title: Perinatal and childhood factors and risk of breast cancer subtypes in adulthood.
abstract: BACKGROUND
  Accumulated exposure to hormones and growth factors during early life may influence the future risk of breast cancer (BC). This study examines the influence of childhood-related, socio-demographic and anthropometric variables on BC risk, overall and by specific pathologic subtypes.
  
  
  METHODS
  This is a case-control study where 1539 histologically-confirmed BC cases (23-85 years) and 1621 population controls, frequency matched by age, were recruited in 10 Spanish provinces. Perinatal and childhood-related characteristics were directly surveyed by trained staff. The association with BC risk, globally and according to menopausal status and pathologic subtypes, was evaluated using logistic and multinomial regression models, adjusting for tumor specific risk factors.
  
  
  RESULTS
  Birth characteristics were not related with BC risk. However, women with high socioeconomic level at birth presented a decreased BC risk (OR=0.45; 95% CI=0.29-0.70), while those whose mothers were aged over 39 years at their birth showed an almost significant excess risk of hormone receptor positive tumors (HR+) (OR=1.35; 95% CI=0.99-1.84). Women who were taller than their girl mates before puberty showed increased postmenopausal BC risk (OR=1.26; 95% CI=1.03-1.54) and increased HR+ BC risk (OR=1.26; 95% CI=1.04-1.52). Regarding prepubertal weight, while those women who were thinner than average showed higher postmenopausal BC risk (OR=1.46; 95% CI=1.20-1.78), associated with HR+ tumors (OR=1.34; 95% CI=1.12-1.61) and with triple negative tumors (OR=1.56; 95% CI=1.03-2.35), those who were heavier than average presented lower premenopausal BC risk (OR=0.64; 95% CI=0.46-0.90) and lower risk of epidermal growth factor receptor positive tumors (OR=0.61; 95% CI=0.40-0.93).
  
  
  CONCLUSIONS
  These data reflect the importance of hormones and growth factors in the early stages of life, when the mammary gland is in development and therefore more vulnerable to proliferative stimuli.
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain. Electronic address: vicarvajal@isciii.es.
authors.forename: Virginia
authors.initials: V
authors.lastname: Lope
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Arzobispo Morcillo 4, 28029 Madrid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: García-Esquinas
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pérez-Gómez
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Public Health Division of Gipuzkoa, Avenida de Navarra 4, 20013 Donostia, San Sebastián, Spain; Biodonostia Research Institute, Doctor Begiristain s/n, 20014 Donostia, San Sebastián, Spain.
authors.forename: Jone M
authors.initials: JM
authors.lastname: Altzibar
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Gracia-Lavedan
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Early Detection Section, Public Health Institute of Navarra, Leyre 15, 31003 Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Irunlarrea 3, 31008 Pamplona, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Ederra
authors.affiliation: Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, 24071 León, Spain.
authors.forename: Antonio José
authors.initials: AJ
authors.lastname: Molina de la Torre
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Universidad de Cantabria-IDIVAL. Avenida Cardenal Herrera Oria s/n, 39011, Santander, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: LLorca
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Instituto Universitario de Oncología, Universidad de Oviedo, Facultad de Medicina, Planta 7, Campus de El Cristo B, 33006 Oviedo, Asturias, Spain.
authors.forename: Adonina
authors.initials: A
authors.lastname: Tardón
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; IDIBELL-Catalan Institute of Oncology, Gran Via km 2.7, 08907L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, Pavelló de Govern, Feixa Llarga s/n 08907, L'Hospitalet del Llobregat, Barcelona, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Moreno
authors.affiliation: Servicio de Oncología Médica, Hospital Juan Ramón Jiménez, Avenida de la Orden s/n, 21005 Huelva, Spain; Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Campus Universitario de El Carmen, 21071 Huelva, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Bayo
authors.affiliation: General Directorate Public Health, and FISABIO, Avenida de Catalunya, 21, 46020 Valencia, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Salas-Trejo
authors.affiliation: Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), Carrer del Sol 15, 17004 Girona, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Marcos-Gragera
authors.affiliation: Grup de Recerca en Epidemiologia Clínica i Molecular del Càncer (GRECMC), Hospital del Mar Medical Research Institute (IMIM), Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Pumarega
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Universidad de Cantabria-IDIVAL. Avenida Cardenal Herrera Oria s/n, 39011, Santander, Spain.
authors.forename: Trinidad
authors.initials: T
authors.lastname: Dierssen-Sotos
authors.affiliation: Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, 24071 León, Spain.
authors.forename: Juan Pablo Barrio
authors.initials: JP
authors.lastname: Lera
authors.affiliation: Navarra Institute for Health Research (IdiSNA), Irunlarrea 3, 31008 Pamplona, Spain; Pathology Department, Navarra Hospital Complex, Irunlarrea 3, 31008 Pamplona, Spain.
authors.forename: M A Concepción
authors.initials: MA
authors.lastname: de Miguel Medina
authors.affiliation: Servei d'Oncologia Mèdica, Hospital del Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain; Cancer Research Program IMIM (Hospital del Mar Medical Research Institute). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Autònoma de Barcelona, Plaza Cívica s/n, 08193 Bellaterra, Barcelona, Spain.
authors.forename: Ignasi
authors.initials: I
authors.lastname: Tusquets
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Public Health Division of Gipuzkoa, Avenida de Navarra 4, 20013 Donostia, San Sebastián, Spain; Biodonostia Research Institute, Doctor Begiristain s/n, 20014 Donostia, San Sebastián, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Boldo
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Aragonés
authors.affiliation: Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Castaño-Vinyals
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222 Madrid, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Pollán
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001827:Body Height; D001835:Body Weight; D001943:Breast Neoplasms / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Breast cancer subtypes; Case-control study; Childhood factors; Childhood height; Childhood weight; Early life factors; Hormone receptor; Maternal age; Perinatal factors; Spain