Breast Cancer

, Volume 5, Issue 4, pp 351–358

Risk Factors for breast cancer among japanese women: A case-control study in Ibaraki, Japan

  • Masaru Ueji
  • Ei Ueno
  • Douglas Osei-Hyiaman
  • Tomoko Saito
  • Hideto Takahashi
  • Katsumi Kano
Original Article



The number of epidemiologic studies on breast cancer risk factors in Japanese women is still quite limited. Our objective was to clarify the relationship between lifestyle, body size and breast cancer risk.


A matched case-control study was conducted in Ibaraki, Japan. The participants were 148 women aged 26-69 diagnosed with breast cancer at Tsukuba University Hospital or Tsukuba Medical Center Hospital between January, 1990 and March, 1997. Two controls were individually matched to the cases by age and residence. A self-administered questionnaire was used to obtain information on the family history of breast cancer, reproductive history, education, body size and lifestyle factors. Conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (95% Cl).


After adjustment for potential confounders, heavy weight and higher body mass index were associated with an increased risk of breast cancer among postmenopausal women (OR=1.76, 95% Cl=0.69, 4.48; OR= 1.57, 95% Cl=0.61, 3.99, respectively). Current or ex-smokers were found to be at an increased risk for breast cancer (OR=3.33; 95% Cl=l.63, 6.80). Women who take hot baths had a decreased risk for breast cancer (OR=0.67; 95% Cl=0.43, 1.06). Recreational physical activity was associated with a reduced risk of breast cancer (PTrend= 0.005). OR for breast cancer among physically active women was 0.36 (95% Cl=0.19, 0.70), as compared with inactive women. Taller women had an increased risk of breast cancer relative to shorter women (OR=1.49; 95% d=0.83, 2.70). No significant association between alcohol consumption and breast cancer risk was detected.


Our results suggest that several potentially modifiable lifestyle factors may be useful for the prevention of breast cancer.

