Skip to main content
Log in

Breast cancers among very young premenopausal women (United States)

  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective: To assess risk factors for breast cancer among very young compared to older premenopausal women. Methods: Between 1990 and 1992 a population-based case–control study conducted in Atlanta, GA, Seattle/Puget Sound, WA, and central NJ interviewed 3307 premenopausal women aged 20–54 years. Logistic regression models estimated adjusted relative risks (RR) and 95% confidence intervals (CI) for each of three 10-year age groups. Results: Among the youngest age group (<35 years, n = 545), significant predictors of risk included African-American race (RR = 2.66; 95% CI 1.4–4.9) and recent use of oral contraceptives (RR = 2.26; 95% CI 1.4–3.6). Although these relationships were strongest for estrogen receptor-negative (ER−) tumors (RRs of 3.30 for race and 3.56 for recent oral contraceptive use), these associations were also apparent for young women with ER+ tumors. Delayed childbearing was a risk factor for ER+ tumors among the older premenopausal women (p trend < 0.01), but not for women <35 years in whom early childbearing was associated with an increased risk, reflecting a short-term increase in risk immediately following a birth. Family history of early-onset breast cancer was more strongly associated with risk among women <35 years (RR = 3.22) than those 45–54 years (RR = 1.51). Risk factors for premenopausal breast cancer not significantly modified by age at diagnosis included early age at menarche, low body mass index, and heavy alcohol consumption. Conclusion: These findings suggest the possibility that women who develop breast cancers at very young ages may be etiologically as well as clinically distinct.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Brinton LA,Schairer C,Hoover RN,Fraumeni JF Jr (1988) Menstrual factors and risk of breast cancer. Cancer Invest 6: 245-254.

    Google Scholar 

  2. Pike MC,Spicer DV,Dahmoush L,Press MF (1993) Estrogens, progestogens, normal breast cell proliferation, and breast cancer risk. Epidemiol Rev 15: 17-35.

    Google Scholar 

  3. Velentgas P,Daling JR (1994) Risk factors for breast cancer in younger women. J Natl Cancer Inst Monogr 15-24.

  4. Friedenreich CM (2001) Review of anthropometric factors and breast cancer risk. Eur J Cancer Prev 10: 15-32.

    Google Scholar 

  5. Cold S,Hansen S,Overvad K,Rose C (1998) A woman's build and the risk of breast cancer. Eur J Cancer 34: 1163-1174.

    Google Scholar 

  6. Anonymous (1996) Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53,297 women with breast cancer and 100,239 women without breast cancer from 54 epidemiological studies. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet 347: 1713-1727.

  7. Leon DA,Carpenter LM,Broeders MJ,Gunnarskog J,Murphy MF (1995) Breast cancer in Swedish women before age 50: evidence of a dual effect of completed pregnancy. Cancer Causes Control 6: 283-291.

    Google Scholar 

  8. Robertson C,Primic-Zakelj M,Boyle P,Hsieh CC (1997) Effect of parity and age at delivery on breast cancer risk in Slovenian women aged 25-54 years. Int J Cancer 73: 1-9.

    Google Scholar 

  9. Lipworth L,Bailey LR,Trichopoulos D (2000) History of breastfeeding in relation to breast cancer risk: a review of the epidemiologic literature. J Natl Cancer Inst 92: 302-312.

    Google Scholar 

  10. Friedenreich CM, Bryant HE, Courneya KS (2001) Case-control study of lifetime physical activity and breast cancer risk. Am J Epidemiol 154: 336-347.

    Google Scholar 

  11. Anonymous (2001) Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58,209 women with breast cancer and 101,986 women without the disease. Lancet 358: 1389-1399.

  12. Talamini R,Franceschi S,La Vecchia C, et al. (1996) The role of reproductive and menstrual factors in cancer of the breast before and after menopause. Eur J Cancer 32A: 303-310.

    Google Scholar 

  13. Titus-Ernstoff L,Longnecker MP,Newcomb PA, et al. (1998) Menstrual factors in relation to breast cancer risk. Cancer Epidemiol. Biomarkers Prev 7: 783-789.

    Google Scholar 

  14. Singletary KW,Gapstur SM (2001) Alcohol and breast cancer: review of epidemiologic and experimental evidence and potential mechanisms. JAMA 286: 2143-2151.

    Google Scholar 

  15. Clavel-Chapelon F,Launoy G,Auquier A, et al. (1995) Reproductive factors and breast cancer risk. Effect of age at diagnosis. Ann Epidemiol 5: 315-320.

