedGoogle Scholar
  22. 22.
    Gutierrez JP, Rivera-Dommarco J, Shamah-Levy T, Villalpando-Hernandez S, Franco A, Cuevas-Nasu L, Romero-Martinez M, Hernandez-Avila M (2012) Encuesta nacional de salud y nutricion 2012. Instituto Nacional de Salud Publica, CuernavacaGoogle Scholar
  23. 23.
    Chavarri-Guerra Y, Villarreal-Garza C, Liedke PE, Knaul F, Mohar A, Finkelstein DM, Goss PE (2012) Breast cancer in Mexico: a growing challenge to health and the health system. Lancet Oncol 13(8):e335–e343. doi: 10.1016/S1470-2045(12)70246-2 PubMedCrossRefGoogle Scholar
  24. 24.
    Romieu I, Lajous M (2009) The role of obesity, physical activity and dietary factors on the risk for breast cancer: Mexican experience. Salud Publica Mex 51(Suppl 2):s172–s180PubMedCrossRefGoogle Scholar
  25. 25.
    Romieu I, Escamilla-Nunez MC, Sanchez-Zamorano LM, Lopez-Ridaura R, Torres-Mejia G, Yunes EM, Lajous M, Rivera-Dommarco JA, Lazcano-Ponce E (2011) The association between body shape silhouette and dietary pattern among Mexican women. Public Health Nutr 15(1):116–125. doi: 10.1017/s1368980011001182 PubMedCrossRefGoogle Scholar
  26. 26.
    Martin LJ, Minkin S, Boyd NF (2009) Hormone therapy, mammographic density, and breast cancer risk. Maturitas 64(1):20–26. doi: 10.1016/j.maturitas.2009.07.009 PubMedCrossRefGoogle Scholar
  27. 27.
    Must A, Willett WC, Dietz WH (1993) Remote recall of childhood height, weight, and body build by elderly subjects. Am J Epidemiol 138(1):56–64PubMedGoogle Scholar
  28. 28.
    Byng JW, Boyd NF, Fishell E, Jong RA, Yaffe MJ (1994) The quantitative analysis of mammographic densities. Phys Med Biol 39(10):1629–1638PubMedCrossRefGoogle Scholar
  29. 29.
    Ursin G, Astrahan MA, Salane M, Parisky YR, Pearce JG, Daniels JR, Pike MC, Spicer DV (1998) The detection of changes in mammographic densities. Cancer Epidemiol Biomarkers Prev 7(1):43–47PubMedGoogle Scholar
  30. 30.
    Torres-Mejia G, De Stavola B, Allen DS, Perez-Gavilan JJ, Ferreira JM, Fentiman IS, Dos Santos Silva I (2005) Mammographic features and subsequent risk of breast cancer: a comparison of qualitative and quantitative evaluations in the Guernsey prospective studies. Cancer Epidemiol Biomarkers Prev 14(5):1052–1059. doi: 10.1158/1055-9965.EPI-04-0717 PubMedCrossRefGoogle Scholar
  31. 31.
    Colditz GA, Frazier AL (1995) Models of breast cancer show that risk is set by events of early life: prevention efforts must shift focus. Cancer Epidemiol Biomarkers Prev 4(5):567–571PubMedGoogle Scholar
  32. 32.
    Tseng M, Olufade TO, Evers KA, Byrne C (2011) Adolescent Lifestyle Factors and Adult Breast Density in U.S. Chinese Immigrant Women. Nutr Cancer 63(3):342–349. doi: 10.1080/01635581.2011.535955 PubMedCrossRefGoogle Scholar
  33. 33.
    Caire-Juvera G, Arendell LA, Maskarinec G, Thomson CA, Chen Z (2008) Associations between mammographic density and body composition in Hispanic and non-Hispanic white women by menopause status. Menopause 15(2):319–325. doi: 10.1097/gme.0b013e3181405b8a PubMedCrossRefGoogle Scholar
  34. 34.
    Gapstur SM, Lopez P, Colangelo LA, Wolfman J, Van Horn L, Hendrick RE (2003) Associations of breast cancer risk factors with breast density in Hispanic women. Cancer Epidemiol Biomarkers Prev 12(10):1074–1080PubMedGoogle Scholar
  35. 35.
    Rogers I, Metcalfe C, Gunnell D, Emmett P, Dunger D, Holly J (2006) Insulin-like growth factor-I and growth in height, leg length, and trunk length between ages 5 and 10 years. J Clin Endocrinol Metab 91(7):2514–2519. doi: 10.1210/jc.2006-0388 PubMedCrossRefGoogle Scholar
  36. 36.
    Wadsworth ME, Hardy RJ, Paul AA, Marshall SF, Cole TJ (2002) Leg and trunk length at 43 years in relation to childhood health, diet and family circumstances; evidence from the 1946 national birth cohort. Int J Epidemiol 31(2):383–390PubMedCrossRefGoogle Scholar
  37. 37.
    Lawlor DA, Okasha M, Gunnell D, Smith GD, Ebrahim S (2003) Associations of adult measures of childhood growth with breast cancer: findings from the British Women’s Heart and Health Study. Br J Cancer 89(1):81–87. doi: 10.1038/sj.bjc.66009726600972 PubMedCrossRefGoogle Scholar
  38. 38.
    Gunnell D (2002) Can adult anthropometry be used as a ‘biomarker’ for prenatal and childhood exposures? Int J Epidemiol 31(2):390–394PubMedCrossRefGoogle Scholar
  39. 39.
