Study of risk factors associated with breast cancer: a case control study

Ashok R. Jadhao, B. K. Sharma, Sanjivani A. Jadhao, Hitesh C. Tayade


Background: Developing countries are facing double burden of infectious and non-communicable diseases. Omran gave epidemiological transition theory, which can be seen in India also. Lifestyle changes made Indian prone to non-communicable diseases. Cancer is among the most common non communicable diseases in India. Breast cancer contributes one fourth of all cancer burden in India. It is noted that more number of cases are being seen in 25 to 40 years age group. Objective of the study was to study risk factor associated with breast cancer.

Methods: Hospital based case control study was conducted in tertiary cancer centre from July 2017 to December 2019. Sample size of 96 cases was calculated, though 100 cases was interviewed and similar number of age group matched controls was selected. Sociodemographic, past history of benign breast lesion, family history of breast cancer, body mass index, waist to hip ratio and reproductive risk factors was assessed.

Results: The significant risk factors on multiple logistic regression were (adjusted odds ratios with 95% CI) age at menarche ≤11 years (1.16, 1.025–1.451), waist to hip ratio more than 0.85 (1.61, 1.473–1.963) and history of abortion (1.14, 1.006–1.366).

Conclusions: Women with early age of menarche, higher waist to hip ratio and history of abortion were found to be at higher risk of developing breast cancer. Annual screening of high risk women, teaching self-breast examination to all women and promoting physical activity to maintain waist to hip ratio less than 0.85 should be done.


Breast cancer, Case control study, Risk factors

Full Text:



Amuna P, Zotor FB. Epidemiologic and Nutritional Transition in developing countries: impact on human health and development. Proceedings of The Nutrition Society. 2008;67(1):82-90.

Detels R, Breslow L. Current scope and concerns in public health. In Oxford Textbook Public Health. Oxford: Oxford University Press. 1997;1:3-17.

Omran AR. The Epidemiologic Transition: a theory of epidemiology of population change. Milbank Q49. 1971;509-38.

India State-Level Disease Burden Initiative Collaborators: Nations within a nation: Variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet. 2017;390:2437-60.

Indian Council of Medical Research, Public Health Foundation of India, Institute for Health Metrics and Evaluation: GBD India Compare Data Visualization: New Delhi—ICMR, PHFI, and IHME, 2017. Available at: Accessed on 20 November 2020.

Gersten O, Wilmoth JR. The cancer transition in Japan since 1951. Demogr Res. 2002;7:271-306.

Bentall WC: Cancer in Travancore: A resume of 1,700 cases. Ind Med Gaz. 1908;43:452-8.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.

Consolidated Report of the Hospital Based Cancer Registries 2012–2014, Three Year Report of the Population Based Cancer Registries. Available at: Accessed on 20 November 2020.

Malvia S, Bagadi SA, Dubey US, Saxena S. Epidemiology of breast cancer in Indian women. Asia Pac J Clin Oncol. 2017;13(4):289-95.

Breast Cancer in Nagpur. Available at: Accessed on 30 November 2019.

Maurice C. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016. A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2018;4(11):1553-68.

Tomasetti C, Li L, Vogelstein B. Stem cell divisions, somatic mutations, cancer etiology, and cancer prevention. Science. 2017;355:1330-4.

Ziegler RG, Hoover RN, Pike MC. Migration patterns and breast cancer risk in Asian-American women. J Natl Cancer Inst. 1993;85:1819-27.

Brinton LA, Gaudet MM, Gierach GL. Breast cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D, eds. Cancer Epidemiology and Prevention. 4th ed. New York: Oxford University Press. 2018;861-88.

Breast cancer: Prevention and Control. Available at: cancer/detection/breastcancer/en/index3.html. Accessed on 14 January 2014.

Balasubramaniam SM, Rotti SB, Vivekanandam S. Risk factors of female breast carcinoma: a case control study at Puducherry. Indian J Cancer. 2013;50(1):65-70.

Sharma R. Revision of Prasad's social classification and provision of an online tool for real-time updating. South Asian J Cancer. 2013;2(3):157.

WHO expert consultation. Appropriate body-mass index in Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63.

Kamath R, Mahajan KS, Ashok L, Sanal TS. A study on risk factors of breast cancer among patients attending the tertiary care hospital, in udupi district. Indian J Community Med. 2013;38(2):95-9.

