| 1. |
- Manjer, Jonas, et al.
(author)
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Breast cancer incidence in ex-smokers in relation to body mass index, weight gain and blood lipid levels
- 2001
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In: European Journal of Cancer Prevention. - 1473-5709. ; 10:3, s. 281-287
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Journal article (peer-reviewed)abstract
- According to several studies breast cancer is more common among former smokers. This study explores whether this association has any relationship with anthropometric measurements or blood lipid levels. The 2082 ex-smokers (mean age 49.9 years) in the Malmo Preventive Cohort were followed for an average of 13.3 years using official cancer registries. This yielded 93 incident breast cancer cases. Oestrogen receptor (ER) status was assessed by an immunological method. Incidence of breast cancer covaried with height, body mass index, weight gain and cholesterol levels. None of these associations reached statistical significance. Incidence of breast cancer increased over quartiles of serum triglycerides, Ptrend: 0.02, relative risk (RR) for triglycerides as a continuous variable: 1.46 (1.21-1.77). Nineteen tumours were ER negative; this subgroup was similarly related to high triglycerides, 1.76 (1.40-2.21). All results were similar when BMI and cholesterol levels were entered into the model. It is concluded that breast cancer incidence covaries with triglyceride levels in ex-smokers.
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| 2. |
- Ranstam, J., et al.
(author)
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Survival in breast cancer and age at start of oral contraceptive usage
- 1991
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In: Anticancer research. - 0250-7005. ; 11:6, s. 2043-2046
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Journal article (peer-reviewed)abstract
- In general, findings in studies on oral contraceptives (OCs) and breast cancer have not indicated prognosis to be worse among users of OCs. In few studies, however, has age at the start of OC usage been considered as a prognostic factor. In the present study prognosis in breast cancer is compared with OC usage particularly with age at the start of OC usage among 193 consecutive patients at the Department of Oncology University Hospital Lund. An earlier series of 193 breast cancer patients at Malmo General Hospital is included for comparisons. In the Lund series five-year survival was 62% among women who started to use OCs before the age of 20, 78% among those who started to use OCs between the ages of 20 and 25, and 86% among non-users and those who started to use OCs after the age of 25 (p = 0.009 test for homogeneity). Although age was found to be a prognostic factor in the Lund series (RR = 0.90, p = 0.001) this was not so in the earlier (older) Malmo series. The relationship with age differed significantly between the two series (p = 0.003) suggesting the apparent effect of age at diagnosis to be a cohort effect due to the introduction of OCs during the sixties. The age-specific relationship between survival and OC usage would seem to indicate the presence of a biological mechanism in which OCs may participate during precancerous and early stages of breast cancer.
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| 3. |
- Adeyinka, A, et al.
(author)
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Cytogenetic heterogeneity and clonal evolution in synchronous bilateral breast carcinomas and their lymph node metastases from a male patient without any detectable BRCA2 germline mutation
- 2000
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In: Cancer Genetics and Cytogenetics. - 0165-4608. ; 118:1, s. 42-47
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Journal article (peer-reviewed)abstract
- Two synchronous bilateral breast carcinomas and their matched lymph node metastases from a 70-year-old man were cytogenetically analyzed. All four tumors were near-diploid, and except for the primary tumor from the right breast, had a 45,X,-Y clone in common. The loss of the Y chromosome was, however, common to all four tumors, whereas metaphase cells from peripheral blood lymphocytes showed a normal 46, XY chromosome complement. The primary tumor from the right breast was monoclonal, with loss of the Y chromosome and gain of 1q, whereas its metastasis had two related clones: the 45,X,-Y clone, and the other a more complex version of the clone in the primary tumor, with inv(3), -14, and del(16)(q13) as additional changes. The primary tumor from the left breast was polyclonal with three unrelated clones: 45,X,-Y/45,XY,-18/47,XY,+20, two of which were present in its metastasis. DNA flow cytometric studies showed diploidy for both primary tumors. No mutation in the BRCA2 gene was found on analysis of DNA from peripheral blood lymphocytes. The present findings show that del(16)(q13) is a recurrent finding among male breast carcinomas and that some of the primary cytogenetic abnormalities, as well as the pattern of chromosomal changes during the progression of sporadic breast carcinoma in the male, are similar to those in the female. In addition, the loss of the Y chromosome in the tumors but not in peripheral blood lymphocytes, suggests a possible role for this abnormality in the pathogenesis of male breast carcinoma.
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| 4. |
- Butt, Salma, et al.
(author)
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Parity in relation to survival following breast cancer.
