Premenopausal bilateral breast cancer is characterized by a strong family risk, and, consequently, a high probability that inherited susceptibility genes may be segregating in these families. Determining whether risk factors that affect other breast cancer cases have a similar effect in the etiology of bilateral breast cancer is of interest. Therefore, as part of an ongoing genetic-epidemiologic study of premenopausal bilateral breast cancer, we conducted a case-control analysis of reproductive variables, benign breast disease, alcohol, and smoking. Cases had premenopausal bilateral breast cancer, and their unaffected sisters served as controls. A set of reproductive variables — including earlier age at menarche, nulliparity, and late age at first full term pregnancy — appeared to increase the risk of breast cancer; the corresponding confidence limits, however, were wide and straddled the null. In addition, other variables associated with increased premenopausal bilateral breast cancer risk were: use of oral contraceptives, history of benign breast disease, and high alcohol consumption. We found no positive association for smoking. Nulliparity and late age at first full-term pregnancy appeared to have different effects in women with family histories of breast cancer than in women without such a history. We detected no substantial effect modification for the other risk factors. In general, risk factors previously identified for breast cancer (usually postmenopausal, unilateral cases) appear also to increase the risk for premenopausal, bilateral breast cancer.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Kelsey JL, Gammon MD: The epidemiology of breast cancer. CA—A Cancer Journal for Clinicians 41: 146–149, 1991
Ursin G, Aragaki CC, Paganini-Hill A, Siemiatycki J, Thompson WD, Haile RW: Oral contraceptives and premenopausal breast cancer: a case-control study. Epidemiology 3: 414–419, 1992
Longnecker MP, Berlin JA, Orza MJ, Chalmers TC: A metaanalysis of alcohol consumption in relation to risk of breast cancer. JAMA 260: 652–656, 1988
Baron JA: Smoking and estrogen-related diseases. Am J Epidemiol 119: 9–22, 1984
Khoury MJ, Beaty TH, Liang K-Y: Can familial aggregation of disease be explained by familial aggregation of environmental risk factors? Am J Epidemiol 127: 674–683, 1988
Goldstein AM, Haile RW, Marazita ML, Paganini-Hill A: A genetic epidemiologic investigation of breast cancer in families with bilateral breast cancer. I. Segregation analysis. JNCI 78: 911–918, 1987
EGRET Reference Manual. Seattle: Statistics and Epidemiology Research Corporation, 1990
Hall JM, Friedman L, Guenther C, Lee MK, Weber JL, Black DM, King M-C: Closing in on a breast cancer gene on chromosome 17q. Am J Hum Genet 50: 1235–1242, 1992
Haile RW, Cortessis VK, Millikan R, Ingles S, Aragaki CC, Richardson L, Thompson WD, Paganini-Hill A, Sparkes RS: A linkage analysis of D17S74 (CMM86) in 35 families with premenopausal bilateral breast cancer. Cancer Res 53: 212–214, 1993
Olsson H, Borg A, Fernö M, Ranstam J, Sigurdsson H: Her-2/neu and INT2 proto-oncogene amplification in malignant breast tumors in relation to reproductive factors and exposure to exogenous hormones. JNCI 83: 1483–1487, 1991
Rohan TE, McMichael J: Alcohol consumption and risk of breast cancer. Int J Cancer 41: 695–699, 1988
Schatzkin A, Jones Y, Hoover RN, Taylor PR, Brinton LA, Ziegler RG, Harvey EB, Carter CL, Licitra LM, Dufour MC, Larson DB: Alcohol consumption and breast cancer in the epidemiologic follow-up study of the first national health and nutrition examination survey. N Engl J Med 316: 1169–1173, 1987
Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Hennekens CH, Speizer FE: Moderate alcohol consumption and risk of breast cancer. N Engl J Med 316: 1174–1180, 1987
Willett WC, Stampfer MJ, Colditz GA: Does alcohol consumption influence the risk of developing breast cancer? Two views. In: De Vita VT, Hellman S, Rosenberg SA (eds) Important Advances in Oncology. J.B. Lippincott, Philadelphia, 1989, pp 267–281
Van't Veer P, Kok FJ, Hermus RJJ, Sturmans F: Alcohol dose, frequency and age at first exposure in relation to the risk of breast cancer. Int J Epidemiol 18: 511–517, 1989
Harvey EB, Schairer C, Brinton L, Hoover RN, Fraumeni JF: Alcohol consumption and breast cancer. JNCI 78: 657–661, 1987
Petrakis NL, Maack CA, Lee RE: Mutagenic activity in nipple aspirates of human breast fluid. Cancer Res 40: 188–189, 1980
MacMahon B, Trichopoulos D, Cole P, Brown J: Cigarette smoking and urinary estrogens. N Engl J Med 307: 1062–1065, 1982
Michnovicz JJ, Hershcopf RJ, Naganuma H, Bradlow HL, Fishman J: Increased 2-hydroxylation of estradiol as a possible mechanism for the anti-estrogenic effect of cigarette smoking. N Engl J Med 315: 1305–1309, 1986
Adami H-O, Lund E, Bergstrom R, Meirik O: Cigarette smoking, alcohol consumption and risk of breast cancer in young women. Br J Cancer 58: 832–837, 1988
Rosenberg L, Schwingl PJ, Kaufman DW, Miller DR, Helmrich SP, Stolley PD, Schottenfeld D, Shapiro S: Breast cancer and cigarette smoking. N Engl J Med 310: 92–94, 1984
Baron JA, Byers T, Greenberg ER, Cummings KM, Swanson M: Cigarette smoking in women with cancers of the breast and reproductive organs. JNCI 77: 677–680, 1986
Rohan TE, Baron JA: Cigarette smoking and breast cancer. Am J Epidemiol 129: 36–42, 1989
Schechter MT, Miller AB, Howe GR: Cigarette smoking and breast cancer: a case-control study of screening program participants. Am J Epidemiol 121: 479–487, 1985
Stockwell HG, Lyman GH: Cigarette smoking and the risk of female reproductive cancer. Am J Obstet Gynecol 157: 35–40, 1987
Hiatt RA, Fireman BH: Smoking, menopause, and breast cancer. JNCI 76: 833–838, 1986
About this article
Cite this article
Haile, R.W., Witte, J.S., Ursin, G. et al. A case-control study of reproductive variables, alcohol, and smoking in premenopausal bilateral breast cancer. Breast Cancer Res Tr 37, 49–56 (1996). https://doi.org/10.1007/BF01806631
- reproductive factors
- premenopausal bilateral breast neoplasms
- case-control study