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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2003 Oct;95(10):930–938.

A case-control study of menstrual factors in relation to breast cancer risk in African-American women.

Jessica S B Beiler 1, Kangmin Zhu 1, Sandra Hunter 1, Kathleen Payne-Wilks 1, Chanel L Roland 1, Vernon M Chinchilli 1
PMCID: PMC2594481  PMID: 14620704

Abstract

Menstrual characteristics may serve as surrogate measures of endogenous estrogen and may be related to breast cancer risk. No previous studies have systematically investigated menstrual factors in relation to the disease in African-American women. This case-control study is aimed to assess the relationship between menstrual factors and breast cancer in African-American women. Cases were 304 African-American women, aged 20-64 living in three Tennessee counties, diagnosed with breast cancer between 1995 and 1998. Controls were selected through random-digit dialing and frequency matched to cases (n=305). Phone interviews were conducted on menstrual factors--age at menarche, time to regularity, cycle length, flow length, age at menopause--and other risk factors. Logistic regression showed that compared to women with short cycle length (<28 days), women with average cycle length > or =28 had decreased risk of breast cancer (odds ratio (OR)=0.60, 95% confidence interval (CI), 0.38-0.94). Dose-response analyses showed decreasing risk with longer cycle length. Results by menopausal status revealed an inverse relationship was shown only in postmenopausal women. No significant associations were observed for other menstrual factors. Findings suggest that cycle length has an inverse association with breast cancer in African-American women that may primarily exist for post-menopausal tumors.

