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Early age at menopause and breast cancer: are leaner women more protected? A prospective analysis of the Dutch DOM cohort

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Abstract

To investigate the relationship between age at menopause, body mass index, and breast cancer risk, we used data from a prospective cohort study (DOM cohort) in the Netherlands. Participants in this breast cancer‐screening project included 10,591 women living in Utrecht, aged 49–66 years at enrolment. During a median follow‐up period of 19 years, women attended screening rounds at which anthropometric measurements were taken and questions were asked about menopausal status, age at menopause, medication use and other risk factors for breast cancer. Cox regression analysis was used to investigate the relationship between age at menopause and subsequent breast cancer risk. Breast cancer incidence decreased with an earlier age at menopause. Women with a menopausal age of 44 years or younger had a 34% lower risk of breast cancer, than women with a menopausal age over 54 years (hazard ratio is 0.66 (95% confidence interval 0.43–0.91)). The annual hazard of breast cancer incidence decreased by 2.6% per year reduction in age at menopause. The protective effect of an early age at menopause was stronger for women with a low body mass index (≤27 kg/m2; reduction of 44%) than for women with a high body mass index (>27 kg/m2; reduction of 24%), although this difference was not statistically significant (P for interaction = 0.58). This difference was most pronounced in women who had ever smoked. Adjustment for known breast cancer risk factors did not alter the crude risk estimates significantly.

In conclusion, this study provides evidence of the protective effect of lower age at menopause on subsequent breast cancer risk. This protective effect may be even stronger in leaner women.

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References

  1. Visser O, Coeberg JWW, Schouten LJ, Dijck van JAAM, (eds): Incidence of cancer in the Netherlands, 1994. Utrecht: Netherlands Cancer Registry 6, 1997

    Google Scholar 

  2. Kvale G: Reproductive factors in breast cancer epidemiology. Acta Oncol 31: 187-194, 1992

    Google Scholar 

  3. Kelsey JL, Gammon MD, John EM: Reproductive factors and breast cancer. Epidemiol Rev 15: 36-47, 1993

    Google Scholar 

  4. Thomas DB: Do hormones cause breast cancer? Cancer 53: 595-604, 1984

    Google Scholar 

  5. Wood JW: Menarche and Menopause. In: Aldine de Gruyter (ed) Dynamics of Human Reproduction: Biology, Biometry, Demography. New York: 1994, pp 401-424

  6. Ota DM, Jones LA, Jackson GL, Jackson PM, Kemp K, Bauman D: Obesity, non-protein-bound estradiol levels, and distribution of estradiol in the sera of breast cancer patients. Cancer 57: 558-562, 1986

    Google Scholar 

  7. Waard de F, Poortman J, Collette HJ: Relationship of weight to the promotion of breast cancer after menopause. Nutr Cancer 2: 37-40, 1981

    Google Scholar 

  8. Lubin F, Ruder AM, Wax Y, Modan B: Overweight and changes in weight throughout adult life in breast cancer etiology. A case-control study. Am J Epidemiol 122: 579-588, 1985

    Google Scholar 

  9. Hunter DJ, Willett WC: Diet, body size, and breast cancer. Epidemiol Rev 15: 110-132, 1993

    Google Scholar 

  10. Ballard Barbash R: Antropometry and breast cancer. Body size — a moving target. Cancer 74: 1090-1100, 1994

    Google Scholar 

  11. Kampert JB, Whittemore AS, Paffenbarger Jr. RS: Combined effect of childbearing, menstrual events, and body size on age-specific breast cancer risk. Am J Epidemiol 128: 962-979, 1988

    Google Scholar 

  12. Hsieh CC, Trichopoulos D, Katsouyanni K, Yuasa S: Age at menarche, age at menopause, height and obesity as risk factors for breast cancer: associations and interactions in an international case-control study [see comments]. Int J Cancer 46: 796-800, 1990

    Google Scholar 

  13. Waard de F, Collette HJA, Rombach JJ, Baanders-Van Halewijn EA, Honing C: The DOM project for the early detection of breast cancer, Utrecht, the Netherlands. J Chron Dis 37: 1-44, 1984

