title: Age-Specific Indicators of a Healthy Lifestyle and Postmenopausal Breast Cancer.
abstract: Modifiable lifestyle factors have been consistently associated with breast cancer, and risk may vary by menopausal status. However, whether these associations vary according to age among postmenopausal women remains unresolved.
  
  
  
  Using postmenopausal women from a population-based case-control study (990 cases and 1006 frequency-matched controls), we conducted multivariable-adjusted unconditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for lifestyle factors (lifetime alcohol intake, body mass index [BMI] in the year before diagnosis, lifetime recreational physical activity [RPA], and nonsteroidal anti-inflammatory drug use) in association with breast cancer stratified by age (<65 vs. 65+). We examined estrogen-related subgroups by (1) further stratifying by hormone replacement therapy (HRT) use and (2) restricting cases to estrogen receptor (ER)+/progesterone receptor (PR)+ cancers.
  
  
  
  Postmenopausal breast cancer incidence in women 65 years and older was positively associated with alcohol intake (OR = 1.79 for 15-30 g/day vs. nondrinkers, 95% CI: 1.03-3.12) and BMI (OR = 1.83 for BMI ≥30 vs. <25, 95% CI: 1.29-2.60), and inversely with RPA (OR = 0.69 for fourth quartile vs. inactive, 95% CI: 0.47-1.03). For postmenopausal women younger than 65, ORs were closer to the null. Tests for heterogeneity by age were significant at the p < 0.10 level for BMI and RPA, but not alcohol. Among older women, associations were stronger among never users of HRT and for those with ER+/PR+ cancers. The inverse associations with aspirin use did not differ by age.
  
  
  
  Interventions targeting modifiable lifestyle factors may reduce the burden of postmenopausal breast cancer among older women.
authors.affiliation: 1 Department of Epidemiology, University of North Carolina , Chapel Hill, North Carolina.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: McClain
authors.affiliation: 2 Department of Epidemiology, Emory University , Atlanta, Georgia .
authors.forename: Lauren E
authors.initials: LE
authors.lastname: McCullough
authors.affiliation: 3 Division of Epidemiology and Biostatistics, School of Public Health, University of California , Berkeley, California.
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Bradshaw
authors.affiliation: 4 GlaxoSmithKline , Singapore, Singapore .
authors.forename: Sumitra
authors.initials: S
authors.lastname: Shantakumar
authors.affiliation: 5 Department of Epidemiology, Columbia University , New York, New York.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Terry
authors.affiliation: 5 Department of Epidemiology, Columbia University , New York, New York.|6 Department of Medicine, Columbia University , New York, New York.
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.affiliation: 1 Department of Epidemiology, University of North Carolina , Chapel Hill, North Carolina.
authors.forename: Marilie D
authors.initials: MD
authors.lastname: Gammon
mesh_terms: D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D016022:Case-Control Studies; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D000070497:Healthy Lifestyle; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009043:Motor Activity; D009518:New York / Q000453:epidemiology; D017698:Postmenopause; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: alcohol; aspirin; breast cancer; obesity; physical activity; risk factors