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Selected References

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  1. Austin H., Cole P., Wynder E. Breast cancer in black American women. Int J Cancer. 1979 Nov 15;24(5):541–544. doi: 10.1002/ijc.2910240504. [DOI] [PubMed] [Google Scholar]
  2. Bernstein L., Ross R. K. Endogenous hormones and breast cancer risk. Epidemiol Rev. 1993;15(1):48–65. doi: 10.1093/oxfordjournals.epirev.a036116. [DOI] [PubMed] [Google Scholar]
  3. Blumenthal D. S., Sung J., Coates R., Williams J., Liff J. Recruitment and retention of subjects for a longitudinal cancer prevention study in an inner-city black community. Health Serv Res. 1995 Apr;30(1 Pt 2):197–205. [PMC free article] [PubMed] [Google Scholar]
  4. Butler L. M., Potischman N. A., Newman B., Millikan R. C., Brogan D., Gammon M. D., Swanson C. A., Brinton L. A. Menstrual risk factors and early-onset breast cancer. Cancer Causes Control. 2000 May;11(5):451–458. doi: 10.1023/a:1008956524669. [DOI] [PubMed] [Google Scholar]
  5. Dowsett M. Use of risk determinants for different breast cancer prevention strategies. Eur J Cancer. 2000 Jun;36(10):1283–1287. doi: 10.1016/s0959-8049(00)00101-5. [DOI] [PubMed] [Google Scholar]
  6. Gao Y. T., Shu X. O., Dai Q., Potter J. D., Brinton L. A., Wen W., Sellers T. A., Kushi L. H., Ruan Z., Bostick R. M. Association of menstrual and reproductive factors with breast cancer risk: results from the Shanghai Breast Cancer Study. Int J Cancer. 2000 Jul 15;87(2):295–300. doi: 10.1002/1097-0215(20000715)87:2<295::aid-ijc23>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  7. Garland M., Hunter D. J., Colditz G. A., Manson J. E., Stampfer M. J., Spiegelman D., Speizer F., Willett W. C. Menstrual cycle characteristics and history of ovulatory infertility in relation to breast cancer risk in a large cohort of US women. Am J Epidemiol. 1998 Apr 1;147(7):636–643. doi: 10.1093/oxfordjournals.aje.a009504. [DOI] [PubMed] [Google Scholar]
  8. Gorelick P. B., Richardson D., Hudson E., Perry C., Robinson D., Brown N., Harris Y. Establishing a community network for recruitment of African Americans into a clinical trial. The African-American antiplatelet stroke Prevention Study (AAASPS) experience. J Natl Med Assoc. 1996 Nov;88(11):701–704. [PMC free article] [PubMed] [Google Scholar]
  9. Grisso J. A., Freeman E. W., Maurin E., Garcia-Espana B., Berlin J. A. Racial differences in menopause information and the experience of hot flashes. J Gen Intern Med. 1999 Feb;14(2):98–103. doi: 10.1046/j.1525-1497.1999.00294.x. [DOI] [PubMed] [Google Scholar]
  10. Harlow S. D., Baird D. D., Weinberg C. R., Wilcox A. J. Urinary oestrogen patterns in long follicular phases. Hum Reprod. 2000 Jan;15(1):11–16. doi: 10.1093/humrep/15.1.11. [DOI] [PubMed] [Google Scholar]
  11. Harlow S. D., Campbell B. Ethnic differences in the duration and amount of menstrual bleeding during the postmenarcheal period. Am J Epidemiol. 1996 Nov 15;144(10):980–988. doi: 10.1093/oxfordjournals.aje.a008868. [DOI] [PubMed] [Google Scholar]
  12. Harlow S. D., Campbell B., Lin X., Raz J. Ethnic differences in the length of the menstrual cycle during the postmenarcheal period. Am J Epidemiol. 1997 Oct 1;146(7):572–580. doi: 10.1093/oxfordjournals.aje.a009316. [DOI] [PubMed] [Google Scholar]
  13. Harris Y., Gorelick P. B., Samuels P., Bempong I. Why African Americans may not be participating in clinical trials. J Natl Med Assoc. 1996 Oct;88(10):630–634. [PMC free article] [PubMed] [Google Scholar]
  14. Henderson B. E. Endogenous and exogenous endocrine factors. Hematol Oncol Clin North Am. 1989 Dec;3(4):577–598. [PubMed] [Google Scholar]
  15. Henderson B. E., Pike M. C., Casagrande J. T. Breast cancer and the oestrogen window hypothesis. Lancet. 1981 Aug 15;2(8242):363–364. doi: 10.1016/s0140-6736(81)90675-9. [DOI] [PubMed] [Google Scholar]
  16. Henderson B. E., Ross R. K., Judd H. L., Krailo M. D., Pike M. C. Do regular ovulatory cycles increase breast cancer risk? Cancer. 1985 Sep 1;56(5):1206–1208. doi: 10.1002/1097-0142(19850901)56:5<1206::aid-cncr2820560541>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  17. Henderson B. E., Ross R., Bernstein L. Estrogens as a cause of human cancer: the Richard and Hinda Rosenthal Foundation award lecture. Cancer Res. 1988 Jan 15;48(2):246–253. [PubMed] [Google Scholar]
  18. Herman-Giddens M. E., Slora E. J., Wasserman R. C., Bourdony C. J., Bhapkar M. V., Koch G. G., Hasemeier C. M. Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network. Pediatrics. 1997 Apr;99(4):505–512. doi: 10.1542/peds.99.4.505. [DOI] [PubMed] [Google Scholar]
  19. Kelsey J. L. Breast cancer epidemiology: summary and future directions. Epidemiol Rev. 1993;15(1):256–263. doi: 10.1093/oxfordjournals.epirev.a036112. [DOI] [PubMed] [Google Scholar]
  20. Kelsey J. L., Gammon M. D., John E. M. Reproductive factors and breast cancer. Epidemiol Rev. 1993;15(1):36–47. doi: 10.1093/oxfordjournals.epirev.a036115. [DOI] [PubMed] [Google Scholar]
  21. Kjerulff K. H., Guzinski G. M., Langenberg P. W., Stolley P. D., Moye N. E., Kazandjian V. A. Hysterectomy and race. Obstet Gynecol. 1993 Nov;82(5):757–764. [PubMed] [Google Scholar]
