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Family history of later-onset breast cancer, breast healthy behavior and invasive breast cancer among postmenopausal women: a cohort study

Robert Gramling1*, Timothy L Lash2, Kenneth J Rothman34, Howard J Cabral5, Rebecca Silliman6, Mary Roberts7, Marcia L Stefanick8, Rosanne Harrigan9, Monica L Bertoia10 and Charles B Eaton7

Author Affiliations

1 Departments of Family Medicine and Community & Preventive Medicine, University of Rochester, 1381 South Avenue, Rochester, NY 14620, USA

2 Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Alle 43-45, 8200 Aarhus N, Denmark

3 RTI Health Solutions, RTI International, 200 Park Offices Drive, Research Triangle Park, NC 27709, USA

4 Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA

5 Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd floor, Boston, MA 02118, USA

6 Section of Geriatrics, Department of Medicine, Boston University School of Medicine Department of Epidemiology, Boston University School of Public Health, 88 East Newton Street, Robinson 2, Boston, MA 02118, USA

7 Center for Primary Care & Prevention, Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860, USA

8 Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Medical School Office Building, 251 Campus Drive, Mail Code 5411, Stanford, CA 94305-5411, USA

9 Complementary and Alternative Medicine, John A. Burns School of Medicine, 651 Ilalo Street, Honolulu, HI 86821, USA

10 Department of Community Health, Warren Alpert Medical School of Brown University, 121 S. Main Street, Box G-S121, Providence, RI 02912, USA

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Breast Cancer Research 2010, 12:R82  doi:10.1186/bcr2727

Published: 12 October 2010



A family history of later-onset breast cancer (FHLBC) may suggest multi-factorial inheritance of breast cancer risk, including unhealthy lifestyle behaviors that may be shared within families. We assessed whether adherence to lifestyle behaviors recommended for breast cancer prevention--including maintaining a healthful body weight, being physically active and limiting alcohol intake--modifies breast cancer risk attributed to FHLBC in postmenopausal women.


Breast cancer outcomes through August 2003 were analyzed in relationship to lifestyle and risk factors collected by questionnaire during enrollment (between 1993 and 1998) of 85,644 postmenopausal women into the Women's Health Initiative Observational Study.


During a mean follow-up of 5.4 years, 1997 women were diagnosed with invasive breast cancer. The rate of invasive breast cancer among women with an FHLBC who participated in all three behaviors was 5.94 per 1,000 woman-years, compared with 6.97 per 1,000 woman-years among women who participated in none of the behaviors. The rate among women with no FHLBC who participated in all three behavioral conditions was 3.51 per 1,000 woman-years compared to 4.67 per 1,000 woman-years for those who participated in none. We did not observe a clinically important departure from additive effects (Interaction Contrast: 0.00014; 95% CI: -0.00359, 0.00388).


Participating in breast healthy behaviors was beneficial to postmenopausal women and the degree of this benefit was the same for women with and without an FHLBC.