American Journal of Epidemiology Vol. 128, No. 2: 309-323
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
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RISK OF CONTRALATERAL BREAST CANCER: ASSOCIATIONS WITH FACTORS RELATED TO INITIAL BREAST CANCER1
Reprint requests to Dr. Pamela L. Horn at present address: Northern California Cancer Center, 1420 Harbor Bay Parkway, Suite 260, Alameda, CA 94501
A case-control study was conducted to assess the risk factors associated with the development of a contralateral primary breast cancer among women who had had a first primary breast cancer. Hospital records were reviewed for 292 women who had an incident contralateral breast cancer, diagnosed in one of eight Connecticut hospitals between July 1, 1975 and December 31, 1983, and for a comparison group of 264 surviving unilateral breast cancer patients previously diagnosed in the same hospitals. All subjects were identified through the records of the Connecticut Tumor Registry. A family history of breast cancer in any first-or second-degree relative was associated with an almost threefold increased risk of developing a contralateral cancer (adjusted odds ratio (OR) = 2.8, 95% confidence interval (Cl) = 1.6–4.9). Further, this relation was modified by the time elapsed since the initial cancer diagnosis (ratio of OR = 1.9, 95% Cl = 1.2–3.0 for a five-year differential in time since initial diagnosis). A delay of 10 years in first full-term pregnancy was associated with a 36% decrease in risk (adjusted OR = 0.6, 95% Cl = 0.3–1.2); this estimate excluded the magnitude of increased risk usually observed in studies of initial breast cancer. A conceptual framework is presented for assessing the study findings in the context of previous studies that have examined the corresponding associations for initial primary breast cancers.
breast neoplasms; neoplasms; multiple primary
1From the Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT
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