  22. Kvåle G., Heuch I. Menstrual factors and breast cancer risk. Cancer. 1988 Oct 15;62(8):1625–1631. doi: 10.1002/1097-0142(19881015)62:8<1625::aid-cncr2820620828>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  23. La Vecchia C., Negri E., Bruzzi P., Dardanoni G., Decarli A., Franceschi S., Palli D., Talamini R. The role of age at menarche and at menopause on breast cancer risk: combined evidence from four case-control studies. Ann Oncol. 1992 Sep;3(8):625–629. doi: 10.1093/oxfordjournals.annonc.a058288. [DOI] [PubMed] [Google Scholar]
  24. Laing A. E., Demenais F. M., Williams R., Kissling G., Chen V. W., Bonney G. E. Breast cancer risk factors in African-American women: the Howard University Tumor Registry experience. J Natl Med Assoc. 1993 Dec;85(12):931–939. [PMC free article] [PubMed] [Google Scholar]
  25. Manson J. M., Sammel M. D., Freeman E. W., Grisso J. A. Racial differences in sex hormone levels in women approaching the transition to menopause. Fertil Steril. 2001 Feb;75(2):297–304. doi: 10.1016/s0015-0282(00)01723-4. [DOI] [PubMed] [Google Scholar]
  26. Mayberry R. M. Age-specific patterns of association between breast cancer and risk factors in black women, ages 20 to 39 and 40 to 54. Ann Epidemiol. 1994 May;4(3):205–213. doi: 10.1016/1047-2797(94)90098-1. [DOI] [PubMed] [Google Scholar]
  27. Mayberry R. M., Stoddard-Wright C. Breast cancer risk factors among black women and white women: similarities and differences. Am J Epidemiol. 1992 Dec 15;136(12):1445–1456. doi: 10.1093/oxfordjournals.aje.a116465. [DOI] [PubMed] [Google Scholar]
  28. Meilahn E. N., Matthews K. A., Egeland G., Kelsey S. F. Characteristics of women with hysterectomy. Maturitas. 1989 Dec;11(4):319–329. doi: 10.1016/0378-5122(89)90028-5. [DOI] [PubMed] [Google Scholar]
  29. Moorman P. G., Jones B. A., Millikan R. C., Hall I. J., Newman B. Race, anthropometric factors, and stage at diagnosis of breast cancer. Am J Epidemiol. 2001 Feb 1;153(3):284–291. doi: 10.1093/aje/153.3.284. [DOI] [PubMed] [Google Scholar]
  30. Moormeier J. Breast cancer in black women. Ann Intern Med. 1996 May 15;124(10):897–905. doi: 10.7326/0003-4819-124-10-199605150-00007. [DOI] [PubMed] [Google Scholar]
  31. Must A., Phillips S. M., Naumova E. N., Blum M., Harris S., Dawson-Hughes B., Rand W. M. Recall of early menstrual history and menarcheal body size: after 30 years, how well do women remember? Am J Epidemiol. 2002 Apr 1;155(7):672–679. doi: 10.1093/aje/155.7.672. [DOI] [PubMed] [Google Scholar]
  32. Parazzini F., La Vecchia C., Negri E., Franceschi S., Tozzi L. Lifelong menstrual pattern and risk of breast cancer. Oncology. 1993 Jul-Aug;50(4):222–225. doi: 10.1159/000227183. [DOI] [PubMed] [Google Scholar]
  33. Pike M. C., Spicer D. V., Dahmoush L., Press M. F. Estrogens, progestogens, normal breast cell proliferation, and breast cancer risk. Epidemiol Rev. 1993;15(1):17–35. doi: 10.1093/oxfordjournals.epirev.a036102. [DOI] [PubMed] [Google Scholar]
  34. Roberson N. L. Clinical trial participation. Viewpoints from racial/ethnic groups. Cancer. 1994 Nov 1;74(9 Suppl):2687–2691. doi: 10.1002/1097-0142(19941101)74:9+<2687::aid-cncr2820741817>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  35. Rockhill B., Moorman P. G., Newman B. Age at menarche, time to regular cycling, and breast cancer (North Carolina, United States). Cancer Causes Control. 1998 Aug;9(4):447–453. doi: 10.1023/a:1008832004211. [DOI] [PubMed] [Google Scholar]
  36. Schatzkin A., Palmer J. R., Rosenberg L., Helmrich S. P., Miller D. R., Kaufman D. W., Lesko S. M., Shapiro S. Risk factors for breast cancer in black women. J Natl Cancer Inst. 1987 Feb;78(2):213–217. [PubMed] [Google Scholar]
  37. Talamini R., Franceschi S., La Vecchia C., Negri E., Borsa L., Montella M., Falcini F., Conti E., Rossi C. The role of reproductive and menstrual factors in cancer of the breast before and after menopause. Eur J Cancer. 1996 Feb;32A(2):303–310. doi: 10.1016/0959-8049(95)00615-x. [DOI] [PubMed] [Google Scholar]
  38. Titus-Ernstoff L., Longnecker M. P., Newcomb P. A., Dain B., Greenberg E. R., Mittendorf R., Stampfer M., Willett W. Menstrual factors in relation to breast cancer risk. Cancer Epidemiol Biomarkers Prev. 1998 Sep;7(9):783–789. [PubMed] [Google Scholar]
  39. Vihko R., Apter D. Endocrine characteristics of adolescent menstrual cycles: impact of early menarche. J Steroid Biochem. 1984 Jan;20(1):231–236. doi: 10.1016/0022-4731(84)90209-7. [DOI] [PubMed] [Google Scholar]
  40. Wallace R. B., Sherman B. M., Bean J. A., Leeper J. P., Treloar A. E. Menstrual cycle patterns and breast cancer risk factors. Cancer Res. 1978 Nov;38(11 Pt 2):4021–4024. [PubMed] [Google Scholar]
  41. Whelan E. A., Sandler D. P., Root J. L., Smith K. R., Weinberg C. R. Menstrual cycle patterns and risk of breast cancer. Am J Epidemiol. 1994 Dec 15;140(12):1081–1090. doi: 10.1093/oxfordjournals.aje.a117208. [DOI] [PubMed] [Google Scholar]
  42. Wu A. H., Ziegler R. G., Pike M. C., Nomura A. M., West D. W., Kolonel L. N., Horn-Ross P. L., Rosenthal J. F., Hoover R. N. Menstrual and reproductive factors and risk of breast cancer in Asian-Americans. Br J Cancer. 1996 Mar;73(5):680–686. doi: 10.1038/bjc.1996.118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. den Tonkelaar I., de Waard F. Regularity and length of menstrual cycles in women aged 41-46 in relation to breast cancer risk: results from the DOM-project. Breast Cancer Res Treat. 1996;38(3):253–258. doi: 10.1007/BF01806143. [DOI] [PubMed] [Google Scholar]

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