Pakseresht S, Ingle GK, Bahadur AK, Ramteke VK, Singh MM, Garg S, Agarwal PN. Risk factors with breast cancer among women in Delhi. Indian J Cancer. 2009;46(2):132-8.

Antony MP, Surakutty B, Vasu TA, Chisthi M. Risk factors for breast cancer among Indian women: A case-control study. Niger J Clin Pract. 2018;21(4):436-42.

Okobia MN, Bunker CH, Okonofua FE, Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer: A cross-sectional study. World J Surg Oncol. 2006;4:11.

Vidya DC, Shalini CN, Nandakumar BS, Murthy NS, Nagnoor I. Risk factors associated with breast cancer among women attending a tertiary care hospital in Bangalore : a case control study. 2018;5(12):5413-9.

Lodha R, Joshi A, Paul D, Lodha KM, Nahar N, Shrivastava A, Bhagat VK, Nandeshwar S. Association between reproductive factors and breast cancer in an urban set up at central India: a case-control study. Indian J Cancer. 2011;48(3):303-7.

Agrawal KH, Rajderkar SS. Clinico-Epidemiological Profile of Female Breast Cancers and Its Important Correlates: a Hospital Based Study. 2012;3(2):316-20.

Gajalakshmi V, Mathew A, Brennan P, Rajan B, Kanimozhi VC, Mathews A, Boffetta P. Breastfeeding and breast cancer risk in India : A multicenter case-control study. 2009;665:662-5.

Yavari P, Mosavizadeh M, Sadrol-Hefazi B, Mehrabi Y. Reproductive characteristics and the risk of breast cancer - A case-control study in Iran. Asian Pac J Cancer Prev. 2005;6(3):370-5.

Das S, Sen S, Mukherjee A. Risk factors of breast cancer among women in eastern India: A tertiary hospital based case control study. Asian Pacific J Cancer Prev. 2012;13(10):4979-81.

Datta K, Biswas J. Influence of Dietary habits, Physical Activity and Affluence Factors on Breast cancer in East India - A Case-Control Study, Asian Pacific J Cancer Prev. 2009;10:219-22.

Ozmen V, Ozmen V, Ozcinar B, Karanlik H. Breast cancer risk factors in Turkish women - a University Hospital based nested case control study. World J Surg Oncol. 2009;7(37):1-8.

Sepandi M, Akrami M, Tabatabaee H. Breast cancer risk factors in women participating in a breast screening program: a study on 11,850 Iranian females. Asian Pacific J Cancer Prev. 2014;15(19):8499-502.

Meshram II, Hiwarkar PA, Kulkarni PN. Reproductive Risk Factors for Breast Cancer: A Case Control Study. Online J Health Allied Sci. 2009;8(3):5.

Nagrani R, Mhatre S, Rajaraman P, Soerjomataram I. Science Direct Central obesity increases risk of breast cancer irrespective of menopausal and hormonal receptor status in women of South Asian Ethnicity. Eur J Cancer. 2016;66:153-61.

Wang F, Liu L, Cui S, Tian F, Fan Z, Geng C, et al. Distinct Effects of Body Mass Index and Waist/Hip Ratio on Risk of Breast Cancer by Joint Estrogen and Progestogen Receptor Status: Results from a Case-Control Study in Northern and Eastern China and Implications for Chemoprevention. Oncologist. 2017;22(12):1431-43.

Bhadoria AS, Kapil U, Sareen N, Singh P, Bhadoria A. Reproductive factors and breast cancer: A case-control study in tertiary care hospital of North India. Indian J Cancer. 2013;50(4):316.

Montazeri A, Sadighi J, Farzadi F. Weight, height, body mass index and risk of breast cancer in portmenopausal women: a case control study. BMC Cancer. 2008;8(278):1-7.

Mohite V, Pratinidhi A, Mohite R. Reproductive risk factors and breast cancer: a case control study from rural India. Bangl J Med Sci. 2015;14(3):258-64.

Rajbongshi N, Mahanta LB, Nath DC. A Matched Case Control Study of Risk Indicators of Breast cancer in Assam, India. Myemensingh Med J. 2015;24(2):385-91.

Takalkar U, Asegaonkar S, Kodlikeri P, Kulkarni U, Borundiya V, Advani S. Hormone Related Risk Factors and Breast Cancer : Hospital Based Case Control Study from India. 2014.