    Google Scholar 

  14. Tonkelaar den I: Fat distribution, menstrual history and breast cancer risk. Utrecht: University Utrecht, 1995

    Google Scholar 

  15. Kvale G, Heuch I: Menstrual factors and breast cancer risk. Cancer 62: 1625-1631, 1988

    Google Scholar 

  16. Hiatt RA, Fireman BH: Smoking, menopause, and breast cancer. J NatI Cancer Inst 76: 833-838, 1986

    Google Scholar 

  17. Pathak DR, Whittemore AS: Combined effects of body size, parity, and menstrual events on breast cancer incidence in seven countries. Am J Epidemiol 135: 153-168, 1992

    Google Scholar 

  18. Rosner B, Colditz GA, Willett WC: Reproductive risk factors in a prospective study of breast cancer: the Nurses Health Study. Am J Epidemiol 139: 819-835, 1994

    Google Scholar 

  19. Tonkelaar den I: Validity and reproducibility of self-reported age at menopause in women participating the DOM project. Maturitas 27: 117-123, 1997

    Google Scholar 

  20. Trichopoulos D, MacMahon B, Cole P: Menopause and breast cancer risk. J Natl Cancer Inst 48: 605-613, 1972

    Google Scholar 

  21. Choi NW, Howe GR, Miller AB, Matthews V, Morgan RW, Munan L, Burch JD, Feather J, Jain M, Kelly A: An epidemiologic study of breast cancer. Am J Epidemiol 107: 510-521, 1978

    Google Scholar 

  22. Hlaing Th, Myin ThM: Risk factors of breast cancer in Burma. Int J Cancer 21: 432-437, 1978

    Google Scholar 

  23. Brinton LA, Williams RR, Hoover RN, Stegens NL, Feinleib M, Fraumeni Jr. JF: Breast cancer risk factors among screening program participants. J Natl Cancer Inst 62: 37-44, 1979

    Google Scholar 

  24. Helmrich SP, Shapiro S, Rosenberg L, Kaufman DW, Slone D, Bain C, Miettinen OS, Stolley PD, Rosenshein NB, Knapp RC, Leavitt JR, Schottenfeld D, Engle Jr. RL, Levy M: Risk factors for breast cancer. Am J Epidemiol 117: 35-45, 1982

    Google Scholar 

  25. Lubin JH, Burns PE, Blot WJ, Lees AW, May C, Morris LE, Fraumeni Jr. JF: Risk factors for breast cancer in women in northern Alberta, Canada, as related to age at diagnosis. J Natl Cancer Inst 68: 211-217, 1982

    Google Scholar 

  26. Ewertz M, Duffy SW: Risk of breast cancer in relation to reproductive factors in Denmark. Brit J Cancer 58: 99-104, 1988

    Google Scholar 

  27. Ewertz M: Risk factors for breast cancer and their prognostic significance. Acta Oncol 27: 733-737, 1988

    Google Scholar 

  28. Negri E, La Vecchia C, Bruzzi P, Dardanoni G, Decarli A, Palli D, Parazzini F, Rosselli del Turco M: Risk factors for breast cancer: pooled results from three Italian case-control studies. Am J Epidemiol 128: 1207-1215, 1988

    Google Scholar 

  29. Negri E, Decarli A, La Vecchia C, Marubini B: Identification of high risk groups for breast cancer by means of logistic models. J Clin Epidemiol 43: 413-418, 1990

    Google Scholar 

  30. Gajalakshmi CK, Shanta V: Risk factors for female breast cancer. A hospital-based case-control study in Madras, India. Acta Oncol 30: 569-574, 1991

    Google Scholar 

  31. MacMahon B, Trichopoulous D, Cole P, Brown J. Cigarette smoking and urinary estrogens. N Engl J Med 307: 1062-1065, 1982

    Google Scholar 

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Authors and Affiliations

  1. Julius Center for Patient Oriented Research, The Netherlands

    Evelyn M. Monninkhof, Yvonne T. van der Schouw & Petra H.M. Peeters

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  1. Evelyn M. Monninkhof
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  2. Yvonne T. van der Schouw
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  3. Petra H.M. Peeters
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Monninkhof, E.M., van der Schouw, Y.T. & Peeters, P.H. Early age at menopause and breast cancer: are leaner women more protected? A prospective analysis of the Dutch DOM cohort. Breast Cancer Res Treat 55, 285–291 (1999). https://doi.org/10.1023/A:1006277207963

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