Reproductive and menstrual factors and risk of ductal carcinoma in situ of the breast in a cohort of postmenopausal women

Geoffrey C. Kabat, Mimi Kim, Nancy F. Woods, Laurel A. Habel, Catherine R. Messina, Jean Wactawski-Wende, Marcia L. Stefanick, Rowan Chlebowski, Sylvia Wassertheil-Smoller, Thomas E. Rohan

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Abstract

Purpose The contribution of menstrual and reproductive factors to risk of ductal carcinoma (DCIS) of the breast is poorly understood. Methods The association between menstrual and reproductive factors and subsequent DCIS risk was examined in Women's Health Initiative (WHI) clinical trial participants, in which mammography was protocol mandated. The cohort consisted of 64,060 women, among whom 664 cases of DCIS were ascertained over a median follow-up of 12.0 years. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Results After adjustment for covariates, only older age at menopause (HR ≥ 55 vs. 45-54 : 1.39, 95% CI 1.08-1.79) was significantly associated with risk; however, reater parity (HR ≥ 5 live births vs. 0: 0.70, 95% CI 0.47-1.03), among parous women, and age at first live birth (HR ≥ 30 years relative to <20 years: 1.32, 95% CI 0.92-1.90) were of borderline significance. Age at menarche and months of breast-feeding were not associated with risk. Associations did not differ between high- and low-/moderate- grade DCIS, or by level of body mass index or family history of breast cancer; however, there was a suggestion that the associations of age at menopause, parity, and age at first live birth were limited to women who had ever used hormone therapy. Conclusions Findings from this large cohort of postmenopausal women suggest that age at menopause, and possibly, age at first live birth, and parity are associated with risk of DCIS, whereas age at menarche and duration of breast-feeding are not.

Original languageEnglish (US)
Pages (from-to)1415-1424
Number of pages10
JournalCancer Causes and Control
Volume22
Issue number10
DOIs
StatePublished - Oct 2011

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Carcinoma, Intraductal, Noninfiltrating
Live Birth
Breast
Birth Order
Menopause
Parity
Confidence Intervals
Menarche
Breast Feeding
Carcinoma, Ductal, Breast
Women's Health
Mammography
Proportional Hazards Models
Body Mass Index
Clinical Trials
Hormones
Breast Neoplasms

Keywords

  • Breast cancer
  • Ductal carcinoma in situ (DCIS)
  • Grade
  • Hormone therapy
  • Mammographic screening
  • Menstrual factors
  • Natural history
  • Reproductive factors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Reproductive and menstrual factors and risk of ductal carcinoma in situ of the breast in a cohort of postmenopausal women. / Kabat, Geoffrey C.; Kim, Mimi; Woods, Nancy F.; Habel, Laurel A.; Messina, Catherine R.; Wactawski-Wende, Jean; Stefanick, Marcia L.; Chlebowski, Rowan; Wassertheil-Smoller, Sylvia; Rohan, Thomas E.

In: Cancer Causes and Control, Vol. 22, No. 10, 10.2011, p. 1415-1424.

