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Analysis of menstrual, reproductive, and life-style factors for breast cancer risk in Turkish women

A case-control study

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Abstract

The aim of this study was to investigate the association between menstrual, reproductive, and life-style factors and breast cancer in Turkish women. In a hospital-based case-control study in Ankara, 622 patients with histologically confirmed breast cancer were compared with 622 age-matched controls, admitted to the same hospital for acute and non-neoplastic diseases. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) related to risk factors. Overall, menopausal status and age at menopause were found to be significantly associated with breast cancer. Having a full-term pregnancy and early age at first birth were associated with decreased breast cancer risk (OR=0.45, 95% CI=0.30–0.66; OR=0.34, 95% CI=0.22–0.53, respectively). Postmenopausal women with lactation longer than 48 mo had reduced risk of breast cancer (OR=0.36, 95% CI=0.14–0.93). In conclusion, decreased parity, late age at first birth, early menopause, and shorter duration of lactation were the most important determinants of breast cancer risk in Turkish women.

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References

  1. Ferlay J, Bray F, Pisani P, Parkin DM. Cancer incidence, mortality and prevalence worldwide, Version 1.0. IARC CancerBase No.5. IARCPress: Lyon, 2001.

    Google Scholar 

  2. Easton DF, Narod SA, Ford D, Steel M. The genetic epidemiology of BRCA1. Breast Cancer Linkage Consortium. Lancet 1994;344:761.

    Article  PubMed  CAS  Google Scholar 

  3. Kelsey JL, Gammon MD, John EM. Breast cancer epidemiology: summary and future directions. Epidemiol Rev 1993;15:36–47.

    PubMed  CAS  Google Scholar 

  4. Prime Ministry State Institute of Statistics. Statistical Yearbook of Turkey, 2000. Ankara, Prime Ministry State Institute of Statistics, Republic of Turkey, 2000, pp. 94–95.

  5. Fidaner C, Eser SY, Parkin DM. Incidence in Izmir in 1993–1994: first results from Izmir Cancer Registry. Eur J Cancer 2001;37:83–92.

    Article  PubMed  CAS  Google Scholar 

  6. Breslow NE, Day NE. Statistical methods in cancer research. The analysis of case-control studies. Vol. 1. IARC Sci Publ 1980, p. 32.

  7. Lupulescu A. Estrogen use and cancer incidence: a review. Cancer Invest 1995;13:287–295.

    PubMed  CAS  Google Scholar 

  8. MacMahon B, et al. Age at menarche, probability of ovulation and breast cancer risk. Int J Cancer 1982;29:13–16.

    Article  PubMed  CAS  Google Scholar 

  9. Brinton LA, Schairer C, Hoover RN, Fraumeni JF Jr. Menstrual factors and risk of breast cancer. Cancer Invest 1988;6:245–254.

    PubMed  CAS  Google Scholar 

  10. Kvale G, Heuch I. Menstrual factors and breast cancer risk. Cancer 1988;2:1625–1631.

    Article  Google Scholar 

  11. Russo J, Tay LK, Russo IH. Differentiation of the mammary gland and susceptibility to carcinogenesis. Breast Cancer Res Treat 1982;2:5–73.

    Article  PubMed  CAS  Google Scholar 

  12. MacMahon B, Cole P, Brown J. Etiology of human breast cancer: a review. J Natl Cancer Inst 1973;50:21–42.

    PubMed  CAS  Google Scholar 

  13. Trichopoulos D, et al. Age at any birth and breast cancer risk. Int J Cancer 1983;31:701–704.

    Article  PubMed  CAS  Google Scholar 

  14. Janerich DT, Hoff MB. Evidence for a crossover in breast cancer risk factors. Am J Epidemiol 1982;116:737–742.

    PubMed  CAS  Google Scholar 

  15. Pathak DR, Speizer FE, Willett WC, Rosner B, Lipnick RJ. Parity and breast cancer risk: Possible effect on age at diagnosis. Int J Cancer 1986;37:21–25.