    Google Scholar 

  16. Stanford JL,Greenberg RS (1989) Breast cancer incidence in young women by estrogen receptor status and race. Am J Public Health 79: 71-73.

    Google Scholar 

  17. Albain KS,Allred DC,Clark GM (1994) Breast cancer outcome and predictors of outcome: are there age differentials? J Natl Cancer Inst Monogr 35-42.

  18. Kim SH,Simkovich-Heerdt A,Tran KN,Maclean B,Borgen PI (1998) Women 35 years of age or younger have higher locoregional relapse rates after undergoing breast conservation therapy. J Am Coll Surg 187: 1-8.

    Google Scholar 

  19. Xiong Q,Valero V,Kau V, et al. (2001) Female patients with breast carcinoma age 30 years and younger have a poor prognosis: the M.D. Anderson Cancer Center experience. Cancer 92: 2523-2528.

    Google Scholar 

  20. Stoll BA (1991) High risk breast cancer in young women. Eur J Cancer 27: 808.

    Google Scholar 

  21. Hankey BF,Miller B,Curtis R,Kosary C (1994) Trends in breast cancer in younger women in contrast to older women. J Natl Cancer Inst Monogr 7-14.

  22. Tavani A,Gallus S,La Vecchia C, et al. (1999) Risk factors for breast cancer in women under 40 years. Eur J Cancer 35: 1361-1367.

    Google Scholar 

  23. Bernstein L,Henderson BE,Hanisch R,Sullivan-Halley J,Ross RK (1994) Physical exercise and reduced risk of breast cancer in young women. J Natl Cancer Inst 86: 1403-1408.

    Google Scholar 

  24. Chen CL,White E,Malone KE,Daling JR (1997) Leisure-time physical activity in relation to breast cancer among young women (Washington, United States). Cancer Causes Control 8: 77-84.

    Google Scholar 

  25. Garland M,Hunter DJ,Colditz GA, et al. (1999) Alcohol consumption in relation to breast cancer risk in a cohort of United States women 25-42 years of age. Cancer Epidemiol Biomarkers Prev 8: 1017-1021.

    Google Scholar 

  26. Innes K,Byers T,Schymura M (2000) Birth characteristics and subsequent risk for breast cancer in very young women. Am J Epidemiol 152: 1121-1128.

    Google Scholar 

  27. Mayberry RM (1994) Age-specific patterns of association between breast cancer and risk factors in black women, ages 20 to 39 and 40 to 54. Ann Epidemiol 4: 205-213.

    Google Scholar 

  28. McCredie MR,Dite GS,Giles GG,Hopper JL (1998) Breast cancer in Australian women under the age of 40. Cancer Causes Control 9: 189-198.

    Google Scholar 

  29. Winchester DP,Osteen RT,Menck HR (1996) The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age. Cancer 78: 1838-1843.

    Google Scholar 

  30. Brinton LA,Daling JR,Liff JM, et al. (1995) Oral contraceptives and breast cancer risk among younger women. J Natl Cancer Inst 87: 827-835.

    Google Scholar 

  31. Madigan MP,Troisi R,Potischman N, et al. (2000) Characteristics of respondents and non-respondents from a case-control study of breast cancer in younger women. Int J Epidemiol 29: 793-798.

    Google Scholar 

  32. Brinton LA,Potischman NA,Swanson CA, et al. (1995) Breastfeeding and breast cancer risk. Cancer Causes Control 6: 199-208.

    Google Scholar 

  33. Swanson CA,Coates RJ,Schoenberg JB, et al. (1996) Body size and breast cancer risk among women under age 45 years. Am J Epidemiol 143: 698-706.

    Google Scholar 

  34. Daling JR,Brinton LA,Voigt LF, et al. (1996) Risk of breast cancer among white women following induced abortion. Am J Epidemiol 144: 373-380.

    Google Scholar 

  35. Gammon MD,Schoenberg JB,Britton JA, et al. (1998) Electric blanket use and breast cancer risk among younger women. Am J Epidemiol 148: 556-63.

    Google Scholar 

  36. Gammon MD,Schoenberg JB,Britton JA, et al. (1998) Recreational physical activity and breast cancer risk among women under age 45 years. Am J Epidemiol 147: 273-280.

    Google Scholar 

  37. Weiss HA,Troisi R,Rossing MA, et al. (1998) Fertility problems and breast cancer risk in young women: a case-control study in the United States. Cancer Causes Control 9: 331-339.

