Nativity-specific odds ratios were obtained using conditional logistic regression, conditioning on five-year age groups, separately for US-born and foreign-born Hispanic women in SFBCS, with independent variables shown in Table 1. Specifically, the log-relative odds main effects model included the following risk factors as of the reference year (ie, the calendar year before diagnosis for case patients or before selection into the study for control participants age at first full-term pregnancy (0 = <20 years, 1 = 20–29 years, 2 = ≥30 years or nulliparous); age at menarche (2 = <12 years, 1 = 12–13 years, and 0 = ≥14 years); history of first-degree relatives with breast cancer (0 = no relatives, 1 = ≥1 relatives); history of biopsy with benign breast disease (0 = no biopsy, 1 = ≥1 biopsies). Age (in five-year age categories) was included to account for matching. The value of the log odds corresponding to variables in Table 1 and their estimated variance-covariance matrix are shown in Supplementary Table 1 (available online). The Supplementary Methods (available online) give additional details on coding and variable selection.
Multivariable relative risk estimates for US-born and foreign-born Hispanic women from the San Francisco Area Breast Cancer Study*
US-born Hispanics . | RR (95% CI) . | No. of case patients (n = 533) . | No. of control patients (n = 464) . |
---|---|---|---|
Risk factor (assigned code) . | |||
Age at first full-term pregnancy (AFP), y | |||
<20 (0) | 1.0 (Referent) | 124 | 134 |
20–29 (1) | 1.26 (1.05 to 1.52) | 280 | 242 |
≥30/nulliparous (2) | 1.59 (1.10 to 2.31) | 129 | 88 |
Biopsy for benign breast disease (BIOP) | |||
No (0) | 1.0 (Referent) | 431 | 385 |
Yes (1) | 1.10 (0.79 to 1.53) | 102 | 79 |
Family history of breast cancer in first-degree female relatives (FH) | |||
No (0) | 1.0 (Referent) | 445 | 396 |
Yes (1) | 1.18 (0.83 to 1.68) | 88 | 68 |
Foreign-born Hispanics | RR (95% CI) | No. of case patients (n = 553) | No. of control patients (n = 947) |
Risk factor (assigned code) | |||
Age at first full-term pregnancy (AFP), y | |||
<20 (0) | 1.0 (Referent) | 100 | 267 |
20–29 (1) | 1.60 (1.35 to 1.88) | 307 | 526 |
≥30/nulliparous (2) | 2.54 (1.84 to 3.53) | 146 | 154 |
Biopsy for benign breast disease (BIOP) | |||
No (0) | 1.0 (Referent) | 468 | 856 |
Yes (1) | 1.62 (1.16 to 2.24) | 85 | 49 |
Family history of breast cancer in first-degree female relatives (FH) | |||
No (0) | 1.0 (Referent) | 486 | 898 |
Yes (1) | 2.48 (1.67 to 3.68) | 85 | 49 |
Age at menarche (MEN), y | |||
≥14 (0) | 1.0 (Referent) | 165 | 370 |
12–13 (1) | 1.30 (1.12 to 1.50) | 248 | 391 |
<12 (2) | 1.68 (1.26 to 2.25) | 140 | 186 |
US-born Hispanics . | RR (95% CI) . | No. of case patients (n = 533) . | No. of control patients (n = 464) . |
---|---|---|---|
Risk factor (assigned code) . | |||
Age at first full-term pregnancy (AFP), y | |||
<20 (0) | 1.0 (Referent) | 124 | 134 |
20–29 (1) | 1.26 (1.05 to 1.52) | 280 | 242 |
≥30/nulliparous (2) | 1.59 (1.10 to 2.31) | 129 | 88 |
Biopsy for benign breast disease (BIOP) | |||
No (0) | 1.0 (Referent) | 431 | 385 |
