Risk Factors for Human Breast Cancer (3f I): High Birth Weight

Stand / Letzte Aktualisierung durch Elisabeth Rieping 2004/07/27

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That early years of life might be important for developing breast cancer got suspected since age at menarche had been described as an important risk
factor for the disease. Very early even prenatal influences acting during intrauterine life came under suspicion only recently [i],[ii].

Preclampsia/eclampsia, prematurity and birth weight became studied[iii].

High birth weight as a risk factor for breast cancer was seen examining prenatal factors in women born in the Uppsala University Hospital between
1874 and 1954.

Those who according to Swedish Cancer Registry developed breast cancer between 1958 and 1990 were compared with controls selected from
females born by mothers who where admitted directly after the probands to the wards of the Uppsala University Hospital.

The results showed history of preclampsia /eclampsia during pregnancy to be connected with a lower breast cancer rate in the offspring.

Weaker results in the same study showed a positive connection of high birth weight and breast cancer incidence. But this risk factor was confirmed
in several studies [iv],[v],[vi],[vii],[viii],[ix],[x],[xi],[xii],[xiii] in different areas as were USA, Norway, Britain, and Denmark.

The result raises interest in the search for factors which influence birth weight and which might influence breast cancer risk too.

One answer comes from a study with 513 London mothers. The dimensions of babies, their birth weight and head circumference was compared with
the diet of their mothers. Among other nutritients, but not for total intake of energy, the diet of mothers with low birth weight babies was poorer in
dairy products than those of heavier newborns[xiv].

In the East African pastoral tribes which original kept a diet of cow’s blood and cow’s milk, women exclude cow’s milk from their diet during late
pregnancy, because they fear birth complications, if they drink to much milk or milk products. They think that the fetus gets to big for an easy
delivery if the mother includes milk in the diet. Especially the bones of the head are expected to be to mature to allow birth without complication.
So that the head will traumatize the birth channel while passing it.

In this connection one should remember that for example in Germany, where women are encouraged to drink milk and eat milk products during
pregnancy, because this food is thought to be especially healthy, episiotomy is a standard prophylaxis in the majority of deliveries to avoid perineal
laceration.

Of cause, in Western countries the necessity of episiotomy is no problem. And it is not even seen as a birth complication, but as a standard
procedure.

For a women in East Africa without access to episiotomy the risks of perineal laceration is one, worth to avoid it by diet restriction.

It is possible that the positiv correlation between higher birth weight and later breast cancer incidence reflects the dairy product intake of the
mothers who give birth to infants with high birth weight and who by this habit of milk consumption offer a route for some milk born factor which is
associated with breast cancer incidence.

Hints that prenatal bovine protein consumption may influence late disease incidence comes from animal models, too.

In the last years, initiated by studies on the risk of Insulin Dependent Diabetes Mellitus IDDM and infant nutrition, especially the some times
observed different risk for breast and bottle-fed infants, it was tried to look at animal models on the influence of infant nutrition and IDDM in
animals.

There are two often used models of IDDM . The Non Obese Diabetic Mouse short NOD mouse and the BB rat.

The NOD mouse is an inbred Japanese derived albino mouse. 25 -30% of the female Nod animals develop IDDM between 120 and 200 days of life,
when fed on the laboratory y mouse chow.

This mouse chow contains wheat, barley, meat and bone meal derived from cows, pigs and sheep and includes offal and is also supplemented with
minerals, trace elements and vitamins.[xv]

Meat and bone meal is something which came in connection with the mad cow disease to the knowledge of a bigger audience and what probably
used to enriched the animal diet in a cheap way with animal protein.
If this meat and bone meal in the diet is replaced by a diet free of complete protein which instead contains protein hydrolysate containing only
amino acids, the diabetes prone animals have difficulties to develop the disease.

Concerning the above outlined hypothesis of connections between maternal consumption of milk products, birth weight and cancer risk and early
contact and breast cancer incidence the following is especially interesting. Although the protein free diet exerts its protecting effect, if started just
before weaning[xvi], its influence is bigger if the diet is started by the mother beginning with conception of the tested litters131 .

