We have examined the relationship between birthweight and risk of breast ca
ncer, taking into account growth in childhood, using data on a total of 222
1 women born in 1946 and followed up to 1997. Thirty-seven breast cancers o
ccurred during follow-up. There was evidence of greater risk of breast canc
er with greater birthweight (rate ratio = 1.76 (95% Cl: 0.92, 3.35) for bir
thweight greater than or equal to 3.5 kg vs birthweight < 3.5 kg), which wa
s more marked at pre-menopausal ages (RR = 2.31, 95% Cl: 0.93, 5.74). The r
elation with birthweight was not substantially confounded by any of the mea
sured adult risk factors. A significant interaction was observed between th
e effects of birthweight and height at age 7 years. Relative to those born
lighter than 3.5 kg, women who were heavy at birth (greater than or equal t
o 3.5 kg) and short or average at 7 years (< 1.22 m) had a 21% increase in
breast cancer rates (RR = 1.21, 95% Cl = 0.49-2.99), while women who were h
eavy at birth (greater than or equal to 3.5 kg) but tall at 7 years (greate
r than or equal to 1.22 m) had a four-fold increase (RR = 4.01; 95% Cl = 1.
82-8.83). These results suggest that the effect of birthweight on breast ca
ncer risk may be modulated by childhood growth. (C) 2000 Cancer Research Ca
mpaign.