Yes (1) | 1.10 (0.79 to 1.53) | 102 | 79 |
Family history of breast cancer in first-degree female relatives (FH) | |||
No (0) | 1.0 (Referent) | 445 | 396 |
Yes (1) | 1.18 (0.83 to 1.68) | 88 | 68 |
Foreign-born Hispanics | RR (95% CI) | No. of case patients (n = 553) | No. of control patients (n = 947) |
Risk factor (assigned code) | |||
Age at first full-term pregnancy (AFP), y | |||
<20 (0) | 1.0 (Referent) | 100 | 267 |
20–29 (1) | 1.60 (1.35 to 1.88) | 307 | 526 |
≥30/nulliparous (2) | 2.54 (1.84 to 3.53) | 146 | 154 |
Biopsy for benign breast disease (BIOP) | |||
No (0) | 1.0 (Referent) | 468 | 856 |
Yes (1) | 1.62 (1.16 to 2.24) | 85 | 49 |
Family history of breast cancer in first-degree female relatives (FH) | |||
No (0) | 1.0 (Referent) | 486 | 898 |
Yes (1) | 2.48 (1.67 to 3.68) | 85 | 49 |
Age at menarche (MEN), y | |||
≥14 (0) | 1.0 (Referent) | 165 | 370 |
12–13 (1) | 1.30 (1.12 to 1.50) | 248 | 391 |
<12 (2) | 1.68 (1.26 to 2.25) | 140 | 186 |
Estimates obtained from multivariable conditional logistic regression models separately for US-born and foreign-born Hispanic women, with risk factors coded as shown. The overall relative risk of developing invasive breast cancer, compared with an individual of the same nativity with all risk factors at their lowest risk level, is estimated by multiplying the relative risks across risk factors. CI = confidence interval; RR = relative risk.
Multivariable relative risk estimates for US-born and foreign-born Hispanic women from the San Francisco Area Breast Cancer Study*
US-born Hispanics . | RR (95% CI) . | No. of case patients (n = 533) . | No. of control patients (n = 464) . |
---|---|---|---|
Risk factor (assigned code) . | |||
Age at first full-term pregnancy (AFP), y | |||
<20 (0) | 1.0 (Referent) | 124 | 134 |
20–29 (1) | 1.26 (1.05 to 1.52) | 280 | 242 |
≥30/nulliparous (2) | 1.59 (1.10 to 2.31) | 129 | 88 |
Biopsy for benign breast disease (BIOP) | |||
No (0) | 1.0 (Referent) | 431 | 385 |
Yes (1) | 1.10 (0.79 to 1.53) | 102 | 79 |
Family history of breast cancer in first-degree female relatives (FH) | |||
No (0) | 1.0 (Referent) | 445 | 396 |
Yes (1) | 1.18 (0.83 to 1.68) | 88 | 68 |
Foreign-born Hispanics | RR (95% CI) | No. of case patients (n = 553) | No. of control patients (n = 947) |
Risk factor (assigned code) | |||
Age at first full-term pregnancy (AFP), y | |||
<20 (0) | 1.0 (Referent) | 100 | 267 |
20–29 (1) | 1.60 (1.35 to 1.88) | 307 | 526 |
≥30/nulliparous (2) | 2.54 (1.84 to 3.53) | 146 | 154 |
Biopsy for benign breast disease (BIOP) | |||
No (0) | 1.0 (Referent) | 468 | 856 |
Yes (1) | 1.62 (1.16 to 2.24) | 85 | 49 |
Family history of breast cancer in first-degree female relatives (FH) | |||
No (0) | 1.0 (Referent) | 486 | 898 |
Yes (1) | 2.48 (1.67 to 3.68) | 85 | 49 |
Age at menarche (MEN), y | |||
≥14 (0) | 1.0 (Referent) | 165 | 370 |
12–13 (1) | 1.30 (1.12 to 1.50) | 248 | 391 |
<12 (2) | 1.68 (1.26 to 2.25) | 140 | 186 |
US-born Hispanics . | RR (95% CI) . | No. of case patients (n = 533) . | No. of control patients (n = 464) . |
---|---|---|---|
Risk factor (assigned code) . | |||