Key words

Breast neoplasms Risk factor Case-control Lifestyle Japanese women 



Body mass index

95% CI

95% confidence interval


Metabolic equivalents


Odds ratio


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  1. 1).
    Helmrich SP, Shapiro S, Rosenberg L,et al: Risk factors for breast cancer.Am J Epidemiol 117: 35–45, 1983.PubMedGoogle Scholar
  2. 2).
    Hulka BS, Stark AT: Breast cancer; Cause and prevention.Lancet 346:883–887, 1995.PubMedCrossRefGoogle Scholar
  3. 3).
    Kelsey JL, Bernstein L: Epidemiology and prevention of breast cancer.Annu Rev Public Health 17:47–67, 1996.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).
    Nagata C, Hu YH, Shimizu H: Effects of menstrual and reproductive factors on the risk of breast cancer; Meta-analysis of the case-control studies in Japan.Jpn J Cancer Res 86:910–915, 1995.PubMedGoogle Scholar
  6. 6).
    Wakai K, Suzuki S, Ohno Y,et al: Epidemiology of breast cancer in Japan.Int J Epidemiol 24:285–291, 1995.PubMedCrossRefGoogle Scholar
  7. 7).
    Hirayama T: Epidemiology of breast cancer with special reference to the role of diet.Prev Med 7:173–195, 1978.PubMedCrossRefGoogle Scholar
  8. 8).
    Hirohata T, Nomura AMY, Hankin JH,et al: An epidemiologic study on the association between diet and breast cancer.JNCI 78:595–600, 1987.PubMedGoogle Scholar
  9. 9).
    Ziegler RG, Hoover RN, Pike MC,et al: Migration patterns and breast cancer risk in Asian-American women.JNCI 85:1819–1827, 1993.PubMedCrossRefGoogle Scholar
  10. 10).
    Hunter DJ, Spiegelman D, Adami HO,et al: Cohort studies of fat intake and the risk of breast cancer; A pooled analysis.N Engl J Med 334:356–361, 1996.PubMedCrossRefGoogle Scholar
  11. 11).
    Noguchi M, Taniya T, Kumaki T,et at Dietary fat and breast cancer; A controversial issue.Breast Cancer 4:67–75, 1997.PubMedCrossRefGoogle Scholar
  12. 12).
    Ainsworth BE, Haskell WL, Leon AS,et al: Compendium of physical activities; Classification of energy costs of human physical activities.Med Sci Sports Exerc 25:71–80, 1993.PubMedCrossRefGoogle Scholar
  13. 13).
    Health Promotion and Nutrition Division, Health Service Bureau, Ministry of Health and Welfare: Recommended Dietary Allowances for the Japanese, fourth revision, Dai-ichi Shuppan, Tokyo, 1986.Google Scholar
  14. 14).
    Health Promotion and Nutrition Division, Health Service Bureau, Ministry of Health and Welfare: Recommended Dietary Allowances for the Japanese, fifth revision, Dai-ichi Shuppan, Tokyo, 1994 (in Japanese).Google Scholar
  15. 15).
    SAS Institute Inc: SAS/STAT User’s Guide, version 6, fourth edition, SAS Institute Inc, Cary, 1990.Google Scholar
  16. 16).
    Kyogoku S, Hirohata T, Takeshita S,et al: Anthropometric indicators of breast cancer risk in Japanese women in Fukuoka.Jpn J Cancer Res 81:731–737, 1990.PubMedGoogle Scholar
  17. 17).
    Hunter DJ, Willett WC: Diet, body size, and breast cancer.Epidemiol Rev 15:110–132, 1993.PubMedGoogle Scholar
  18. 18).
    Ziegler RG, Hoover RN, Nomura AM,et al: Relative weight, weight change, height, and breast cancer risk in Asian-American women.JNCI 88:650–660, 1996.PubMedCrossRefGoogle Scholar
  19. 19).
    Trentham-Dietz A, Newcomb PA, Storer BE,et al: Body size and risk of breast cancer.Am J Epidemiol 145:1011–1019, 1997.PubMedGoogle Scholar
  20. 20).
    Kato I, Miura S, Kasumi F,et al: A case-control study of breast cancer among Japanese women; With special reference to family history and reproductive and dietary factors.Breast Cancer Res Treat 24:51–59, 1992.PubMedCrossRefGoogle Scholar
  21. 21).
    Wakai K, Ohno Y, Watanabe S,et al: Risk factors for breast cancer among Japanese women in Tokyo; A case-control study.J Epidemiol 4:65–71, 1994.Google Scholar
  22. 22).
    Goodman MT, Cologne JB, Moriwaki H,et al: Risk factors for primary breast cancer in Japan; 8-Year follow-up atomic bomb survivors.Prev Med 26:144–153, 1997.PubMedCrossRefGoogle Scholar
  23. 23).
    Hu YH, Nagata C, Shimizu H,et al: Association of body mass index, physical activity, and reproductive histories with breast cancer; A case-control study in Gifu, Japan.Breast Cancer Res Treat 43:65–72, 1997.PubMedCrossRefGoogle Scholar
  24. 24).
    De Waard F, Cornelis JP, Aoki K,et al: Breast cancer incidence according to weight and height in two cities of the Netherlands and in Aichi prefecture, Japan.Cancer 40:1269–1275, 1977.PubMedCrossRefGoogle Scholar
  25. 25).
    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
  26. 26).
    Palmer JR, Rosenberg L: Cigarette smoking and the risk of breast cancer.Epidemiol Rev 15:145–156, 1993.PubMedGoogle Scholar
  27. 27).
