Document Type : Original Article


1 Department of Epidemiology, Shahroud University of Medical Sciences, Shahroud

2 Department of Radiotherapy Oncology, Breast Cancer Study Group, Seiedo-Shohada Hospital

3 Department of Internal Medicine, Breast Cancer Study Group, School of Medicine,

4 Department of Surgery, Breast Cancer Study Group, Seiedo-Shohada Hospital

5 Research Center for Modeling in Health, Institute for Futures Studies in Health, Department of Epidemiology and Biostatistics, Kerman University of Medical Sciences, Kerman, Iran

6 Department of Pathology, Breast Cancer Study Group, Seiedo-Shohada Hospital


Background: Breast cancer is the most prevalent type of cancer among Iranian females;
it is noteworthy that the condition of this type of cancer among Iranian women does not
significantly differ from what has been reported from other countries. Considering the
importance of this issue, identification of the backgrounds factors and risk factors of the
breast cancer risk are highly needed. Therefore, the present study is aimed to compare
the risk factors of resident patients of Isfahan province, Iran, with accredited risk factors by
other countries and also identify the importance of each factor in the incidence of cancer.
Materials and Methods: The present work is a case-control study, which was conducted
in 2011. In order to conduct the study, 216 women who had been clinically identified with
breast cancer were selected from Seiedo-Shohada Hospital, Isfahan, Iran, as the case group.
Moreover, 41 healthy women who were the relatives of the selected patients (i.e., sisters and
aunts) were selected as the control group. The data and information of the patients from
1999 to 2010 were collected from either assessing the database system of the center for breast
cancer research or interviewing the patients through phone. To analyze the data, multiple
logistic regression method was applied. Results: The range of age among selected individuals
in this study was from 20-75 years old. The determinant factors for odds of breast cancer
included in the applied multiple logistic regression model were the use of oral contraceptive
pills (OCPs) (odds ratio [OR] =0.18, 95% confidence interval [CI] = 0.04-0.75) as the protective
factor, hormone replacement therapy (OR = 10.2, 95% CI = 1.18-88.89) and menopause at
old age (OR = 1.26, 95% CI = 1.11-2.12) as the risk factors. Furthermore, there was not seen
any significant relationship between age, vocation, and marital status with odds of breast
cancer in multiple model. Conclusion: Based
on the results, use of OCPs as protective
factor, hormone replacement therapy, and
menopause at old age are identified as the
risk factors in developing breast cancer
among women. Influencing and modifiable
factors should be considered very important
in society based interventions and preventive
interventions planning.


1. Akbari ME. Iran Cancer Report. Tehran: Cancer Research Center,
Shahid Beheshti University of Medical Sciences, Qom, Dar‑olfekr;
2. Naghavi M. Profile of death in 23 provenances of Iran. Tehran:
Deputy of Health, Ministry of Health and Medical Education; 2004.
3. Naghavi M. Profile of death in 18 provenances of Iran. Tehran:
Deputy of Health, Ministry of Health and Medical Education, Tandis;
1382. p. 75.
4. Byers T, Graham S, Rzepka T, Marshall J. Lactation and breast
cancer. Evidence for a negative association in premenopausal
women. Am J Epidemiol 1985;121:664‑74.
5. Nojomi M, Mirfakhraee R, Hosseini N. Relationship between
hormonal factors and breast cancer. J Hakim 1383;7:19‑25.
6. Ozmen V. Brest cancer in the world and Turkey. J Breast Health
7. Fidaner C, Eser SY, Parkin DM. Incidence in Izmir in 1993‑1994: First
results from Izmir Cancer Registry. Eur J Cancer 2001;37:83‑92.
8. Kuru B, Ozaslan C, Ozdemir P, Dinç S, Camlibel M, Alagöl H. Risk
factors for breast cancer in Turkish women with early pregnancies
and long‑lasting lactation – A case‑control study. Acta Oncol
9. Lambe M, Hsieh CC, Chan HW, Ekbom A, Trichopoulos D,
Adami HO. Parity, age at first and last birth, and risk of breast
cancer: A population‑based study in Sweden. Breast Cancer Res
Treat 1996;38:305‑11.
10. Clavel‑Chapelon F, E3N‑EPIC Group. Differential effects of reproductive
factors on the risk of pre‑ and postmenopausal breast cancer. Results
from a large cohort of French women. Br J Cancer 2002;86:723‑7.
11. Yang L, JacobsenKH. A systematic review of the association between
breastfeeding and breast cancer. J Womens Health (Larchmt)
12. Ozmen V, Ozcinar B, Karanlik H, Cabioglu N, Tukenmez M, Disci R,
et al. Breast cancer risk factors in Turkish women – A University
Hospital based nested case control study. World J Surg Oncol
13. Beji NK, Reis N. Risk factors for breast cancer in Turkish women:
A hospital‑based case‑control study. Eur J Cancer Care (Engl)
14. Lupulescu A. Estrogen use and cancer incidence: A review. Cancer
Invest 1995;13:287‑95.
15. Rosenblatt KA, Gao DL, Ray RM, Rowland MR, Nelson ZC, Wernli KJ,
et al. Induced abortions and the risk of all cancers combined
and site‑specific cancers in Shanghai. Cancer Causes Control
16. Michels KB, Xue F, Colditz GA, Willett WC. Induced and spontaneous
abortion and incidence of breast cancer among young women:
A prospective cohort study. Arch Intern Med 2007;167:814‑20.
17. Brewster DH, Stockton DL, Dobbie R, Bull D, Beral V. Risk of
breast cancer after miscarriage or induced abortion: A Scottish
record linkage case‑control study. J Epidemiol Community Health
18. Reeves GK, Kan SW, Key T, Tjønneland A, Olsen A, Overvad K,
et al. Breast cancer risk in relation to abortion: Results from the
EPIC study. Int J Cancer 2006;119:1741‑5.
19. Oran B, Celik I, Erman M, Baltali E, Zengin N, Demirkazik F, et al.
Analysis of menstrual, reproductive, and life‑style factors for breast
cancer risk in Turkish women: A case‑control study. Med Oncol
20. Becher H, Schmidt S, Chang‑Claude J. Reproductive factors
and familial predisposition for breast cancer by age 50 years.
A case‑control‑family study for assessing main effects and possible
gene‑environment interaction. Int J Epidemiol 2003;32:38‑48.
21. Travis RC, Key TJ. Oestrogen exposure and breast cancer risk.
Breast Cancer Res 2003;5:239‑47.
22. Ross RK, Paganini‑Hill A, Wan PC, Pike MC. Effect of hormone
replacement therapy on breast cancer risk: Estrogen versus
estrogen plus progestin. J Natl Cancer Inst 2000;92:328‑32.
23. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C,
Stefanick ML, et al. Risks and benefits of estrogen plus progestin
in healthy postmenopausal women: Principal results From the
Women’s Health Initiative randomized controlled trial. JAMA
24. von Euler‑Chelpin M. Breast cancer incidence and use of
hormone therapy in Denmark 1978‑2007. Cancer Causes Control
25. Zhu H, Lei X, Feng J, Wang Y. Oral contraceptive use and risk of
breast cancer: A meta‑analysis of prospective cohort studies. Eur
J Contracept Reprod Health Care 2012;17:402‑14.
26. Anothaisintawee T, Wiratkapun C, Lerdsitthichai P, Kasamesup V,
Wongwaisayawan S, Srinakarin J, et al. Risk factors of breast cancer:
A systematic review and meta‑analysis. Asia Pac J Public Health