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J Natl Cancer Inst. 2013 Dec 4;105(23):1833-6. doi: 10.1093/jnci/djt317. Epub 2013 Nov 14.

Breast cancer risk in opposite-sexed twins: influence of birth weight and co-twin birth weight.

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Affiliations of authors: Clinical Epidemiology Unit, Department of Medicine (MH, SB, SC), Center for Pharmacoepidemiology, Department of Medicine (SB), and Department of Medical Epidemiology and Biostatistics (ANI), Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard School of Public Health, Boston, MA (SO); Faculty of Public Health, Golestan University of Medical Sciences, Iran (MH, SB).


Most, but not all, studies report a positive association between birth weight, as an indirect marker of prenatal hormone exposure, and offspring breast cancer risk, particularly premenopausal breast cancer. Females from opposite-sexed twin pairs may also be prenatally exposed to androgens from their twin brothers. A Swedish study of opposite-sexed twins with a small sample size found a very strong positive association between female birth weight and breast cancer risk. In this case-control study, nested within a cohort of female opposite-sexed twins, we included 543 breast cancer case subjects diagnosed in the period from 1972 to 2008 and 2715 matched control subjects. Conditional logistic regression estimated the breast cancer risk associated with birth weight and other birth characteristics, including gestational age and co-twin birth weight. All statistical tests were two-sided. There was no association between birth weight (odds ratio = 1.01; 95% confidence interval = 0.70 to 1.46) or twin brother's birth weight and risk of breast cancer, which suggests the previously reported strong positive association may have been a chance finding.

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