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Birth size and survival in breast cancer patients from the Uppsala Birth Cohort Study

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Abstract

Purpose

Previous studies suggest that larger birth size is associated with a higher breast cancer incidence, but studies on birth measures and mortality in breast cancer cases are scarce. This study investigates survival of women after breast cancer diagnosis (n = 437) in the Uppsala Birth Cohort born in 1915–1929.

Methods

Cox regression was used to analyze mortality from any cause after a breast cancer diagnosis. Birth measures including gestational age (GA), birth weight (BW), BW for GA, birth length, and ponderal index (PI) were converted to standard deviation (SD) scores, and all analyses were adjusted for age and calendar time at diagnosis. Analyses were performed with and without adjustment for other birth measures, reproductive history, and adult socioeconomic position.

Results

In fully adjusted analyses, one SD increase in GA was associated with 17 % [95 % confidence interval (CI) 6–26 %] lower mortality and one SD increase in BW was associated with 29 % (7–56 %) higher mortality. PI showed a weaker trend in the same direction: hazard ratio = 1.16 (95 % CI 1.03–1.30).

Conclusions

Our results bring in new evidence that both high GA and low BW predict a better survival in breast cancer cases. Further studies need to investigate mediation of these associations.

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Abbreviations

BL:

Birth length

BW:

Birth weight

CI:

Confidence interval

GA:

Gestational age

HR:

Hazard ratio

IQR:

Interquartile range

PI:

Ponderal index

SEP:

Socioeconomic position

UBCoS:

Uppsala Birth Cohort Study

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Acknowledgments

We would like to thank Dan Altmann for his advice on an earlier data analysis, and Valerie McCormack and Bianca De Stavola for statistical advice. We would also like to thank Anna Goodman for her help with data management. The Uppsala Birth Cohort Multigenerational Study is supported by grants from the Swedish Research Council (2006-7498 PI Ilona Koupil) and from the Swedish Council for Working Life and Social Research (2007-1010 PI Ilona Koupil). IK is funded by the Swedish Council for Working Life and Social Research.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK

    Ulla Sovio, Rebecca Jones & Isabel dos Santos Silva

  2. Centre for Health Equity Studies, Stockholm University/Karolinska Institute, 10691, Stockholm, Sweden

    Ulla Sovio & Ilona Koupil

Authors
  1. Ulla Sovio
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  2. Rebecca Jones
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  3. Isabel dos Santos Silva
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  4. Ilona Koupil
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Corresponding author

Correspondence to Ulla Sovio.

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Sovio, U., Jones, R., dos Santos Silva, I. et al. Birth size and survival in breast cancer patients from the Uppsala Birth Cohort Study. Cancer Causes Control 24, 1643–1651 (2013). https://doi.org/10.1007/s10552-013-0238-5

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  • DOI: https://doi.org/10.1007/s10552-013-0238-5

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