title: Early life socioeconomic environment and mammographic breast density.
abstract: Early life social environment may influence breast cancer through shaping risk factors operating in early life, adolescence and adulthood, or may be associated with breast cancer risk independent of known risk factors. We investigated the associations between early life socioeconomic status (SES) and mammographic density, a strong risk factor for breast cancer, and the extent to which these associations were independent of risk factors across the lifecourse.
  
  
  
  We used data from an adult follow-up study of two U.S. birth cohorts of women (average age = 43 years) with prospectively collected data starting during the pregnancy of the mother and continuing through early childhood of the offspring. We collected data on factors in later life periods through computer-assisted interviews with the offspring as adults, and obtained routine clinical mammograms for measurement of percent density and dense and nondense breast areas using a computer assisted method. We used generalized estimating equation models for multivariable analysis to account for correlated data for sibling sets within the study sample (n = 700 composed of 441 individuals and 127 sibling sets).
  
  
  
  Highest vs. lowest family income level around the time of birth was associated with smaller dense breast area after adjustment for early life factors (e.g., birthweight, maternal smoking during pregnancy) and risk factors in later life periods, including adult body mass index (BMI) and adult SES (β = -8.2 cm2, 95% confidence interval [CI]: -13.3, -3.2). Highest vs. lowest parental educational attainment was associated with higher percent density in models that adjusted for age at mammogram and adult BMI (e.g., β = 4.8, 95% CI = 0.6, 9.1 for maternal education of college or higher degree vs. less than high school), but the association was attenuated and no longer statistically significant after further adjustment for early life factors. There were no associations between early life SES indicators and non-dense area after adjustment for adult BMI. Neither adult education nor adult income was statistically significantly associated with any measure of mammographic density after adjusting for age and adult BMI.
  
  
  
  We did not observe consistent associations between different measures of early life SES and mammographic density in adulthood.
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA. Pt140@columbia.edu.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA. Pt140@columbia.edu.
authors.forename: Parisa
authors.initials: P
authors.lastname: Tehranifar
authors.affiliation: The Center for Research on Women and Children's Health, The Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cohn
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.
authors.forename: Julie D
authors.initials: JD
authors.lastname: Flom
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.
authors.forename: Angeline
authors.initials: A
authors.lastname: Protacio
authors.affiliation: The Center for Research on Women and Children's Health, The Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA.
authors.forename: Piera
authors.initials: P
authors.lastname: Cirillo
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.|The Imprints Center for Genetic and Environmental Lifecourse Studies, Columbia University Mailman School of Public Health, New York, NY, USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Lumey
authors.affiliation: Department of Epidemiology, University of California (UCLA) Fielding School of Public Health, Los Angeles, CA, USA.|Institute for Prevention and Cancer Epidemiology, Freiburg University Medical Center, Freiburg, Germany.
authors.forename: Karin B
authors.initials: KB
authors.lastname: Michels
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.|The Imprints Center for Genetic and Environmental Lifecourse Studies, Columbia University Mailman School of Public Health, New York, NY, USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Terry
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001940:Breast / Q000473:pathology*; D000071060:Breast Density; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008019:Life Style; D008327:Mammography / Q000379:methods*; D015233:Models, Statistical; D011379:Prognosis; D012307:Risk Factors; D012923:Social Class; D014481:United States / Q000453:epidemiology
keywords: Life-course; Lifestyles; Mammographic breast density; Reproductive factors; Socioeconomic status