Age at first full-term pregnancy (AFP), y | |||
<20 (0) | 1.0 (Referent) | 124 | 134 |
20–29 (1) | 1.26 (1.05 to 1.52) | 280 | 242 |
≥30/nulliparous (2) | 1.59 (1.10 to 2.31) | 129 | 88 |
Biopsy for benign breast disease (BIOP) | |||
No (0) | 1.0 (Referent) | 431 | 385 |
Yes (1) | 1.10 (0.79 to 1.53) | 102 | 79 |
Family history of breast cancer in first-degree female relatives (FH) | |||
No (0) | 1.0 (Referent) | 445 | 396 |
Yes (1) | 1.18 (0.83 to 1.68) | 88 | 68 |
Foreign-born Hispanics | RR (95% CI) | No. of case patients (n = 553) | No. of control patients (n = 947) |
Risk factor (assigned code) | |||
Age at first full-term pregnancy (AFP), y | |||
<20 (0) | 1.0 (Referent) | 100 | 267 |
20–29 (1) | 1.60 (1.35 to 1.88) | 307 | 526 |
≥30/nulliparous (2) | 2.54 (1.84 to 3.53) | 146 | 154 |
Biopsy for benign breast disease (BIOP) | |||
No (0) | 1.0 (Referent) | 468 | 856 |
Yes (1) | 1.62 (1.16 to 2.24) | 85 | 49 |
Family history of breast cancer in first-degree female relatives (FH) | |||
No (0) | 1.0 (Referent) | 486 | 898 |
Yes (1) | 2.48 (1.67 to 3.68) | 85 | 49 |
Age at menarche (MEN), y | |||
≥14 (0) | 1.0 (Referent) | 165 | 370 |
12–13 (1) | 1.30 (1.12 to 1.50) | 248 | 391 |
<12 (2) | 1.68 (1.26 to 2.25) | 140 | 186 |
Estimates obtained from multivariable conditional logistic regression models separately for US-born and foreign-born Hispanic women, with risk factors coded as shown. The overall relative risk of developing invasive breast cancer, compared with an individual of the same nativity with all risk factors at their lowest risk level, is estimated by multiplying the relative risks across risk factors. CI = confidence interval; RR = relative risk.
Projected absolute risk (%) of developing invasive breast cancer within 5, 10, 20, or 30 years by relative risk, initial age, and years of follow-up for Hispanic women*
Initial age, y . | Years of follow-up . | Project absolute risk, % . | |||||||
---|---|---|---|---|---|---|---|---|---|
US-born Hispanic initial relative risk . | Foreign-born Hispanic initial relative risk . | ||||||||
1 . | 2 . | 5 . | 10 . | 1 . | 2 . | 5 . | 10 . | ||
20 | |||||||||
5 | 0.01 | 0.01 | 0.03 | 0.06 | 0.00 | 0.00 | 0.01 | 0.02 | |
10 | 0.03 | 0.07 | 0.17 | 0.34 | 0.01 | 0.03 | 0.07 | 0.14 | |
20 | 0.36 | 0.72 | 1.80 | 3.56 | 0.12 | 0.25 | 0.62 | 1.23 | |
30 | 1.50 | 2.98 | 7.27 | 14.01 | 0.53 | 1.06 | 2.62 | 5.17 | |
30 | |||||||||
5 | 0.10 | 0.20 | 0.51 | 1.02 | 0.03 | 0.07 | 0.17 | 0.34 | |
10 | 0.33 | 0.66 | 1.64 | 3.25 | 0.11 | 0.22 | 0.55 | 1.10 | |
20 | 1.47 | 2.92 | 7.14 | 13.77 | 0.52 | 1.03 | 2.56 | 5.06 | |
30 | 3.34 | 6.57 | 15.62 | 28.75 | 1.20 | 2.38 | 5.85 | 11.35 | |
40 | |||||||||
5 | 0.46 | 0.91 | 2.26 | 4.46 | 0.16 | 0.33 | 0.81 | 1.62 | |
10 | 1.15 | 2.29 | 5.64 | 10.95 | 0.41 | 0.82 | 2.03 | 4.02 | |
20 | 3.05 | 6.00 | 14.32 | 26.55 | 1.09 | 2.18 | 5.35 | 10.41 | |
30 | 5.14 | 10.00 | 23.09 | 40.69 | 2.00 | 3.97 | 9.62 | 18.30 | |
50 | |||||||||
5 | 0.89 | 1.77 | 4.37 | 8.55 | 0.32 | 0.63 | 1.57 | 3.11 | |
10 | 1.95 | 3.86 | 9.36 | 17.84 | 0.69 | 1.38 | 3.43 | 6.73 | |
20 | 4.10 | 8.02 | 18.83 | 34.02 | 1.62 | 3.21 | 7.83 | 15.03 | |
