Lifestyle factors and breast cancer in a Moroccan population case-control study of the center Mohammed VI for cancer treatment

Drissi Houda, Imad Fatima Ezzahra, Bendahhou Karima, Benider Abdelatif, Radallah Driss


Background: The study aims to examine the association between lifestyle habits and breast cancer risk in a Moroccan population.

Methods: This is a case-control study conducted at the Mohammed VI Centre for cancer treatment in Casablanca.

Results: The results highlighted that family history of breast cancer (OR=5.73) and alcohol consumption                     (OR=3.76) were positively associated with breast cancer. Analysis of anthropometric parameters showed that the risk of developing breast cancer is estimated at 1.78 in overweight women and 2.39 in obese women compared to those of normal weight. The risk of developing breast cancer is estimated at 1.82 for women with a WC greater than 88 cm and 1.70 for women with a WHR greater than 0.85. At age 10, the risk is 1.60 for women with a large figure compared to women with a small figure. However, at age 40, the average body shape relative to the lean body was associated with a decreased risk of breast cancer. In addition, the data confirmed that physical activity participation decreases with age; in childhood and adolescence, women are more active while in post-menopause, women become moderately active. Being very active in childhood, peri-menopause and post-menopause seems to be a protective factor against the occurrence of breast cancer.

Conclusions: The study showed that the risk of breast cancer is potentially high in elderly women, overweight women and women with a family history of cancer. This risk was increased by behavioral factors such as toxic habits and physical inactivity.


Anthropometric measurements, Breast cancer, Case-control study, Physical activity, Toxic habits

Full Text:



Antoniou AC, Pharoah PDP, Narod S, Risch HA, Eyfjord JE, Hopper JL. Breast and ovarian cancer risks to carriers of the BRCA1 5382insC and 185delAG and BRCA2 6174delT mutations: a combined analysis of 22 population based studies. J Med Genetics. 2005;42(7):602-3.

Dumitrescu RG, Cotarla I. Understanding breast cancer risk where do we stand in 2005? J Cellular Molecular Med. 2005;9(1):208-1.

Colditz GA, Atwood KA, Emmons K, Monson RR, Willett WC, Trichopoulos D, Hunter DJ. Harvard report on cancer prevention. Harvard Cancer Risk Index. 2000;11(6):477-88.

Hulka BS, Moorman PG. Breast cancer: hormones and other risk factors. Mauritas. 2001;38:103-16.

Collaborative Group on Hormonal Factors in Breast Cancer. Alcohol, tobacco and breast cancer – collaborative reanalysis of individual data from 53 epidemiological studies, including 58515 women with breast cancer and 95067 women without the disease. Br J Cancer 2002; 87:1234-45.

Stasiolek D, Kwasniewska M, Drygas W. Raksutka - selected risk factor, primary prevention. Przeglad Lekarski. 2002;59:26-30.

Nkondjock A, Shatenstein B, Ghadirian P. A case-control study of breast cancer and dietary intake of individual fatty acids and antioxidants in Montreal, Canada. Breast. 2003;12:128-35.

McTiernan. Behavioral risk factors in breast cancer: can risk be modified? The Oncologist. 2003;8:426-34.

Sorensen TI, Stunkard AJ, Teasdale TW, Higgins MW. The accuracy of reports of weight: children's recall of their parents' weights 15 years earlier. Int J Obes. 1983;7:115-22.

Casey VA, Dwyer JT, Coleman KA, Krall EA, Gardner J, Valadian I. Clarification of the recall of middle-aged participants in a longitudinal study of their body size and maturation indices earlier in life. Ann Human Biol. 1991;18(2):155-66.

Must A, Phillips SM, Naumova EN, Blum M, Harris S, Hughes D, Rand B. Reminder of menstrual history and body size: after 30 years, to what extent do women remember? Am J Epidemiol. 2002;155(7):672-9.

Claus EB, Schildkraut JM, Thompson LD. The genetic attributable risk of breast cancer and ovarian cancer. Cancer. 1996;77:2318-24.

Reinier KS, Vacek PM, Geller BM. Risk factors for breast carcinoma in situ versus invasive breast cancer in a prospective study of pre- and post-menopausal women. Breast Cancer Res Treat. 2007;103:343-8.

Hirose K, Tajima K, Hamajima N. A large-scale, hospital-based case-control study of risk factors of breast cancer according to menopausal status. Jpn J Cancer Res. 1995;86:146-54.

Hirose K, Tajima K, Hamajima N. Association of family history and other risk factors with breast cancer risk among Japanese premenopausal and postmenopausal women. Cancer Causes Control. 2001;12:349-58.

Minami Y, Ohuchi N, Fukao A. Risk factors for breast cancer: A case-control study of screen-detected breast cancer Miyagi Prefecture, Japan. Breast Cancer Res Treat. 1997;44:225-33.

Lissowska J, Brinton LA, Zatonski W. Mannose-binding lectin-2 genetic variation and stomach cancer risk. Int J Cancer. 2006;119:1961-9.

Hu YH, Nagata C, Shimizu H. Association of body mass index, physical activity and reproductive histories with breast cancer: a case-control study in Gifu, Japan. Breast Cancer Res Treat. 1997;43:65-72.

Khuder SA, Mutgi AB, Nugent S. Smoking and breast cancer: a meta-analysis. Rev Environ Health. 2001;16:253-61.

