Abstract
In order to thoroughly analyze risk factors of breast cancer (BC) in premenopausal Uruguayan women, a case-control study was carried out at the Pereira Rossell Women's Hospital, Montevideo, where 253 incident BC cases and 497 frequency-matched healthy controls were interviewed on menstrual and reproductive story, were administered a short food frequency questionnaire and undertook a series of body measurements necessary to calculate body composition and somatotype. Odds ratio (OR) coefficients were taken as estimates of relative risk derived from unconditional logistic regression. Among the classical risk factors, only the family history of BC in first degree relatives was significantly associated with risk of premenopausal BC (OR=2.20, 95% CI 1.33-3.62). Interestingly, this risk factor was found to be stronger in women of ages >40 (OR=4.05, 95% CI 2.10-7.81), late menarche (OR= 2.39, 95% CI 1.18-4.85), early age for their first delivery (OR=3.02, 95% CI 1.26-7.22), short time between menarche and first delivery (OR=3.22, 95% CI 1.29-8.07), and with high parity (OR=4.10, 95% CI 1.79-9.36), although heterogeneity was detected only for age and parity. High consumption of red meat was positively associated with the disease risk (OR=2.20, 95% CI 1.35-3.60), in the same way as fried foods (OR=1.79, 95% CI 1.12-2.84). Conversely, a high intake of plant foods displayed a protective effect (OR=0.41, 95% CI 0.26-0.65). Except for hypertension (OR=1.55, 95% CI 1.03-2.35), none of the analyzed components of metabolic syndrome were associated to BC risk. Particular increases of risk for premenopausal BC were found for family history in first degree relatives in certain subsets derived from the menstrual-reproductive history. Preventive strategies could broaden their scope if new studies confirm the present results, in view of the limited prevention measures that premenopausal BC currently has.
Highlights
Established risk factors for breast cancer (BC) in women include certain reproductive factors, as earlier menarche, later age at first pregnancy, less breastfeeding, lower parity, and longer interval between births
Among the classical risk factors, only the family history of BC in first degree relatives was significantly associated with risk of premenopausal BC (OR=2.20, 95% Confidence Intervals (CI) 1.33-3.62)
Except for hypertension (OR=1.55, 95% CI 1.03-2.35), none of the analyzed components of metabolic syndrome were associated to BC risk
Summary
Established risk factors for breast cancer (BC) in women include certain reproductive factors, as earlier menarche, later age at first pregnancy, less breastfeeding, lower parity, and longer interval between births. A recent study strongly suggested that lower overall adiposity and higher central adiposity are independent risk factors for premenopausal BC in the general population (Dettenborn, 2008) Their results support the possibility that differences in patterns of adiposity may contribute to familial risk of premenopausal BC, and suggest the importance of conducting other population-based studies of the link between body size characteristics and familial BC risk. Concerning anthropometry, we have recently reported possible roles of somatotype and risk of BC, which were related to a positive association for high endomorphism among premenopausal women but not in postmenopausal ones (Ronco et al, 2008). Taking into account the feasibility for such epidemiologic research in Uruguay and in the quoted population subset, we decided to perform the present study in order to explore the role of different variables in the etiology of premenopausal BC in the Uruguayan population
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