- 2009
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In: European Journal of Surgical Oncology. - : Elsevier BV. - 1532-2157 .- 0748-7983. ; 35, s. 702-708
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Journal article (peer-reviewed)abstract
- AIM: The present study examines the association between parity and survival following breast cancer diagnosis. METHODS: Medical records of 4453 women diagnosed with breast cancer in Malmö, Sweden, between 1961 and 1991 were analysed. All women were followed until 31 December 2003, using the Swedish Cause-of-Death Registry. Breast cancer specific mortality rate was calculated in different levels of parity. Corresponding relative risks, with 95% confidence intervals (CI), were obtained using Cox's proportional hazards analysis. All analyses were adjusted for potential prognostic factors and stratified for age, menopausal status and diagnostic period. RESULTS: As compared to women with one child, nulliparity (RR 1.27: 95% CI 1.09-1.47), and high parity (four or more children) (1.49: 1.20-1.85) were positively associated with a high mortality from breast cancer. When adjusted for potential confounders, the association was only statistically significant for high parity (1.33: 1.07-1.66). In the analyses stratified on age and menopausal status, there was a similar positive association between high parity and breast cancer death in all strata, although only statistically significant among women older than 45years of age or postmenopausal. Nulliparity was associated with breast cancer death in women that were younger than 45years of age (1.28: 0.79-2.09) or premenopausal (1.30: 0.95-1.80), but these associations did not reach statistical significance. There was no association between nulliparity and breast cancer death in women older than 45years of age or postmenopausal. All associations were similar in analyses stratified for diagnostic period. CONCLUSION: Women with four or more children have a poor breast cancer survival as compared to women with one child.
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| 5. |
- Manjer, Jonas, et al.
(author)
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Breast cancer incidence in relation to smoking cessation
- 2000
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In: Breast Cancer Research and Treatment. - 1573-7217. ; 61:2, s. 121-129
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Journal article (peer-reviewed)abstract
- High plasma levels of oestrogens are associated with increased breast cancer risk. If smoking, as has been suggested, have both a tumour initiating mutagenic effect and a protective anti-oestrogenic effect, one would assume that smokers who give up smoking have the highest incidence of breast cancer. This was evaluated in the follow-up of a cohort of 10,902 women of whom 4,359 were premenopausal. Record-linkage with official cancer registries yielded 416 incident cases during an average follow-up of 13.6 years. The adjusted relative risk in all ex-smokers was 1.31 (1.02-1.69), as compared to never smokers, and in premenopausal ex-smokers it was 1.57 (1.07-2.30). Breast cancer incidence in premenopausal ex-smokers was inversely related to time since cessation, (p for trend = 0.01), and was highest among the women who had given-up smoking less than 12 months before screening: 2.76 (1.55-4.91). There was no significant association between current smoking and breast cancer risk. We conclude that incidence of breast cancer in premenopausal women who have given up smoking is higher than it is in smokers and never smokers. To what extent this may be related to endocrine effects associated with smoking cessation remains to be evaluated.
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| 6. |
- Manjer, Jonas, et al.
(author)
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Intra-urban differences in breast cancer mortality: a study from the city of Malmo in Sweden
- 2000
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In: Journal of Epidemiology and Community Health. - : BMJ. - 1470-2738 .- 0143-005X. ; 54:4, s. 279-285
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Journal article (peer-reviewed)abstract
- STUDY OBJECTIVE: To assess whether in an urban population stage at breast cancer diagnosis is related to area of living and to what extent intra-urban differences in breast cancer mortality are related to incidence respectively stage at diagnosis. DESIGN: National registries were used to identify cases. Mortality in 17 residential areas was studied in relation to incidence and stage distribution using linear regression analysis. Areas with high and low breast cancer mortality, incidence and proportion of stage II+ tumours at diagnosis were also compared in terms of their sociodemographic profile. SETTING: City of Malmo in southern Sweden. PATIENTS: The 1675 incident breast cancer cases and 448 deaths that occurred in women above 45 years of age in Malmo 1986-96. MAIN RESULTS: Average annual age standardised breast cancer mortality ranged between residential areas, from 35/10(5) to 107/10(5), p = 0.04. Mortality of breast cancer was not correlated to incidence, r = 0.22, p = 0.39. The ratio of stage II+/0-I cancer incidence varied between areas from 0.45 to 1.99 and was significantly correlated to breast cancer mortality, r = 0.53, p = 0.03. Areas with high proportion of stage II+ cancers and high mortality/incidence ratio were characterised by a high proportion of residentials receiving income support, being foreigners and current smokers. CONCLUSIONS: Within this urban population there were marked differences in breast cancer mortality between residential areas. Stage at diagnosis, but not incidence, contributed to the pattern of mortality. Areas with high proportion of stage II+ tumours differed unfavourably in several sociodemographic aspects from the city average.
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| 7. |
- Manjer, Jonas, et al.
(author)
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Parity in relation to risk of axillary lymph node involvement in women with breast cancer. Results from Swedish population-based series of 3,472 consecutive cases.