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  17. Kvale G, Heuch I, Eide GE. A prospective study of reproductive factors and breast cancer. I. Parity. Am J Epidemiol 1987;126:831–841.

    PubMed  CAS  Google Scholar 

  18. Gao YT, et al. Association of menstrual and reproductive factors with breast cancer risk: results from the Shanghai breast cancer study. Int J Cancer 2000;87:295–300.

    Article  PubMed  CAS  Google Scholar 

  19. Russo J, Russo IH. Susceptibility of the mammary gland to carcinogenesis. II. Pregnancy interruption as a risk factor in tumor incidence. Am J Pathol 1980;100:497–512.

    PubMed  CAS  Google Scholar 

  20. Brinton LA, Hoover R, Fraumeni JF Jr. Reproductive factors in the aetiology of breast cancer. Br J Cancer 1983;47:757–762.

    PubMed  CAS  Google Scholar 

  21. Ewertz M, Duffy SW. Risk of breast cancer in relation to reproductive factors in Denmark. Br J Cancer 1988;58:99–104.

    PubMed  CAS  Google Scholar 

  22. Hadjimichael OC, Boyle CA, Meigs JW. Abortion before first live-birth and risk of breast cancer. Br J Cancer 1986;53:281–284.

    PubMed  CAS  Google Scholar 

  23. Melbye M, et al. Induced abortion and the risk of breast cancer. N Engl J Med 1997;336:81–85.

    Article  PubMed  CAS  Google Scholar 

  24. Lazovich D, Thompson JA, Mink PJ, Sellers TA, Anderson KE. Induced abortion and breast cancer risk. Epidemiology 2000;11:76–80.

    Article  PubMed  CAS  Google Scholar 

  25. Zhang J. Differences between spontaneous and induced abortions as risk factors for breast cancer. Epidemiology 1996;7:316–318.

    PubMed  CAS  Google Scholar 

  26. Lipworth L, Bailey LR, Trichopoulos D. History of breast-feeding in relation to breast cancer risk: a review of the epidemiologic literature. J Natl Cancer Inst 2000;92:302–312.

    Article  PubMed  CAS  Google Scholar 

  27. Freudeheim JL, et al. Lactation history and breast cancer risk. Am J Epidemiol 1997;146:932–938.

    Google Scholar 

  28. Furberg H, Newman B, Moorman P, Millikan R. Lactation and breast cancer risk. Int J Epidemiol 1999;28:396–402.

    Article  PubMed  CAS  Google Scholar 

  29. Newcomb PA, et al. Lactation in relation to postmenopausal breast cancer. Am J Epidemiol 1999;150:174–182.

    PubMed  CAS  Google Scholar 

  30. Michels KB, et al. Prospective assessment of breastfeeding and breast cancer incidence among 89,887 women. Lancet 1996;347:431–436.

    Article  PubMed  CAS  Google Scholar 

  31. London SJ, et al. Lactation and risk of breast cancer in a cohort of US women. Am J Epidemiol 1990;132:17–26.

    PubMed  CAS  Google Scholar 

  32. Tryggvadóttir L, Tulinius H, Eyfjord JE, Sigurvinsson T. Breastfeeding and reduced risk of breast cancer in an Icelandic cohort study. Am J Epidemiol 2001;154:37–42.

    Article  PubMed  Google Scholar 

  33. Yuan JM, Yu MC, Ross RK, Gao YT, Henderson BE. Risk factors for breast cancer in Chinese women in Shanghai. Cancer Res 1988;48:1949–1953.

    PubMed  CAS  Google Scholar 

  34. Tao SC, Yu MC, Ross RK, Xiu KW. Risk factors for breast cancer in Chinese women of Beijing. Int J Cancer 1988;42:495–498.

    Article  PubMed  CAS  Google Scholar 

  35. Wang QS, Ross RK, Yu MC, Ning JP, Henderson BE, Kimm HT. A case-control study of breast cancer in Tianjin, China. Cancer Epidemiol Biomarkers Prev 1992;1:435–439.

