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Published in: Breast Cancer Research 1/2014

Open Access 01-02-2014 | Research article

Timing of pubertal stages and breast cancer risk: the Breakthrough Generations Study

Authors: Danielle H Bodicoat, Minouk J Schoemaker, Michael E Jones, Emily McFadden, James Griffin, Alan Ashworth, Anthony J Swerdlow

Published in: Breast Cancer Research | Issue 1/2014

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Abstract

Introduction

Breast development and hormonal changes at puberty might affect breast cancer risk, but epidemiological analyses have focussed largely on age at menarche and not at other pubertal stages.

Methods

We investigated associations between the timing of pubertal stages and breast cancer risk using data from a cohort study of 104,931 women (Breakthrough Generations Study, UK, 2003–2013). Pubertal variables were reported retrospectively at baseline. Breast cancer risk was analysed using Cox regression models with breast cancer diagnosis as the outcome of interest, attained age as the underlying time variable, and adjustment for potentially confounding variables.

Results

During follow-up (mean = 4.1 years), 1094 breast cancers (including ductal carcinoma in situ) occurred. An increased breast cancer risk was associated with earlier thelarche (age when breast growth begins; HR [95% CI] = 1.23 [1.02, 1.48], 1 [referent] and 0.80 [0.69, 0.93] for ≤10, 11–12 and ≥13 years respectively), menarche (initiation of menses; 1.06 [0.93, 1.21], 1 [referent] and 0.78 [0.62, 0.99] for ≤12, 13–14 and ≥15 years), regular periods (0.99 [0.83, 1.18], 1 [referent] and 0.74 [0.59, 0.92] for ≤12, 13–14 and ≥15 years) and age reached adult height (1.25 [1.03, 1.52], 1 [referent] and 1.07 [0.87, 1.32] for ≤14, 15–16 and ≥17 years), and with increased time between thelarche and menarche (0.87 [0.65, 1.15], 1 [referent], 1.14 [0.96, 1.34] and 1.27 [1.04, 1.55] for <0, 0, 1 and ≥2 years), and shorter time between menarche and regular periods (1 [referent], 0.87 [0.73, 1.04] and 0.66 [0.50, 0.88] for 0, 1 and ≥2 years). These associations were generally similar when considered separately for premenopausal and postmenopausal breast cancer.

Conclusions

Breast duct development may be a time of heightened susceptibility to risk of carcinogenesis, and greater attention needs to be given to the relation of breast cancer risk to the different stages of puberty.
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Metadata
Title
Timing of pubertal stages and breast cancer risk: the Breakthrough Generations Study
Authors
Danielle H Bodicoat
Minouk J Schoemaker
Michael E Jones
Emily McFadden
James Griffin
Alan Ashworth
Anthony J Swerdlow
Publication date
01-02-2014
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 1/2014
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/bcr3613

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