The online version of this article (doi:10.1186/s13058-017-0875-9) contains supplementary material, which is available to authorized users.
Please see Consistency, now what?, an editorial article, commenting on the attempt that this article has made to find a consistent pattern between body size and breast cancer risk, by looking at how the female body changes from childhood and adolescence into adulthood.
Body size in early life is inversely associated with adult breast cancer (BC) risk, but it is unclear whether the associations differ by tumor characteristics.
In a pooled analysis of two Swedish population-based studies consisting of 6731 invasive BC cases and 28,705 age-matched cancer-free controls, we examined the associations between body size in early life and BC risk. Self-reported body sizes at ages 7 and 18 years were collected by a validated nine-level pictogram (aggregated into three categories: small, medium and large). Odds ratios (OR) and corresponding 95% confidence intervals (CI) were estimated from multivariable logistic regression models in case-control analyses, adjusting for study, age at diagnosis, age at menarche, number of children, hormone replacement therapy, and family history of BC. Body size change between ages 7 and 18 were also examined in relation to BC risk. Case-only analyses were performed to test whether the associations differed by tumor characteristics.
Medium or large body size at age 7 and 18 was associated with a statistically significant decreased BC risk compared to small body size (pooled OR (95% CI): comparing large to small, 0.78 (0.70–0.86), Ptrend <0.001 and 0.72 (0.64–0.80), Ptrend <0.001, respectively). The majority of the women (~85%) did not change body size categories between age 7 and 18 . Women who remained medium or large between ages 7 and 18 had significantly decreased BC risk compared to those who remained small. A reduction in body size between ages 7 and 18 was also found to be inversely associated with BC risk (0.90 (0.81–1.00)). No significant association was found between body size at age 7 and tumor characteristics. Body size at age 18 was found to be inversely associated with tumor size (Ptrend = 0.006), but not estrogen receptor status and lymph node involvement. For all analyses, the overall inferences did not change appreciably after further adjustment for adult body mass index.
Our data provide further support for a strong and independent inverse relationship between early life body size and BC risk. The association between body size at age 18 and tumor size could be mediated by mammographic density.
Additional file 1: Table S1. Distributions of somatotype at age 7 and 18 years and body size category change between age 7 and 18. Table S2. Degree of missingness for tumor characteristic information retrieved from the Swedish Cancer Registry. Table S3. Degree of missingness for participant characteristics (n, %). (DOCX 24 kb)
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- Body size in early life and risk of breast cancer
Md. Shajedur Rahman Shawon
- BioMed Central
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