Breast Cancer Research and Treatment

, Volume 145, Issue 3, pp 567–579 | Cite as

Breast cancer risk accumulation starts early: prevention must also

  • Graham A. Colditz
  • Kari Bohlke
  • Catherine S. Berkey


Nearly one in four breast cancers is diagnosed before the age of 50, and many early-stage premalignant lesions are present but not yet diagnosed. Therefore, we review evidence to support the strategy that breast cancer prevention efforts must begin early in life. This study follows the literature review methods and format. Exposures during childhood and adolescence affect a woman’s long-term risk of breast cancer, but have received far less research attention than exposures that occur later in life. Breast tissue undergoes rapid cellular proliferation between menarche and first full-term pregnancy, and risk accumulates rapidly until the terminal differentiation that accompanies first pregnancy. Evidence on childhood diet and growth in height, and adolescent alcohol intake, among other adolescent factors is related to breast cancer risk and risk of premalignant proliferative benign lesions. Breast cancer prevention efforts will have the greatest effect when initiated at an early age and continued over a lifetime. Gaps in knowledge are identified and deserve increase attention to inform prevention.


Premalignant lesions Prevention Adolescent diet Childhood Adiposity 



GAC and KB are supported by the Foundation for Barnes-Jewish Hospital, St. Louis, Missouri. GAC and CSB are also supported by the Breast Cancer Research Foundation.

Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Graham A. Colditz
    • 1
    • 2
  • Kari Bohlke
    • 1
    • 2
  • Catherine S. Berkey
    • 3
  1. 1.The Division of Public Health Sciences, Department of SurgeryWashington University School of MedicineSt. LouisUSA
  2. 2.The Siteman Cancer Center, Barnes-Jewish HospitalWashington University School of MedicineSt. LouisUSA
  3. 3.Channing Division of Network Medicine, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA

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