30 | 6.07 | 11.74 | 26.68 | 45.85 | 2.59 | 5.11 | 12.27 | 22.96 | |
60 | |||||||||
5 | 1.18 | 2.35 | 5.77 | 11.20 | 0.46 | 0.91 | 2.26 | 4.47 | |
10 | 2.28 | 4.51 | 10.88 | 20.55 | 0.96 | 1.90 | 4.69 | 9.16 | |
20 | 4.37 | 8.53 | 19.90 | 35.58 | 1.96 | 3.89 | 9.42 | 17.90 | |
70 | |||||||||
5 | 1.23 | 2.44 | 5.99 | 11.61 | 0.55 | 1.10 | 2.73 | 5.39 | |
10 | 2.36 | 4.66 | 11.22 | 21.10 | 1.10 | 2.19 | 5.37 | 10.44 |
Initial age, y . | Years of follow-up . | Project absolute risk, % . | |||||||
---|---|---|---|---|---|---|---|---|---|
US-born Hispanic initial relative risk . | Foreign-born Hispanic initial relative risk . | ||||||||
1 . | 2 . | 5 . | 10 . | 1 . | 2 . | 5 . | 10 . | ||
20 | |||||||||
5 | 0.01 | 0.01 | 0.03 | 0.06 | 0.00 | 0.00 | 0.01 | 0.02 | |
10 | 0.03 | 0.07 | 0.17 | 0.34 | 0.01 | 0.03 | 0.07 | 0.14 | |
20 | 0.36 | 0.72 | 1.80 | 3.56 | 0.12 | 0.25 | 0.62 | 1.23 | |
30 | 1.50 | 2.98 | 7.27 | 14.01 | 0.53 | 1.06 | 2.62 | 5.17 | |
30 | |||||||||
5 | 0.10 | 0.20 | 0.51 | 1.02 | 0.03 | 0.07 | 0.17 | 0.34 | |
10 | 0.33 | 0.66 | 1.64 | 3.25 | 0.11 | 0.22 | 0.55 | 1.10 | |
20 | 1.47 | 2.92 | 7.14 | 13.77 | 0.52 | 1.03 | 2.56 | 5.06 | |
30 | 3.34 | 6.57 | 15.62 | 28.75 | 1.20 | 2.38 | 5.85 | 11.35 | |
40 | |||||||||
5 | 0.46 | 0.91 | 2.26 | 4.46 | 0.16 | 0.33 | 0.81 | 1.62 | |
10 | 1.15 | 2.29 | 5.64 | 10.95 | 0.41 | 0.82 | 2.03 | 4.02 | |
20 | 3.05 | 6.00 | 14.32 | 26.55 | 1.09 | 2.18 | 5.35 | 10.41 | |
30 | 5.14 | 10.00 | 23.09 | 40.69 | 2.00 | 3.97 | 9.62 | 18.30 | |
50 | |||||||||
5 | 0.89 | 1.77 | 4.37 | 8.55 | 0.32 | 0.63 | 1.57 | 3.11 | |
10 | 1.95 | 3.86 | 9.36 | 17.84 | 0.69 | 1.38 | 3.43 | 6.73 | |
20 | 4.10 | 8.02 | 18.83 | 34.02 | 1.62 | 3.21 | 7.83 | 15.03 | |
30 | 6.07 | 11.74 | 26.68 | 45.85 | 2.59 | 5.11 | 12.27 | 22.96 | |
60 | |||||||||
5 | 1.18 | 2.35 | 5.77 | 11.20 | 0.46 | 0.91 | 2.26 | 4.47 | |
10 | 2.28 | 4.51 | 10.88 | 20.55 | 0.96 | 1.90 | 4.69 | 9.16 | |
20 | 4.37 | 8.53 | 19.90 | 35.58 | 1.96 | 3.89 | 9.42 | 17.90 | |
70 | |||||||||
5 | 1.23 | 2.44 | 5.99 | 11.61 | 0.55 | 1.10 | 2.73 | 5.39 | |
10 | 2.36 | 4.66 | 11.22 | 21.10 | 1.10 | 2.19 | 5.37 | 10.44 |
Tables present absolute risk estimates for various initial ages, follow-up durations, and relative risks for US-born and foreign-born Hispanic women. For example, to project invasive breast cancer risk over 20 years for a 30-year-old foreign-born Hispanic woman who had her first full-term pregnancy at age 28 years (age at first full-term pregnancy [AFP] = 1), who never had a biopsy for benign breast disease (biopsy for benign breast disease [BIOP] = 0), whose mother had breast cancer (family history of breast cancer in first-degree female relatives [FH] = 1), and who began menstruating at age 11 years (age at menarche [MEN] = 2). From Table 1, the woman’s relative risk is 1.60 (for AFP = 1) x 1.00 (for BIOP = 0) x 2.48 (for FH = 1) x 1.68 (for MEN = 2) = 6.67. As shown in the table, the woman’s 20-year absolute risk is between 2.56% for relative risk 5 and 5.06% for relative risk 10. By linear interpolation, the approximate risk is 2.56 + (5.06–2.56)(6.67–5.00)/(10–5) = 3.40%.
