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Bodyweight and other correlates of symptom-detected breast cancers in a population offered screening

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Abstract

Objective

To determine the factors associated with symptom-detected breast cancers in a population offered screening.

Methods

We interviewed 1,459 Australian women aged 40–69, 946 with symptom-detected and 513 with mammogram-detected invasive breast cancers ≥1.1 cm in diameter about their personal, mammogram, and breast histories before diagnosis and reviewed medical records for tumor characteristics and mammogram dates, calculating ORs and 95% confidence intervals (CIs) for symptom- versus mammogram-detected cancers in logistic regression models.

Results

Lack of regular mammograms (<2 mammograms in the 4.5 years before diagnosis) was the strongest correlate of symptom-detected breast cancer (OR = 3.04 for irregular or no mammograms). In women who had regular mammograms (≥2 mammograms in the 4.5 years before diagnosis), the independent correlates of symptom-detected cancers were low BMI (OR < 25 kg/m2 vs. ≥ 30 kg/m2 = 2.18, 95% CI 1.23–3.84; p = 0.008), increased breast density (available in 498 women) (OR highest quarter vs. lowest = 3.50, 95% CI 1.76–6.97; p trend = 0.004), high-grade cancer, and a larger cancer (each p < 0.01). In women who did not have regular mammograms, the independent correlates were age <50 years, a first cancer, and a ≥2-cm cancer. Smoking appeared to modify the association of symptom-detected cancer with low BMI (higher ORs for low BMI in current smokers) and estrogen receptor (ER) status (higher ORs for low BMI in ER cancers).

Conclusion

Women with low BMI may benefit from a tailored approach to breast cancer detection, particularly if they smoke.

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Acknowledgments

The study was funded by the National Health and Medical Research Council of Australia (project grant no. 197801) and The University of Sydney Medical Foundation. Bruce Armstrong’s research was supported by a University of Sydney Medical Foundation program grant. We gratefully acknowledge the individuals who participated in the research, the clinicians who gave permission for us to approach their patients, Professor Beth Newman who led the study in Queensland and Sheree Harrison for data collection there, Sharon Gill for data collection in Victoria and Lisa Trotter in NSW, and staff at the NSW Central Cancer Registry and Queensland and Victorian Cancer Registries and the Hunter Valley Research Foundation.

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Authors and Affiliations

  1. Sydney School of Public Health, University of Sydney, QEII Building D02, Sydney, NSW, 2006, Australia

    Anne Kricker, Chris Goumas & Bruce K. Armstrong

  2. School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia

    Tracey DiSipio

  3. Melbourne School of Population Health, The University of Melbourne, Carlton, VIC, 3010, Australia

    Jennifer Stone

  4. Department of Anatomical Pathology, Mater Health Services, South Brisbane, QLD, 4101, Australia

    Jane E. Armes

  5. Victorian Cervical Cytology Registry, PO Box 161, Carlton South, VIC, 3053, Australia

    Dorota M. Gertig

Authors
  1. Anne Kricker
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  2. Tracey DiSipio
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  7. Bruce K. Armstrong
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Correspondence to Anne Kricker.

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Kricker, A., DiSipio, T., Stone, J. et al. Bodyweight and other correlates of symptom-detected breast cancers in a population offered screening. Cancer Causes Control 23, 89–102 (2012). https://doi.org/10.1007/s10552-011-9858-9

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  • DOI: https://doi.org/10.1007/s10552-011-9858-9

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