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Menarche, menopause, and breast cancer risk: Individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies

Hamajima, N and Hirose, K and Tajima, K and Rohan, T and Friedenreich, CM and Calle, EE and Gapstur, SM and Patel, AV and Coates, RJ and Liff, JM and Talamini, R and Chantarakul, N and Koetsawang, S and Rachawat, D and Marcou, Y and Kakouri, E and Duffy, SW and Morabia, A and Schuman, L and Stewart, W and Szklo, M and Coogan, PF and Palmer, JR and Rosenberg, L and Band, P and Coldman, AJ and Gallagher, RP and Hislop, TG and Yang, P and Cummings, SR and Canfell, K and Sitas, F and Chao, P and Lissowska, J and Horn-Ross, PL and John, EM and Kolonel, LM and Nomura, AMY and Ghiasvand, R and Hu, J and Johnson, KC and Mao, Y and Beral, V and Bull, D and Callaghan, K and Crossley, B and Goodill, A and Green, J and Hermon, C and Key, T and Lindgard, I and Liu, B and Pirie, K and Reeves, G and Collins, R and Doll, R and Peto, R and Bishop, T and Fentiman, IS and De Sanjosé, S and Gonzalez, CA and Lee, N and Marchbanks, P and Ory, HW and Peterson, HB and Wingo, P and Ebeling, K and Kunde, D and Nishan, P and Hopper, JL and Eliassen, H and Hankinson, S and Gajalakshmi, V and Martin, N and Pardthaisong, T and Silpisornkosol, S and Theetranont, C and Boosiri, B and Chutivongse, S and Jimakorn, P and Virutamasen, P and Wongsrichanalai, C and Neugut, A and Santella, R and Baines, CJ and Kreiger, N and Miller, AB and Wall, C and Tjonneland, A and Jorgensen, T and Stahlberg, C and Pedersen, AT and Flesch-Janys, D and Hakansson, N and Cauley, J and Heuch, I and Adami, HO and Persson, I and Weiderpass, E and Magnusson, C (2012) Menarche, menopause, and breast cancer risk: Individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. The Lancet Oncology, 13 (11). 1141 - 1151. ISSN 1470-2045

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Background Menarche and menopause mark the onset and cessation, respectively, of ovarian activity associated with reproduction, and affect breast cancer risk. Our aim was to assess the strengths of their effects and determine whether they depend on characteristics of the tumours or the affected women. Methods Individual data from 117 epidemiological studies, including 118 964 women with invasive breast cancer and 306 091 without the disease, none of whom had used menopausal hormone therapy, were included in the analyses. We calculated adjusted relative risks (RRs) associated with menarche and menopause for breast cancer overall, and by tumour histology and by oestrogen receptor expression. Findings Breast cancer risk increased by a factor of 1.050 (95% CI 1.044-1.057; p<0.0001) for every year younger at menarche, and independently by a smaller amount (1.029, 1.025-1.032; p<0.0001), for every year older at menopause. Premenopausal women had a greater risk of breast cancer than postmenopausal women of an identical age (RR at age 45-54 years 1.43, 1.33-1.52, p<0.001). All three of these associations were attenuated by increasing adiposity among postmenopausal women, but did not vary materially by women's year of birth, ethnic origin, childbearing history, smoking, alcohol consumption, or hormonal contraceptive use. All three associations were stronger for lobular than for ductal tumours (p<0.006 for each comparison). The effect of menopause in women of an identical age and trends by age at menopause were stronger for oestrogen receptor-positive disease than for oestrogen receptor-negative disease (p<0.01 for both comparisons). Interpretation The effects of menarche and menopause on breast cancer risk might not be acting merely by lengthening women's total number of reproductive years. Endogenous ovarian hormones are more relevant for oestrogen receptorpositive disease than for oestrogen receptor-negative disease and for lobular than for ductal tumours.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Hamajima, N
Hirose, K
Tajima, K
Rohan, T
Friedenreich, CM
Calle, EE
Gapstur, SM
Patel, AV
Coates, RJ
Liff, JM
Talamini, R
Chantarakul, N
Koetsawang, S
Rachawat, D
Marcou, Y
Kakouri, E
Duffy, SW
Morabia, A
Schuman, L
Stewart, W
Szklo, M
Coogan, PF
Palmer, JR
Rosenberg, L
Band, P
Coldman, AJ
Gallagher, RP
Hislop, TG
Yang, P
Cummings, SR
Canfell, K
Sitas, F
Chao, P
Lissowska, J
Horn-Ross, PL
John, EM
Kolonel, LM
Nomura, AMY
Ghiasvand, R
Hu, J
Johnson, KC
Mao, Y
Beral, V
Bull, D
Callaghan, K
Crossley, B
Goodill, A
Green, J
Hermon, C
Key, T
Lindgard, I
Liu, B
Pirie, K
Reeves, G
Collins, R
Doll, R
Peto, R
Bishop, T
Fentiman, IS
De Sanjosé, S
Gonzalez, CA
Lee, N
Marchbanks, P
Ory, HW
Peterson, HB
Wingo, P
Ebeling, K
Kunde, D
Nishan, P
Hopper, JL
Eliassen, H
Hankinson, S
Gajalakshmi, V
Martin, N
Pardthaisong, T
Silpisornkosol, S
Theetranont, C
Boosiri, B
Chutivongse, S
Jimakorn, P
Virutamasen, P
Wongsrichanalai, C
Neugut, A
Santella, R
Baines, CJ
Kreiger, N
Miller, AB
Wall, C
Tjonneland, A
Jorgensen, T
Stahlberg, C
Pedersen, AT
Flesch-Janys, D
Hakansson, N
Cauley, JJCauley@edc.pitt.eduJCAULEY
Heuch, I
Adami, HO
Persson, I
Weiderpass, E
Magnusson, C
Date: 1 November 2012
Date Type: Publication
Journal or Publication Title: The Lancet Oncology
Volume: 13
Number: 11
Page Range: 1141 - 1151
DOI or Unique Handle: 10.1016/s1470-2045(12)70425-4
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 1470-2045
Date Deposited: 03 Apr 2015 01:13
Last Modified: 30 Mar 2021 13:55


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