Projected absolute risk (%) of developing invasive breast cancer within 5, 10, 20, or 30 years by relative risk, initial age, and years of follow-up for Hispanic women*
Initial age, y . | Years of follow-up . | Project absolute risk, % . | |||||||
---|---|---|---|---|---|---|---|---|---|
US-born Hispanic initial relative risk . | Foreign-born Hispanic initial relative risk . | ||||||||
1 . | 2 . | 5 . | 10 . | 1 . | 2 . | 5 . | 10 . | ||
20 | |||||||||
5 | 0.01 | 0.01 | 0.03 | 0.06 | 0.00 | 0.00 | 0.01 | 0.02 | |
10 | 0.03 | 0.07 | 0.17 | 0.34 | 0.01 | 0.03 | 0.07 | 0.14 | |
20 | 0.36 | 0.72 | 1.80 | 3.56 | 0.12 | 0.25 | 0.62 | 1.23 | |
30 | 1.50 | 2.98 | 7.27 | 14.01 | 0.53 | 1.06 | 2.62 | 5.17 | |
30 | |||||||||
5 | 0.10 | 0.20 | 0.51 | 1.02 | 0.03 | 0.07 | 0.17 | 0.34 | |
10 | 0.33 | 0.66 | 1.64 | 3.25 | 0.11 | 0.22 | 0.55 | 1.10 | |
20 | 1.47 | 2.92 | 7.14 | 13.77 | 0.52 | 1.03 | 2.56 | 5.06 | |
30 | 3.34 | 6.57 | 15.62 | 28.75 | 1.20 | 2.38 | 5.85 | 11.35 | |
40 | |||||||||
5 | 0.46 | 0.91 | 2.26 | 4.46 | 0.16 | 0.33 | 0.81 | 1.62 | |
10 | 1.15 | 2.29 | 5.64 | 10.95 | 0.41 | 0.82 | 2.03 | 4.02 | |
20 | 3.05 | 6.00 | 14.32 | 26.55 | 1.09 | 2.18 | 5.35 | 10.41 | |
30 | 5.14 | 10.00 | 23.09 | 40.69 | 2.00 | 3.97 | 9.62 | 18.30 | |
50 | |||||||||
5 | 0.89 | 1.77 | 4.37 | 8.55 | 0.32 | 0.63 | 1.57 | 3.11 | |
10 | 1.95 | 3.86 | 9.36 | 17.84 | 0.69 | 1.38 | 3.43 | 6.73 | |
20 | 4.10 | 8.02 | 18.83 | 34.02 | 1.62 | 3.21 | 7.83 | 15.03 | |
30 | 6.07 | 11.74 | 26.68 | 45.85 | 2.59 | 5.11 | 12.27 | 22.96 | |
60 | |||||||||
5 | 1.18 | 2.35 | 5.77 | 11.20 | 0.46 | 0.91 | 2.26 | 4.47 | |
10 | 2.28 | 4.51 | 10.88 | 20.55 | 0.96 | 1.90 | 4.69 | 9.16 | |
20 | 4.37 | 8.53 | 19.90 | 35.58 | 1.96 | 3.89 | 9.42 | 17.90 | |
70 | |||||||||
5 | 1.23 | 2.44 | 5.99 | 11.61 | 0.55 | 1.10 | 2.73 | 5.39 | |
10 | 2.36 | 4.66 | 11.22 | 21.10 | 1.10 | 2.19 | 5.37 | 10.44 |
Initial age, y . | Years of follow-up . | Project absolute risk, % . | |||||||
---|---|---|---|---|---|---|---|---|---|
US-born Hispanic initial relative risk . | Foreign-born Hispanic initial relative risk . | ||||||||
1 . | 2 . | 5 . | 10 . | 1 . | 2 . | 5 . | 10 . | ||
20 | |||||||||
5 | 0.01 | 0.01 | 0.03 | 0.06 | 0.00 | 0.00 | 0.01 | 0.02 | |
10 | 0.03 | 0.07 | 0.17 | 0.34 | 0.01 | 0.03 | 0.07 | 0.14 | |