The BB rat another animal prone to develop diabetes was shown to be protected too from developing this disease by the introduction of a protein
free diet shortly after weaning [xvii] .

[i] Epidemiologic evidence of perinatal influence in the etiology of adult cancers. Janerich DT, Hayden CL, Thompson WD, Selenkas SL, Mettlin
C. J Clin epidemiol 1989; 42: 151-7.

[ii] Hypothesis: does breast cancer originate in utero? Trichopoulos D. Lancet. 1990 Apr 1;335(8695):939-40.

[iii] Evidence of prenatal influences on breast cancer risk. Ekbom A, Trichopolous D, Adami H, Hsieh C, Lan S, Lancet 1992, 340:1015-8

[iv] Perinatal factors and the risk of breast cancer.Sanderson M,Williams MA, Malone KE, Epidemiology 1996, 7:34-37 .

[v] Birthweight as a risk factor for breast cancer. Michels KB, Trichopoulos D, Robins JM, Rosner BA, Manson JE, Hunter DJ, Colditz GA, Hankinson SE, Speizer FE, Willett
WE, Lancet 1996, 348:1542-6.

[vi] Birthweight, childhood growth and risk of breast cancer in a British cohort.Stavola BL, Hardy R, Kuh D, Silva IS, Wadsworth M, Swerdlow
AJ.Br J Cancer. 2000 Oct;83(7):964-8.

[vii] Associations of adult measures of childhood growth with breast cancer: findings from the British Women's Heart and Health Study.Lawlor DA, Okasha M, Gunnell D,
Smith GD, Ebrahim S. Br J Cancer. 2003 Jul 7;89(1):81-7.
[viii] Birth characteristics and subsequent risk for breast cancer in very young women.Innes K, Byers T, Schymura M.Am J Epidemiol. 2000 Dec
15;152(12):1121-8.

[ix] Cancer risk in Swedish women: the relation to size at birth. Andersson SW, Bengtsson C, Hallberg L, Lapidus L, Niklasson A, Wallgren A,
Hulthen L.Br J Cancer. 2001 May 4;84(9):1193-8.

[x] Fetal growth and subsequent risk of breast cancer: results from long term follow up of Swedish cohort.McCormack VA, dos Santos Silva I, De
Stavola BL, Mohsen R, Leon DA, Lithell HO.BMJ. 2003 Feb 1;326(7383):248.

[xi] Birth weight as a predictor of breast cancer: a case-control study in Norway.

Vatten LJ, Maehle BO, Lund Nilsen TI, Tretli S, Hsieh CC, Trichopoulos D, Stuver SO. Br J Cancer. 2002 Jan 7;86(1):89-91.

[xii] Birth weight and risk of early-onset breast cancer (Denmark).Mellemkjaer L, Olsen ML, Sorensen HT, Thulstrup AM, Olsen J, Olsen
JH.Cancer Causes Control. 2003 Feb;14(1):61-4.

[xiii] Birth weight and risk of breast cancer in a cohort of 106,504 women.
Int J Cancer. 2003 Dec 20;107(6):997-1000.Ahlgren M, Sorensen T, Wohlfahrt J, Haflidadottir A, Holst C, Melbye M.

[xiv] The association of maternal social class with maternal diet and the dimensions babies in a plopulation of London women. Wynn SW, Wynn
AH, Doyle W, Crawford MA, Nutr Health, 1994, 9:303-15.

[xv] Acombined casein-free-nicotinamide diet prevents diabetes in the NOD mouse with minimum insulinitis. Reddy S, Bibby NJ, Wu D, Swinney
C, Barrow G, Elliot RB, Diabetes Research and Clinical Practise 1995,29: 83-92

[xvi] Dietary Prevention of diabetites in the non-obese diabetic mouse. Elliott RB, Reddy SN, Bibby NJ, Kida K. Diabetologia 1988,31:62-64

[xvii] Dietary Protein: a trigger of insulin-dependent diabetes in the BB rat? ElliottRB, Martin JM, Diabetologia 1984, 26: 297-9

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