Role of reproductive factors in breast cancer in a low-risk area: a case–control study

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Abstract
A case-control study of 689 breast cancer patients seen at Tata Memorial Hospital during the period 1980-84 was carried out. During the same period 711 females who attended the hospital without a history of benign breast lesions or gynaecological complaints were selected as controls. Patients were interviewed by trained investigators to collect data on reproductive factors, menstrual history, tobacco smoking and chewing habit, dietary practices (vegetarian and non-vegetarian diet) and alcohol consumption. Cases and controls were stratified into four age groups (< 35 years, 35-44, 45-54 and 55+ years) and three places of residence (Bombay, Maharashtra, others). The adjusted relative risk (RR) for unmarried women compared with married women was 2.3. Nulliparous women had a 2.2-fold higher risk than parous women. Late age at marriage (30 years and above) and late age at first pregnancy (30 years and above) showed excess risks of 2.5 and 5.4 compared with women married at the age of 14 years and age at first pregnancy of < or = 14 years. Three or more pregnancies was associated with a 40-50% reduction in risk (P < 0.01). Non-vegetarian diet, literacy status and a history of stillbirth and abortion did not emerge as significant risk factors for breast cancer in our study. These findings, in a low-risk population, were consistent with those reported from high-risk populations.