20 | 0.36 | 0.72 | 1.80 | 3.56 | 0.12 | 0.25 | 0.62 | 1.23 | |
30 | 1.50 | 2.98 | 7.27 | 14.01 | 0.53 | 1.06 | 2.62 | 5.17 | |
30 | |||||||||
5 | 0.10 | 0.20 | 0.51 | 1.02 | 0.03 | 0.07 | 0.17 | 0.34 | |
10 | 0.33 | 0.66 | 1.64 | 3.25 | 0.11 | 0.22 | 0.55 | 1.10 | |
20 | 1.47 | 2.92 | 7.14 | 13.77 | 0.52 | 1.03 | 2.56 | 5.06 | |
30 | 3.34 | 6.57 | 15.62 | 28.75 | 1.20 | 2.38 | 5.85 | 11.35 | |
40 | |||||||||
5 | 0.46 | 0.91 | 2.26 | 4.46 | 0.16 | 0.33 | 0.81 | 1.62 | |
10 | 1.15 | 2.29 | 5.64 | 10.95 | 0.41 | 0.82 | 2.03 | 4.02 | |
20 | 3.05 | 6.00 | 14.32 | 26.55 | 1.09 | 2.18 | 5.35 | 10.41 | |
30 | 5.14 | 10.00 | 23.09 | 40.69 | 2.00 | 3.97 | 9.62 | 18.30 | |
50 | |||||||||
5 | 0.89 | 1.77 | 4.37 | 8.55 | 0.32 | 0.63 | 1.57 | 3.11 | |
10 | 1.95 | 3.86 | 9.36 | 17.84 | 0.69 | 1.38 | 3.43 | 6.73 | |
20 | 4.10 | 8.02 | 18.83 | 34.02 | 1.62 | 3.21 | 7.83 | 15.03 | |
30 | 6.07 | 11.74 | 26.68 | 45.85 | 2.59 | 5.11 | 12.27 | 22.96 | |
60 | |||||||||
5 | 1.18 | 2.35 | 5.77 | 11.20 | 0.46 | 0.91 | 2.26 | 4.47 | |
10 | 2.28 | 4.51 | 10.88 | 20.55 | 0.96 | 1.90 | 4.69 | 9.16 | |
20 | 4.37 | 8.53 | 19.90 | 35.58 | 1.96 | 3.89 | 9.42 | 17.90 | |
70 | |||||||||
5 | 1.23 | 2.44 | 5.99 | 11.61 | 0.55 | 1.10 | 2.73 | 5.39 | |
10 | 2.36 | 4.66 | 11.22 | 21.10 | 1.10 | 2.19 | 5.37 | 10.44 |
Tables present absolute risk estimates for various initial ages, follow-up durations, and relative risks for US-born and foreign-born Hispanic women. For example, to project invasive breast cancer risk over 20 years for a 30-year-old foreign-born Hispanic woman who had her first full-term pregnancy at age 28 years (age at first full-term pregnancy [AFP] = 1), who never had a biopsy for benign breast disease (biopsy for benign breast disease [BIOP] = 0), whose mother had breast cancer (family history of breast cancer in first-degree female relatives [FH] = 1), and who began menstruating at age 11 years (age at menarche [MEN] = 2). From Table 1, the woman’s relative risk is 1.60 (for AFP = 1) x 1.00 (for BIOP = 0) x 2.48 (for FH = 1) x 1.68 (for MEN = 2) = 6.67. As shown in the table, the woman’s 20-year absolute risk is between 2.56% for relative risk 5 and 5.06% for relative risk 10. By linear interpolation, the approximate risk is 2.56 + (5.06–2.56)(6.67–5.00)/(10–5) = 3.40%.
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