Research output: Contribution to journalArticle

Kabat, GC, Kim, M, Woods, NF, Habel, LA, Messina, CR, Wactawski-Wende, J, Stefanick, ML, Chlebowski, R, Wassertheil-Smoller, S & Rohan, TE 2011, 'Reproductive and menstrual factors and risk of ductal carcinoma in situ of the breast in a cohort of postmenopausal women', Cancer Causes and Control, vol. 22, no. 10, pp. 1415-1424. https://doi.org/10.1007/s10552-011-9814-8
Kabat, Geoffrey C. ; Kim, Mimi ; Woods, Nancy F. ; Habel, Laurel A. ; Messina, Catherine R. ; Wactawski-Wende, Jean ; Stefanick, Marcia L. ; Chlebowski, Rowan ; Wassertheil-Smoller, Sylvia ; Rohan, Thomas E. / Reproductive and menstrual factors and risk of ductal carcinoma in situ of the breast in a cohort of postmenopausal women. In: Cancer Causes and Control. 2011 ; Vol. 22, No. 10. pp. 1415-1424.
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abstract = "Purpose The contribution of menstrual and reproductive factors to risk of ductal carcinoma (DCIS) of the breast is poorly understood. Methods The association between menstrual and reproductive factors and subsequent DCIS risk was examined in Women's Health Initiative (WHI) clinical trial participants, in which mammography was protocol mandated. The cohort consisted of 64,060 women, among whom 664 cases of DCIS were ascertained over a median follow-up of 12.0 years. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95{\%} confidence intervals (95{\%} CI). Results After adjustment for covariates, only older age at menopause (HR ≥ 55 vs. 45-54 : 1.39, 95{\%} CI 1.08-1.79) was significantly associated with risk; however, reater parity (HR ≥ 5 live births vs. 0: 0.70, 95{\%} CI 0.47-1.03), among parous women, and age at first live birth (HR ≥ 30 years relative to <20 years: 1.32, 95{\%} CI 0.92-1.90) were of borderline significance. Age at menarche and months of breast-feeding were not associated with risk. Associations did not differ between high- and low-/moderate- grade DCIS, or by level of body mass index or family history of breast cancer; however, there was a suggestion that the associations of age at menopause, parity, and age at first live birth were limited to women who had ever used hormone therapy. Conclusions Findings from this large cohort of postmenopausal women suggest that age at menopause, and possibly, age at first live birth, and parity are associated with risk of DCIS, whereas age at menarche and duration of breast-feeding are not.",
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AU - Kabat, Geoffrey C.

AU - Kim, Mimi

AU - Woods, Nancy F.

AU - Habel, Laurel A.

AU - Messina, Catherine R.

AU - Wactawski-Wende, Jean

AU - Stefanick, Marcia L.

AU - Chlebowski, Rowan

AU - Wassertheil-Smoller, Sylvia

AU - Rohan, Thomas E.

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N2 - Purpose The contribution of menstrual and reproductive factors to risk of ductal carcinoma (DCIS) of the breast is poorly understood. Methods The association between menstrual and reproductive factors and subsequent DCIS risk was examined in Women's Health Initiative (WHI) clinical trial participants, in which mammography was protocol mandated. The cohort consisted of 64,060 women, among whom 664 cases of DCIS were ascertained over a median follow-up of 12.0 years. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Results After adjustment for covariates, only older age at menopause (HR ≥ 55 vs. 45-54 : 1.39, 95% CI 1.08-1.79) was significantly associated with risk; however, reater parity (HR ≥ 5 live births vs. 0: 0.70, 95% CI 0.47-1.03), among parous women, and age at first live birth (HR ≥ 30 years relative to <20 years: 1.32, 95% CI 0.92-1.90) were of borderline significance. Age at menarche and months of breast-feeding were not associated with risk. Associations did not differ between high- and low-/moderate- grade DCIS, or by level of body mass index or family history of breast cancer; however, there was a suggestion that the associations of age at menopause, parity, and age at first live birth were limited to women who had ever used hormone therapy. Conclusions Findings from this large cohort of postmenopausal women suggest that age at menopause, and possibly, age at first live birth, and parity are associated with risk of DCIS, whereas age at menarche and duration of breast-feeding are not.

AB - Purpose The contribution of menstrual and reproductive factors to risk of ductal carcinoma (DCIS) of the breast is poorly understood. Methods The association between menstrual and reproductive factors and subsequent DCIS risk was examined in Women's Health Initiative (WHI) clinical trial participants, in which mammography was protocol mandated. The cohort consisted of 64,060 women, among whom 664 cases of DCIS were ascertained over a median follow-up of 12.0 years. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Results After adjustment for covariates, only older age at menopause (HR ≥ 55 vs. 45-54 : 1.39, 95% CI 1.08-1.79) was significantly associated with risk; however, reater parity (HR ≥ 5 live births vs. 0: 0.70, 95% CI 0.47-1.03), among parous women, and age at first live birth (HR ≥ 30 years relative to <20 years: 1.32, 95% CI 0.92-1.90) were of borderline significance. Age at menarche and months of breast-feeding were not associated with risk. Associations did not differ between high- and low-/moderate- grade DCIS, or by level of body mass index or family history of breast cancer; however, there was a suggestion that the associations of age at menopause, parity, and age at first live birth were limited to women who had ever used hormone therapy. Conclusions Findings from this large cohort of postmenopausal women suggest that age at menopause, and possibly, age at first live birth, and parity are associated with risk of DCIS, whereas age at menarche and duration of breast-feeding are not.

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