Katsouyanni K, Trichopoulou A, Stuver S, Ethanol and breast cancer: an association may be both confounded and causal. Int J Cancer. 1994;58:356-61.

Favero A, Parpinel M, Franceschi S. Diet and risk of breast cancer: major findings from an Italian case-control study. Biomed Pharmacother. 1998;52:109-15.

Carmichel AR, Bates T. Obesity and breast cancer: a review of literature. The Breast. 2004;13:85-92.

Connolly BS, Barnett C, Vogt KN. A meta-analysis of published literature on waist-to-hip ratio and risk of breast cancer. Nutr Cancer. 2002;44(2):127-38.

Hall IJ, Newman B, Millikan RC. Body size and breast cancer risk in black women and white women: the carolina breast cancer study. Am J Epidemiol. 2000;151(8):754-64.

Harvie M, Hooper L, Howell AH. Central obesity and breast cancer risk: a systematic review. Obes Rev. 2003;4(3):157-73.

Shu XO, Jin F, Dai Q. Association of body size and fat distribution with risk of breast cancer among Chinese women. Int J Cancer. 2001;94(3):449-55.

Shin A, Matthews CE, Shu XO. Joint effects of body size, energy intake, and physical activity on breast cancer risk. Breast Cancer Res Treat. 2009;113(1):153-61.

John EM, Sangaramoorthy M, Phipps AI. Adult body size, hormone receptor status, and premenopausal breast cancer risk in a multiethnic population: the San Francisco bay area breast cancer study. Am J Epidemiol. 2011;173(2):201-16.

Slattery ML, Sweeney C, Edwards S. Body size, weight change, fat distribution and breast cancer risk inHispanic and non-Hispanic white women. Breast Cancer Res Treat. 2007;102(1):85-101.

Palmer JR, Campbell LL, Boggs DA. A prospective study of body size and breast cancer in black women. Cancer Epidemiol Biomarkers Prev. 2007;16(9):1795-802.

Baer HJ, Colditz GA, Rosner B. Body fatness during childhood and adolescence and incidence of breast cancer in premenopausal women: a prospective cohort study. Breast Cancer Res. 2005;7(3):314-25.

Baer HJ, Tworoger SS, Hankinson SE. Body fatness at young ages and risk of breast cancer throughout life. Am J Epidemiol. 2010;171(11):1183-94.

Berstad P, Coates RJ, Bernstein L. A case-control study of body mass index and breast cancer risk in white and African-American women. Cancer Epidemiol Biomarkers Prev. 2010;19(6):1532-44.

Bardia A, Vachon CM, Olson JE. Relative weight at age 12 and risk of postmenopausal breast cancer. Cancer Epidemiol Biomarkers Prev. 2008;17(2):374-8.

Tehard B, Saris WH, Astrup A, Martinez JA, Taylor MA, Barbe P, Oppert JM. Comparison of two physical activity questionnaires in obese subjects: the NUGENOB study. Med Sci Sports Exercise. 2005;37(9):1535-541.

Ahmed ML, Ong KK, Dunger DB. Childhood obesity and the time of puberty. Trends in Endocrin Metab. 2009;20(5):237-42.

Althuis MD, Fergenbaum JH, Closas GM, Brinton LA, Madigan MP, Sherman ME. Etiology of hormone receptor-defined breast cancer: systematic review of the literature. Cancer Epidemiol Biomarkers Prevention. 2004;13(10):1558-68.

Bertrand T, Chapelon FC. The E3N group. Several anthropometric measurements and breast cancer risk: results of the E3N cohort study. Int J Obes. 2006;30(1):156-63.

Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579-91.

Key TJ, Appleby PN, Reeves GK. Insulin-like growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: pooled individual data analysis of 17 prospective studies. Lancet Oncol. 2010;11(6):530-42.

Key T, Appleby P, Barnes I. Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst. 2002;94(8):606-16.

Rinaldi S, Peeters PH, Berrino F. IGF-I, IGFBP-3 and breast cancer risk in women: the European Prospective Investigation into Cancer and Nutrition (EPIC). Endocr Relat Cancer. 2006; 3(2):593-605.

Slattery ML, Baumgartner KB, Byers T. Genetic, anthropometric, and lifestyle factors associated with IGF-1 and IGFBP-3 levels in Hispanic and non-Hispanic white women. Cancer Causes Control. 2005;16(10):1147-57.

Wenten M, Gilliland FD, Baumgartner K. Associations of weight, weight change, and body mass with breast cancer risk in Hispanic and non-Hispanic white women. Ann Epidemiol. 2002;12(6):435-4.

International agency for research on cancer (IARC). IARC Handbooks of Cancer Prevention. Weight Control and Physical Activity. IARC Press: Lyon. 2002;6.

Kamarudin R, Shah SA, Hidayah N. Lifestyle factors and breast cancer: a case-control study in Kuala Lumpur, Malaysia. Asian Pacific J Cancer Prev. 2006;7:51-4.

Dallal CM, Halley J, Ross RK. Long-term recreational physical activity and risk of invasive and in situ breast cancer: the California teachers study. Arch Intern Med. 2007;167:408-15.

Master C. Relationship between physical activity, weight balance and breast cancer Relationship between physical activity, weight balance and breast cancer. Annals of Endocrinology. 2013;74(2):148-53.