title: Risk of premenopausal breast cancer and patterns of established breast cancer risk factors among teachers and nurses.
abstract: BACKGROUND
  Contrasting results have been published regarding the risk of breast cancer among teachers and nurses. Confounding by reproductive factors may explain the increased risk observed among women in these occupations as information on those factors were not available in most studies.
  
  
  METHODS
  We examined the risk of premenopausal breast cancer among teachers and nurses using occupational histories in a case-control study where information on established risk factors was available.
  
  
  RESULTS
  Having ever held a teaching job was not related to breast cancer (OR = 0.74, 95% CI = 0.44-1.28) and women who worked for 10 years or less in this occupation had a non-significant deficit of risk (OR = 0.52, 95% CI = 0.27-1.02). No elevation in risk was found in association with having ever been a nurse (OR = 0.85, 95% CI = 0.45-1.61) or with duration of nursing. Although direct comparison of established risk factors among teachers and nurses and other women in the study showed some evidence of differential distribution, especially when comparing teachers to other women, adjustment for reproductive variables and other breast cancer risk factors did not change the results of this study.
  
  
  CONCLUSIONS
  These findings suggest that teachers and nurses are not at an increased risk of breast cancer. This study also suggests that established risk factors for premenopausal breast cancer may not explain the elevation of risk found in other studies of teachers and nurses. However, this conclusion is limited by the fact that in the present study teachers and nurses had lower than expected breast cancer risk with or without adjustment for established risk factors. Limitations of this study such as low response rates and limited statistical power should be considered in the interpretation of these findings.
authors.affiliation: Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, USA. spi126@nih.gov
authors.forename: S A
authors.initials: SA
authors.lastname: Petralia
authors.forename: J E
authors.initials: JE
authors.lastname: Vena
authors.forename: J L
authors.initials: JL
authors.lastname: Freudenheim
authors.forename: A
authors.initials: A
authors.lastname: Michalek
authors.forename: M S
authors.initials: MS
authors.lastname: Goldberg
authors.forename: A
authors.initials: A
authors.lastname: Blair
authors.forename: J
authors.initials: J
authors.lastname: Brasure
authors.forename: S
authors.initials: S
authors.lastname: Graham
mesh_terms: D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000209:etiology* / Q000235:genetics; D016022:Case-Control Studies; D016001:Confidence Intervals; D015986:Confounding Factors, Epidemiologic; D004522:Educational Status; D005260:Female; D006801:Humans; D007774:Lactation; D008423:Maternal Age; D008572:Menarche; D008875:Middle Aged; D009726:Nurses; D009784:Occupational Diseases / Q000209:etiology*; D016017:Odds Ratio; D010298:Parity; D017697:Premenopause; D017584:Reproductive History; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013663:Teaching; D013997:Time Factors