The authors declare that they have no competing interests.
RG, TLL, KJR, HJC, RS, and CBE took part in all analyses and drafts of this manuscript. MR and MLB participated in some analyses and contributed substantially to final drafts and resubmission of this work. MLS and RH took part in data collection as part of the original WHI and contributed substantially to final drafts of this work. All authors read and approved the final manuscript.
A family history of later-onset breast cancer (FHLBC) may suggest multi-factorial inheritance of breast cancer risk, including unhealthy lifestyle behaviors that may be shared within families. We assessed whether adherence to lifestyle behaviors recommended for breast cancer prevention--including maintaining a healthful body weight, being physically active and limiting alcohol intake--modifies breast cancer risk attributed to FHLBC in postmenopausal women.
Breast cancer outcomes through August 2003 were analyzed in relationship to lifestyle and risk factors collected by questionnaire during enrollment (between 1993 and 1998) of 85,644 postmenopausal women into the Women's Health Initiative Observational Study.
During a mean follow-up of 5.4 years, 1997 women were diagnosed with invasive breast cancer. The rate of invasive breast cancer among women with an FHLBC who participated in all three behaviors was 5.94 per 1,000 woman-years, compared with 6.97 per 1,000 woman-years among women who participated in none of the behaviors. The rate among women with no FHLBC who participated in all three behavioral conditions was 3.51 per 1,000 woman-years compared to 4.67 per 1,000 woman-years for those who participated in none. We did not observe a clinically important departure from additive effects (Interaction Contrast: 0.00014; 95% CI: -0.00359, 0.00388).
Participating in breast healthy behaviors was beneficial to postmenopausal women and the degree of this benefit was the same for women with and without an FHLBC.
McTiernan A, Kooperberg C, White E, Wilcox S, Coates R, Adams-Campbell LL, Woods N, Ockene J, Women's Health Initiative Cohort Study: Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women's Health Initiative Cohort Study. JAMA. 2003, 290: 1331-1336. 10.1001/jama.290.10.1331. CrossRefPubMed
Feigelson HS, Jonas CR, Robertson AS, McCullough ML, Thun MJ, Calle EE: Alcohol, folate, methionine, and risk of incident breast cancer in the American Cancer Society Cancer Prevention Study II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev. 2003, 12: 161-164. PubMed
Morimoto LM, White E, Chen Z, Chlebowski RT, Hays J, Kuller L, Lopez AM, Manson J, Margolis KL, Muti PC, Stefanick ML, McTiernan A: Obesity, body size, and risk of postmenopausal breast cancer: the Women's Health Initiative (United States). Cancer Causes Control. 2002, 13: 741-751. 10.1023/A:1020239211145. CrossRefPubMed
Chen PL, Sellers TA, Rich SS, Potter JD, Folsom AR: Examination of the effect of nongenetic risk factors on the familial risk of breast cancer among relatives of postmenopausal breast cancer patients. Cancer Epidemiol Biomarkers Prev. 1994, 3: 549-555. PubMed
American Cancer Society: The complete guide - nutrition and physical activity. [ http://www.cancer.org/docroot/PED/content/PED_3_2X_Diet_and_Activity_Factors_That_Affect_Risks.asp?sitearea=PED]
American Cancer Society: What causes breast cancer?. [ http://www.cancer.org/docroot/CRI/content/CRI_2_2_2X_What_causes_breast_cancer_5.asp?sitearea=]
Rothman KJ, Greenland S, Walker AM: Concepts of interaction. Am J Epidemiol. 1980, 112: 467-470. PubMed
Rothman KJ, Greenland S: Modern Epidemiology. 1998, Philadelphia: Lippincott-Raven Publishers, 2
Patterson TL, Rupp JW, Sallis JF, Atkins CJ, Nader PR: Aggregation of dietary calories, fats, and sodium in Mexican-American and Anglo families. Am J Prev Med. 1988, 4: 75-82. PubMed
Oliveria SA, Ellison RC, Moore LL, Gillman MW, Garrahie EJ, Singer MR: Parent-child relationships in nutrient intake: the Framingham Children's Study. Am J Clin Nutr. 1992, 56: 593-598. PubMed
Trask PC, Paterson AG, Wang C, Hayasaka S, Milliron KJ, Blumberg LR, Gonzalez R, Murray S, Merajver SD: Cancer-specific worry interference in women attending a breast and ovarian cancer risk evaluation program: impact on emotional distress and health functioning. Psychooncology. 2001, 10: 349-360. 10.1002/pon.510. CrossRefPubMed
Andersen MR, Smith R, Meischke H, Bowen D, Urban N: Breast cancer worry and mammography use by women with and without a family history in a population-based sample. Cancer Epidemiol Biomarkers Prev. 2003, 12: 314-320. PubMed
Women's Health Initiative Study Investigators. [ http://www.whiscience.org/publications/WHI_investigators_shortlist.pdf]
- Family history of later-onset breast cancer, breast healthy behavior and invasive breast cancer among postmenopausal women: a cohort study
Timothy L Lash
Kenneth J Rothman
Howard J Cabral
Marcia L Stefanick
Monica L Bertoia
Charles B Eaton
- BioMed Central
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