    Yoo KY, Tajima K, Kuroishi T,et al: Life-style in relation to the risk of breast cancer.J Epidemiol 2 (Suppl):S155-S165, 1992.Google Scholar
  28. 28).
    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
  29. 29).
    Yoo KY, Tajima K, Miura S,et al: Breast cancer risk factors according to combined estrogen and progesterone receptor status; A case-control analysis.Am J Epidemiol 146:307–314, 1997.PubMedGoogle Scholar
  30. 30).
    Criqui MH, Barett-Connor E, Austin M: Differences between respondents and non-respondents in a population-based cardiovascular disease study.Am J Epidemiol 108:367–372, 1978.PubMedGoogle Scholar
  31. 31).
    Bull SB, Pederson LL, Ashley MJ,et al: Intensity of follow-up; Effects on estimates in a population telephone survey with an extension of Kish’s (1965) approach.Am J Epidemiol 127:552–561, 1988.PubMedGoogle Scholar
  32. 32).
    Benfante B, Reed D, MacLean C,et al: Response bias in the Honolulu Heart Program.Am J Epidemiol 130: 1088–1100, 1989.PubMedGoogle Scholar
  33. 33).
    Criqui MH, Austin M, Barett-Connor E: The effect of non-response on risk ratios in a cardiovascular disease study.J Chronic Dis 32:633–638, 1979.PubMedCrossRefGoogle Scholar
  34. 34).
    Criqui MH: Response bias and risk ratios in epidemiologic studies.Am J Epidemiol 109:394–399, 1979.PubMedGoogle Scholar
  35. 35).
    Austin M, Criqui MH, Barett-Connor E,et al: The effect of response bias on the odds ratio.Am J Epidemiol 114:137–143, 1981.PubMedGoogle Scholar
  36. 36).
    Rosenberg L, Metzger LS, Palmer JR: Alcohol consumption and risk of breast cancer; A review of the epidemiologic evidence.Epidemiol Rev 15:133–144, 1993.PubMedGoogle Scholar
  37. 37).
    Longnecker MP: Alcoholic beverage consumption in relation to risk of breast cancer; Meta-analysis and review.Cancer Causes Control 5:73–82, 1994.PubMedCrossRefGoogle Scholar
  38. 38).
    Smith-Warner SA, Spiegelman D, Yaun S-S,et al: Alcohol and breast cancer in women; A pooled analysis of cohort studies.JAMA 279:535–540, 1998.PubMedCrossRefGoogle Scholar
  39. 39).
    Tajima K, Hirose K, Ogawa H,et al: Hospital epidemiology; A comparative case control study of breast and cervical cancer.Gan No Rinsho 36:351–364, 1990 (in Japanese with English abstract).Google Scholar
  40. 40).
    Hirayama T: A large scale cohort study on the effect of life styles on the risk of cancer by each site.Gan No Rinsho Spec No:233-242, 1990(in Japanese with English abstract).Google Scholar
  41. 41).
    Kikuchi S, Okamoto N, Suzuki T,et al: A case control study of breast cancer, mammary cyst and dietary, drinking or smoking habit in Japan.Gan No Rinsho Spec No:365-369, 1990 (in Japanese with English abstract).Google Scholar
  42. 42).
    Kato I, Tominaga S, Terao C: Alcohol consumption and cancers of hormone-related organs in females.Jpn J Clin Oncol 19: 202–207, 1989.PubMedGoogle Scholar
  43. 43).
    Crile G Jr: Selective destruction of cancers after exposure to heat.Ann Surg 156:404–407,1962.PubMedCrossRefGoogle Scholar
  44. 44).
    Hynynen K, Lulu BA: Hyperthermia in cancer treatment.Invest Radiol 25:824–834, 1990.PubMedCrossRefGoogle Scholar
  45. 45).
    Hamazoe R, Maeta M, Kaibara N: Intraperitoneal thermochemotherapy for prevention of peritoneal recurrence of gastric cancer.Cancer 73:2048–2052, 1994.PubMedCrossRefGoogle Scholar
  46. 46).
    Frisch RE, Wyshak G, Albright NL,et al: Lower prevalence of breast cancer and cancers of the reproductive system among former college athletes compared to non-athletes.Br J Cancer 52:885–891, 1985.PubMedGoogle Scholar
  47. 47).
    Bernstein L, Henderson BE, Hanisch R,et al: Physical exercise and reduced risk of breast cancer in young women.JNCI 86:1403–1408, 1994.PubMedCrossRefGoogle Scholar
  48. 48).
    Thune I, Brenn T, Lund E,et al: Physical activity and the risk of breast cancer.N Engl J Med 336:1269–1275, 1997.PubMedCrossRefGoogle Scholar
  49. 49).
    Dorgan JF, Brown C, Barrett M,et al: Physical activity and risk of breast cancer in the Framingham Heart Study.Am J Epidemiol 139:662–669, 1994.PubMedGoogle Scholar
  50. 50).
    Chen CL, White E, Malone KE,et al: Leisure-time physical activity in relation to breast cancer among young women (Washington, United States).Cancer Causes Control 8:77–84, 1997.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 1998

Authors and Affiliations

  • Masaru Ueji
    • 1
  • Ei Ueno
    • 2
  • Douglas Osei-Hyiaman
    • 1
  • Tomoko Saito
    • 1
  • Hideto Takahashi
    • 2
  • Katsumi Kano
    • 2
  1. 1.Graduate School of MedicineUniversity or TsukubaTsukubaJapan
  2. 2.Institutes of Clinical MedicineUniversity of TsukubaJapan

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