    Rice MS, Tworoger SS, Rosner BA, Pollak MN, Hankinson SE, Tamimi RM (2012) Insulin-like growth factor-1, insulin-like growth factor-binding protein-3, growth hormone, and mammographic density in the Nurses’ Health Studies. Breast Cancer Res Treat. doi: 10.1007/s10549-012-2303-2 Google Scholar
  40. 40.
    Byrne C, Colditz GA, Willett WC, Speizer FE, Pollak M, Hankinson SE (2000) Plasma insulin-like growth factor (IGF) I, IGF-binding protein 3, and mammographic density. Cancer Res 60(14):3744–3748PubMedGoogle Scholar
  41. 41.
    Aiello EJ, Tworoger SS, Yasui Y, Stanczyk FZ, Potter J, Ulrich CM, Irwin M, McTiernan A (2005) Associations among circulating sex hormones, insulin-like growth factor, lipids, and mammographic density in postmenopausal women. Cancer Epidemiol Biomarkers Prev 14(6):1411–1417. doi: 10.1158/1055-9965 PubMedCrossRefGoogle Scholar
  42. 42.
    Diorio C, Berube S, Byrne C, Masse B, Hebert-Croteau N, Yaffe M, Cote G, Pollak M, Brisson J (2006) Influence of insulin-like growth factors on the strength of the relation of vitamin D and calcium intakes to mammographic breast density. Cancer Res 66(1):588–597. doi: 10.1158/0008-5472.can-05-1959 PubMedCrossRefGoogle Scholar
  43. 43.
    dos Santos Silva I, Johnson N, De Stavola B, Torres-Mejia G, Fletcher O, Allen DS, Allen NE, Key TJ, Fentiman IS, Holly JM, Peto J (2006) The insulin-like growth factor system and mammographic features in premenopausal and postmenopausal women. Cancer Epidemiol Biomarkers Prev 15(3):449–455. doi: 10.1158/1055-9965 CrossRefGoogle Scholar
  44. 44.
    Bremnes Y, Ursin G, Bjurstam N, Rinaldi S, Kaaks R, Gram IT (2007) Insulin-like growth factor and mammographic density in postmenopausal Norwegian women. Cancer Epidemiol Biomarkers Prev 16(1):57–62. doi: 10.1158/1055-9965 PubMedCrossRefGoogle Scholar
  45. 45.
    Maskarinec G, Takata Y, Chen Z, Gram IT, Nagata C, Pagano I, Hayashi K, Arendell L, Skeie G, Rinaldi S, Kaaks R (2007) IGF-I and mammographic density in four geographic locations: a pooled analysis. Int J Cancer 121(8):1786–1792. doi: 10.1002/ijc.22834 PubMedCrossRefGoogle Scholar
  46. 46.
    Dorgan JF, Klifa C, Shepherd JA, Egleston BL, Kwiterovich PO Jr, Himes JH, Gabriel KP, Horn LV, Snetselaar LG, Stevens VJ, Barton BA, Robson AM, Lasser NL, Deshmukh S, Hylton NM (2012) Height, adiposity and body fat distribution and breast density in young women. Breast Cancer Res 14(4):R107. doi: 10.1186/bcr3228 PubMedCrossRefGoogle Scholar
  47. 47.
    Sung J, Song YM, Stone J, Lee K, Kim SY (2010) Association of body size measurements and mammographic density in Korean women: the Healthy Twin study. Cancer Epidemiol Biomarkers Prev 19(6):1523–1531. doi: 10.1158/1055-9965 PubMedCrossRefGoogle Scholar
  48. 48.
    Riza E, Remoundos DD, Bakali E, Karadedou-Zafiriadou E, Linos D, Linos A (2009) Anthropometric characteristics and mammographic parenchymal patterns in post-menopausal women: a population-based study in Northern Greece. Cancer Causes Control 20(2):181–191. doi: 10.1007/s10552-008-9232-8 PubMedCrossRefGoogle Scholar
  49. 49.
    Pettersson A, Hankinson SE, Willett WC, Lagiou P, Trichopoulos D, Tamimi RM (2011) Nondense mammographic area and risk of breast cancer. Breast Cancer Res 13(5):R100. doi: 10.1186/bcr3041 PubMedCrossRefGoogle Scholar
  50. 50.
    Pettersson A, Tamimi RM (2012) Breast fat and breast cancer. Breast Cancer Res Treat 135(1):321–323. doi: 10.1007/s10549-012-2186-2 PubMedCrossRefGoogle Scholar
  51. 51.
    Lokate M, Peeters PH, Peelen LM, Haars G, Veldhuis WB, van Gils CH (2011) Mammographic density and breast cancer risk: the role of the fat surrounding the fibroglandular tissue. Breast Cancer Res 13(5):R103. doi: 10.1186/bcr3044 PubMedCrossRefGoogle Scholar
  52. 52.
    Tseng M, Byrne C (2011) Adiposity, adult weight gain and mammographic breast density in US Chinese women. Int J Cancer 128(2):418–425. doi: 10.1002/ijc.25338 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Megan S. Rice
    • 1
    • 2
  • Kimberly A. Bertrand
    • 1
    • 2
  • Martin Lajous
    • 1
    • 3
  • Rulla M. Tamimi
    • 1
    • 2
  • Gabriela Torres-Mejía
    • 3
  • Carine Biessy
    • 4
  • Ruy López-Ridaura
    • 3
  • Isabelle Romieu
    • 3
    • 4
  1. 1.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  2. 2.Channing Division of Network MedicineBrigham & Women’s HospitalBostonUSA
  3. 3.Instituto Nacional de Salud PúblicaCuernavacaMexico
  4. 4.International Agency for Research on CancerLyonFrance

Personalised recommendations