    Google Scholar 

  38. Breslow NE,Day NE (1980) The analysis of case-control studies. Statistical Methods in Cancer Research, Vol. 1. Lyon, France: IARC Scientific Publications, pp. 5-338.

    Google Scholar 

  39. Furberg H,Millikan R,Dressler L,Newman B,Geradts J (2001) Tumor characteristics in African American and white women. Breast Cancer Res Treat 68: 33-43.

    Google Scholar 

  40. Wingo PA,Lee NC,Ory HW,Beral V,Peterson HB,Rhodes P (1993) Age-specific differences in the relationship between oral contraceptive use and breast cancer. Cancer 71: 1506-1517.

    Google Scholar 

  41. Cooper JA,Rohan TE,Cant EL,Horsfall DJ,Tilley WD (1989) Risk factors for breast cancer by oestrogen receptor status: a population-based case-control study. Br J Cancer 59: 119-125.

    Google Scholar 

  42. Stanford JL,Szklo M,Boring CC, et al. (1987) A case-control study of breast cancer stratified by estrogen receptor status. Am J Epidemiol 125: 184-194.

    Google Scholar 

  43. Gapstur SM,Dupuis J,Gann P,Collila S,Winchester DP (1996) Hormone receptor status of breast tumors in black, Hispanic, and non-Hispanic white women. An analysis of 13,239 cases. Cancer 77: 1465-1471.

    Google Scholar 

  44. Hildreth NG,Kelsey JL,Eisenfeld AJ,LiVolsi VA,Holford TR,Fischer DB (1983) Differences in breast cancer risk factors according to the estrogen receptor level of the tumor. J Natl Cancer Inst 70: 1027-1031.

    Google Scholar 

  45. McTiernan A,Thomas DB,Johnson LK,Roseman D (1986) Risk factors for estrogen receptor-rich and estrogen receptor-poor breast cancers. J Natl Cancer Inst 77: 849-854.

    Google Scholar 

  46. Ruder AM,Lubin F,Wax Y,Geier A,Alfundary E,Chetrit A (1989) Estrogen and progesterone receptors in breast cancer patients. Epidemiologic characteristics and survival differences. Cancer 64: 196-202.

    Google Scholar 

  47. Wohlfahrt J,Mouridsen H,Andersen PK,Melbye M (1999) Reproductive risk factors for breast cancer by receptor status, histology, laterality and location. Int J Cancer 81: 49-55.

    Google Scholar 

  48. Potter JD,Cerhan JR,Sellers TA, et al. (1995) Progesterone and estrogen receptors and mammary neoplasia in the Iowa Women's Health Study: how many kinds of breast cancer are there? Cancer Epidemiol Biomarkers Prev 4: 319-326.

    Google Scholar 

  49. Loman N,Johannsson O,Kristoffersson U,Olsson H,Borg A (2001) Family history of breast and ovarian cancers and BRCA1 and BRCA2 mutations in a population-based series of early-onset breast cancer. J Natl Cancer Inst 93: 1215-1223.

    Google Scholar 

  50. Peto J,Collins N,Barfoot R, et al. (1999) Prevalence of BRCA1 and BRCA2 gene mutations in patients with early-onset breast cancer. J Natl Cancer Inst 91: 943-949.

    Google Scholar 

  51. Liu X,Sennett C,Legorreta AP (2001) Mammography utilization among California women age 40-49 in a managed care environment. Breast Cancer Res. Treat 67: 181-186.

    Google Scholar 

  52. Antman K,Shea S (1999) Screening mammography under age 50. JAMA 281: 1470-1472.

    Google Scholar 

  53. Weiss HA,Brinton LA,Brogan D, et al. (1996) Epidemiology of in situ and invasive breast cancer in women aged under 45. Br J Cancer 73: 1298-1305.

    Google Scholar 

  54. Prorok PC,Andriole GL,Bresalier RS, et al. (2000) Design of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Control Clin Trials 21: 273S-309S.

    Google Scholar 

  55. Newman B,Moorman PG,Millikan R, et al. (1995) The Carolina Breast Cancer Study: integrating population-based epidemiology and molecular biology. Breast Cancer Res Treat 35: 51-60.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michelle D. Althuis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Althuis, M.D., Brogan, D.D., Coates, R.J. et al. Breast cancers among very young premenopausal women (United States). Cancer Causes Control 14, 151–160 (2003). https://doi.org/10.1023/A:1023006000760

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1023006000760

Navigation