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Risk Factors for the Incidence of Breast Cancer: Do They Affect Survival From the Disease?

Gillian C. Barnett, Mitul Shah, Karen Redman, Douglas F. Easton, Bruce A.J. Ponder, Paul D. P. Pharoah

From the Oncology Centre, Addenbrooke's Hospital; Departments of Oncology and Public Health and Primary Care, University of Cambridge; and Strangeways Research Laboratories, Cambridge, United Kingdom

Corresponding author: Gillian C. Barnett, MD, Oncology Centre, Box 193, Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 2QQ, United Kingdom; e-mail: gillbarnett{at}doctors.org.uk

Purpose Risk factors that influence the incidence of breast cancer may also affect survival after diagnosis.

Methods Data from 4,560 women with invasive breast cancer who had taken part in the population-based Studies of Epidemiology and Risk Factors in Cancer Heredity (SEARCH) breast cancer study were used to investigate the influence on survival of variables related to pregnancy, menarche and menopause, prior use of exogenous hormones, height, weight, body mass index (BMI), smoking history, and alcohol intake.

Results In univariate analyses, there was no association between prognosis and age at menarche and menopause, menopausal status at diagnosis, smoking history, or prior use of the oral contraceptive pill. Women whose most recent pregnancy was more than 30 years ago had a 35% reduced risk of dying (95% CI, 8% to 54%) compared with women who had a full-term pregnancy in the past 15 years, and the use of hormone replacement therapy for more than 4 years was associated with a similar risk reduction. BMI was associated with a 3% (95% CI, 1% to 4%) increase in mortality per unit increase. Improved prognosis was seen with increasing current alcohol consumption, with a 2% (95% CI, 1% to 3%) reduction in the risk of death per unit of alcohol consumed per week.

Conclusion The apparent benefit of alcohol intake has not been described before, and our data need to be interpreted with some caution. However, our finding that an increase in BMI is associated with a poorer prognosis supports previously published data and suggests that advice on weight loss should be given to all obese patients with breast cancer.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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• Host-Related Factors in Breast Cancer: An Underappreciated Piece of the Puzzle?
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  JCO 2008 26: 3299-3300 [Full Text]

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• Alcohol Consumption and Breast Cancer Survival
  Elisa V. Bandera and David A. August
  JCO 2009 27: 1727 [Full Text]

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