- 2005
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In: European Surgical Research. - : S. Karger AG. - 0014-312X .- 1421-9921. ; 37:3, s. 179-184
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Journal article (peer-reviewed)abstract
- <i>Objective:</i> To investigate the association between parity and axillary lymph node involvement (ALNI) at breast cancer diagnosis. <i>Methods:</i> One surgeon has reviewed all breast cancer cases in Malmö, Sweden, diagnosed 1961–1991. This study includes the 3,472 women who had a first-time diagnosis of unilateral invasive breast cancer, and who had undergone axillary dissection. Information was collected regarding date of birth, date of diagnosis, age at diagnosis, menopausal status, tumour size, histological type, tumour location, type of surgery, stage (ALNI), and parity. Parity was investigated in relation to ALNI using logistic regression analysis, adjusted for potential confounders, yielding odds ratios (OR) with 95% confidence intervals (CI). The analyses were repeated in different strata with regard to birth-years cohort, age at diagnosis, and period of diagnosis. <i>Results:</i> High parity was associated with ALNI, the adjusted OR for ALNI among women with 4 or more children was 1.56 (1.13–2.15). This association was stronger in comparatively old women (≧67.45 years), OR 1.78 (1.10–2.88). Considering parity a continuous variable, the OR for ALNI among all women was 1.06 (1.01–1.12). <i>Conclusions:</i> We conclude that women with 4 or more children had an increased risk of ALNI at breast cancer diagnosis.
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| 8. |
- Manjer, Jonas, et al.
(author)
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Survival of women with breast cancer in relation to smoking
- 2000
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In: European Journal of Surgery. - : Oxford University Press (OUP). - 1102-4151. ; 166:11, s. 852-858
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To compare survival of patients with breast cancer who had never smoked, were smokers, and who were ex-smokers. DESIGN: Observational study. SETTING: City of Malmo, Sweden. PATIENTS: 792 patients with breast cancer diagnosed between 1977-1986 in the Malmo mammographic screening trial. INTERVENTIONS: Follow-up of breast cancer cases through record-linkage with the Swedish Cause of Death Registry. MAIN OUTCOME MEASURES: Death from breast cancer. Relative risk (RR) with 95% confidence interval (CI) of death from breast cancer was calculated for different smoking groups using Cox's proportional hazards analysis. RESULTS: During a mean follow-up of 12.1 years, 145 patients died of breast cancer. Breast cancer mortality was 1347/10(5) person-years in those who had never smoked, 1941/10(5) in smokers, and 1493/10(5) in ex-smokers. The crude RR for smokers and ex-smokers, compared with those who had never smoked were 1.44 (1.01 to 2.06) and 1.13 (0.66 to 1.94), respectively. The RR associated with smoking remained significant after adjustment for age and stage at diagnosis, 2.14 (1.47 to 3.10), and other potential confounders. CONCLUSIONS: Survival after breast cancer was, as expected, strongly related to stage at diagnosis. However, stage by stage there was considerable variation between individual patients. We conclude that differences with regard to exposure to smoking contribute to this heterogeneity.
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| 9. |
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| 10. |
- Olsson, A, et al.
(author)
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Body mass index and breast cancer survival in relation to the introduction of mammographic screening.
- 2009
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In: European Journal of Surgical Oncology. - : Elsevier BV. - 1532-2157 .- 0748-7983. ; 35, s. 1261-1267
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Journal article (peer-reviewed)abstract
- AIMS: Mammographic screening reduces mortality in breast cancer. It is not known if this reduction is more pronounced in certain groups. Obesity has been associated with worse survival following breast cancer diagnosis. This study investigates BMI in relation to breast cancer mortality, and if this association is affected by invitation to mammographic screening. METHODS: In 1976, a randomised mammographic screening trial, inviting 50% of all women aged 45-69 years (n=42 283), was set up in Malmö, Sweden. BMI in relation to breast cancer mortality was examined separately in women invited or not invited to screening in the trial. The analyses also included a historical control-group diagnosed before the screening trial. The study included 2974 women diagnosed in 1961-1991. Relative risks (RR) with a 95% confidence interval was obtained from a Cox proportional hazard analysis and in the analysis of all women, follow-up was limited to 10 years. RESULTS: Obese women (BMI>/=30) not invited to mammographic screening had a higher adjusted RR of dying of breast cancer as compared to normal weight women (2.08:1.13-3.81) in the 10-year follow-up. In women invited to screening there was no association between BMI and breast cancer mortality. In the historical control group, mortality was increased in overweight women (BMI: 25-30), RR=1.27:0.99-1.62, and obese women, RR=1.32:0.94-1.84, but these associations totally disappeared in the multivariate analysis, following adjustment for tumour size and stage. CONCLUSIONS: Overweight and obese women may be a group that profit from mammographic screening to more than normal weight women.
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