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Breast Cancer Res. 2017 Jun 8;19(1):69. doi: 10.1186/s13058-017-0849-y.

Pubertal development in girls by breast cancer family history: the LEGACY girls cohort.

Author information

1
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA. mt146@cumc.columbia.edu.
2
Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA. mt146@cumc.columbia.edu.
3
Division of Hematology and Oncology, University of California (UC) Davis School of Medicine, and UC Davis Comprehensive Cancer Center, Sacramento, CA, USA.
4
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA.
5
Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.
6
Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada.
7
Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA.
8
Department of Medicine, University of Utah Health Sciences Center, Huntsman Cancer Institute, Salt Lake City, UT, USA.
9
Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA.
10
Departments of Biomedical Data Sciences and Health Research and Policy, and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA.
11
Departments of Medicine, Hematology/Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
12
Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
13
Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
14
Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY, USA.
15
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
16
Cancer Prevention Institute of California, Fremont, CA, USA.
17
Department of Health Research and Policy (Epidemiology), and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA.

Abstract

BACKGROUND:

Pubertal milestones, such as onset of breast development and menstruation, play an important role in breast cancer etiology. It is unclear if these milestones are different in girls with a first- or second-degree breast cancer family history (BCFH).

METHODS:

In the LEGACY Girls Study (n = 1040), we examined whether three mother/guardian-reported pubertal milestones (having reached Tanner Stage 2 or higher (T2+) for breast and pubic hair development, and having started menstruation) differed by BCFH. We also examined whether associations between body size and race/ethnicity and pubertal milestones were modified by BCFH. We used mother/guardian reports as the primary measure of pubertal milestones, but also conducted sensitivity analyses using clinical Tanner measurements available for a subcohort (n = 204). We analyzed cross-sectional baseline data with logistic regression models for the entire cohort, and longitudinal data with Weibull survival models for the subcohort of girls that were aged 5-7 years at baseline (n = 258).

RESULTS:

BCFH was modestly, but not statistically significantly, associated with Breast T2+ (odds ratio (OR) = 1.36, 95% confidence interval (CI) = 0.88-2.10), with a stronger association seen in the subcohort of girls with clinical breast Tanner staging (OR = 2.20, 95% CI = 0.91-5.32). In a longitudinal analysis of girls who were aged 5-7 years at baseline, BCFH was associated with a 50% increased rate of having early breast development (hazard ratio (HR) = 1.49, 95% CI = 1.0-2.21). This association increased to twofold in girls who were not overweight at baseline (HR = 2.04, 95% CI = 1.29-3.21). BCFH was not associated with pubic hair development and post-menarche status. The median interval between onset of breast development and menarche was longer for BCFH+ than BCFH- girls (2.3 versus 1.7 years), suggesting a slower developmental tempo for BCFH+ girls. Associations between pubertal milestones and body size and race/ethnicity were similar in girls with or without a BCFH. For example, weight was positively associated with Breast T2+ in both girls with (OR = 1.06 per 1 kg, 95% CI = 1.03-1.10) and without (OR = 1.14 per 1 kg, 95% CI = 1.04-1.24) a BCFH.

CONCLUSIONS:

These results suggest that BCFH may be related to earlier breast development and slower pubertal tempo independent of body size and race/ethnicity.

KEYWORDS:

BMI; Breast cancer; Breast cancer family history; Menarche; Pubertal development

PMID:
28595647
PMCID:
PMC5465536
DOI:
10.1186/s13058-017-0849-y
[Indexed for MEDLINE]
Free PMC Article

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