Female breast cancer mortality in relation to puberty on Staten Island, New York

Pursuant to a Congressional act in 2008, the Department of Health and Human Services established the Interagency Breast Cancer and Environmental Research Coordinating Committee to address the burden of breast cancer in the United States. Subsequently, the Committee recommended researchers study the timing of exposure to breast cancer risk factors. Given the high breast cancer mortality rate on Staten Island, this paper presents a case-control study investigating breast cancer risk associated with puberty while living on Staten Island. The dataset combined New York City Department of Health and Mental Hygiene female death certificate information between 1985 and 2006, with life history information from newspaper obituaries. Data analyzed included: age, length of residence on Staten Island, birth on Staten Island, and residence on Staten Island during puberty. Cases were individuals who died of breast cancer and controls were individuals who died of non-malignant causes. Analysis included multivariate logistic regression on the full dataset and multiple replicates of randomized one case to two controls simulations. Results indicated that living on Staten Island during puberty (ages 9-19) was associated with an elevated risk of dying from breast cancer (odds ratio 1.35, p < 0.001, 95% CI = 1.18, 1.55). This paper suggests the importance of studying puberty as a window of susceptibility for breast cancer risk.