    PubMed  CAS  Google Scholar 

  36. Yoo KY, et al. Independent protective effect of lactation against breast cancer: a case-control study in Japan. Am J Epidemiol 1992;135:726–733.

    PubMed  CAS  Google Scholar 

  37. Romieu I, Hernandez-Avila M, Lazcano E, Lopez L, Romero-Jaime R. Breast cancer and lactation history in Mexican women. Am J Epidemiol 1996;143:543–552.

    PubMed  CAS  Google Scholar 

  38. Gilliland FD, et al. Reproductive risk factors for breast cancer in Hispanic and non-Hispanic white women: the New Mexico Women’s Health Study. Am J Epidemiol 1998; 148:683–692.

    Article  PubMed  CAS  Google Scholar 

  39. Zheng T, et al. Lactation reduces breast cancer risk in Shandong Province, China. Am J Epidemiol 2000;152:1129–1135.

    Article  PubMed  CAS  Google Scholar 

  40. Tovar-Guzman V, et al. Breast cancer in Mexican women: an epidemiological study with cervical cancer control. Rev Saude Publica 2000;34:113–119.

    Article  PubMed  CAS  Google Scholar 

  41. Thomas DB, Noonan EA. Breast cancer and prolonged lactation. The WHO Collaborative Study of Neoplasia and Contraceptives. Int J Epidemiol 1993;22:619–626.

    Article  PubMed  CAS  Google Scholar 

  42. Yazici H, et al. BRCA1 and BRCA2 mutations in Turkish breast/ovarian families and young breast cancer patients. Br J Cancer 2000;83:737–742.

    Article  PubMed  CAS  Google Scholar 

  43. Ozdag H, et al. Germ line BRCA1 and BRCA2 gene mutations in Turkish breast cancer patients. Eur J Cancer 2000;36:2076–2082.

    Article  PubMed  CAS  Google Scholar 

  44. Collaborative Group on Hormonal Factors in Breast Cancer. Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiologic studies including 58 209 women with breast cancer and 101 986 women without the disease. Lancet 2001;358:1389–1394.

    Article  Google Scholar 

  45. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiologic studies of 52 705 women with breast cancer and 108 411 women without breast cancer. Lancet 1997;350:1047–1059.

    Article  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  47. Negri E, et al. Risk factors for breast cancer: pooled results from three Italian case-control studies. Am J Epidemiol 1988;128:1207–1215.

    PubMed  CAS  Google Scholar 

  48. London SJ, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Speizer FE. Prospective study of relative weight, height, and risk of breast cancer. JAMA 1989;262:2853–2858.

    Article  PubMed  CAS  Google Scholar 

  49. Ballard-Barbash R, et al. Body fat distribution and breast cancer in the Framingham Study. J Natl Cancer Inst 1990;82:1943–1944.

    Google Scholar 

  50. Tretli S. Height and weight in relation to breast cancer morbidity and mortality: A prospective study of 570,000 women in Norway. Int J Cancer 1989;44:23–30.

    Article  PubMed  CAS  Google Scholar 

  51. 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 1985;122:579–588.

    PubMed  CAS  Google Scholar 

  52. La Vecchia C, et al. Body mass index and post-menopausal breast cancer: an age-spesific analysis. Br J Cancer 1997;75:441–444.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey

    Betul Oran MD, Mustafa Erman & Esmen Baltali

  2. Department of Preventive Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey

    Ismail Celik

  3. Department of Internal Medicine, Numune Hospital, Ankara, Turkey

    Nurullah Zengin

  4. Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Figen Demirkazik

  5. Department of Public Health, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Sabahat Tezcan

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  1. Betul Oran MD
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  2. Ismail Celik
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  3. Mustafa Erman
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  4. Esmen Baltali
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  5. Nurullah Zengin
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Correspondence to Betul Oran MD.

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Oran, B., Celik, I., Erman, M. et al. Analysis of menstrual, reproductive, and life-style factors for breast cancer risk in Turkish women. Med Oncol 21, 31–39 (2004). https://doi.org/10.1385/MO:21:1:31

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  • DOI: https://doi.org/10.1385/MO:21:1:31

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