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Modification of breast cancer risk according to age and menopausal status: a combined analysis of five population-based case–control studies

  • Epidemiology
  • Published:
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Abstract

While several risk factors for breast cancer have been identified, studies have not consistently shown whether these factors operate more strongly at certain ages or for just pre- or postmenopausal women. We evaluated whether risk factors for breast cancer differ according to age or menopausal status. Data from five population-based case–control studies conducted during 1988–2008 were combined and analyzed. Cases (N = 23,959) and population controls (N = 28,304) completed telephone interviews. Logistic regression was used to estimate adjusted odds ratios and 95 % confidence intervals and tests for interaction by age and menopausal status. Odds ratios for first-degree family history of breast cancer were strongest for younger women—reaching twofold elevations—but were still statistically significantly elevated by 58–69 % among older women. Obesity was inversely associated with breast cancer among younger women and positively associated with risk for older women (interaction P < 0.0001). Recent alcohol intake was more strongly related to breast cancer risk among older women, although consumption of 3 or more drinks/day among younger women also was associated with elevated odd ratios (P < 0.0001). Associations with benign breast disease and most reproductive/menstrual factors did not vary by age. Repeating analysis stratifying by menopausal status produced similar results. With few exceptions, menstrual and lifestyle factors are associated with breast cancer risk regardless of age or menopausal status. Variation in the association of family history, obesity, and alcohol use with breast cancer risk by age and menopausal status may need to be considered when determining individual risk for breast cancer.

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Abbreviations

BI-RADS:

Breast imaging-reporting and data system

BMI:

Body mass index

CI:

Confidence interval

ER:

Estrogen receptor

HER2:

Human epidermal growth factor receptor 2

ICD-O:

International Classification of Diseases-Oncology

OR:

Odds ratio

SE:

Standard error

SEER:

Surveillance, Epidemiology and End-Results

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Acknowledgments

The authors thank the many colleagues who have provided valuable advice over the course of the included studies and the current research effort including Drs. Diana Buist, Jeanne Mandelblatt, Henry Anderson, Larry Hanrahan, Stephanie Robert, Meir Stampfer, Walter C. Willett, John A. Baron, E. Robert Greenberg, Hazel Nichols, and Ronald Gangnon. We are grateful to the staff of the state tumor registries and the study offices for assistance with data collection, and to the women who participated in these studies. This work was supported by the following grants from the National Cancer Institute at the National Institutes of Health (grant numbers U01 CA152958, U01 CA086076, P01 CA154292, R01 CA069664, R01 CA047305, U01 CA082004, P50 CA014520, and R01 CA047147).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Population Health Sciences, University of Wisconsin Carbone Cancer Center, University of Wisconsin, 610 Walnut St., Madison, WI, 53726, USA

    Amy Trentham-Dietz & Patrick L. Remington

  2. Department of Surgery and Vermont Cancer Center, University of Vermont, Burlington, VT, 05405, USA

    Brian L. Sprague

  3. Department of Public Health Sciences, University of California, Davis, CA, 95616, USA

    Diana L. Miglioretti

  4. Group Health Research Institute, Seattle, WA, 98101, USA

    Diana L. Miglioretti

  5. Department of Medical Informatics and Clinical Epidemiology and Medicine, Oregon Health & Sciences University, and Providence Cancer Center, Providence Health and Services, Portland, OR, 97239, USA

    Heidi D. Nelson

  6. Geisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA

    Linda J. Titus

  7. Moffitt Cancer Center, Tampa, FL, 33612, USA

    Kathleen M. Egan

  8. Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA

    Polly A. Newcomb

  9. Carbone Cancer Center, University of Wisconsin, Madison, WI, USA

    John M. Hampton & Polly A. Newcomb

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  1. Amy Trentham-Dietz
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  2. Brian L. Sprague
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  4. Diana L. Miglioretti
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  7. Kathleen M. Egan
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  8. Patrick L. Remington
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  9. Polly A. Newcomb
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Correspondence to Amy Trentham-Dietz.

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Trentham-Dietz, A., Sprague, B.L., Hampton, J.M. et al. Modification of breast cancer risk according to age and menopausal status: a combined analysis of five population-based case–control studies. Breast Cancer Res Treat 145, 165–175 (2014). https://doi.org/10.1007/s10549-014-2905-y

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