Adult height and body weight are positively associated with breast cancer risk after menopause, but few studies have investigated these factors according to molecular breast cancer subtype. A total of 18,562 postmenopausal Norwegian women who were born between 1886 and 1928 were followed up for breast cancer incidence from the time (between 1963 and 1975) height and weight were measured until 2008. Immunohistochemical and in situ hybridization techniques were used to subtype 734 incident breast cancer cases into Luminal A, Luminal B [human epidermal growth factor receptor 2 (HER2-)], Luminal B (HER2+), HER2 subtype, basal-like phenotype (BP) and five-negative phenotype (5NP). We used Cox regression analysis to assess adult height and body mass index (BMI) in relation to risk of these subtypes. We found a positive association of height with risk of Luminal A breast cancer (ptrend , 0.004), but there was no clear association of height with any other subtype. BMI was positively associated with risk of all luminal breast cancer subtypes, including Luminal A (ptrend , 0.002), Luminal B (HER2-) (ptrend , 0.02), Luminal B (HER2+) (ptrend , 0.06), and also for the HER2 subtype (ptrend , 0.04), but BMI was not associated with risk of the BP or 5NP subtypes. Nonetheless, statistical tests for heterogeneity did not provide evidence that associations of height and BMI differed across breast cancer subtypes. This study of breast cancer risk among postmenopausal women suggests that height is positively associated with risk of Luminal A breast cancer. BMI is positively associated with risk of all luminal subtypes and for the HER2 subtype.
Institutt for laboratoriemedisin, barne- og kvinnesykdommer, Norges teknisk-naturvitenskapelige universitet og Avdeling for klinisk farmakologi, St. Olavs hospital, Olav Kyrres gate 17, 7006 Trondheim, Norway. firstname.lastname@example.org
BACKGROUND: At the turn of 2007/2008, four Norwegian men died after ingestion of commercially available supposedly denatured ethanol. MATERIAL AND METHODS: The four deaths are presented and discussed. RESULTS: Methanol concentrations, consistent with lethal methanol poisoning, were detected in blood and urine for all four. The imbibed mixture was subsequently shown to contain a 70/30 mixture of methanol/ethanol. INTERPRETATION: The events emphasize the importance of investigating methanol findings from deceased to identify the source, and that investigations are instigated promptly to prevent further exposure.
Breast cancer can be classified into molecular subtypes that differ in clinical characteristics and prognosis. There is some but conflicting evidence that reproductive risk factors may differ between distinct breast cancer subtypes.
We investigated associations of reproductive factors with the risk for six molecular breast cancer subtypes in a cohort of 21,532 Norwegian women who were born between 1886 and 1928 and followed up for breast cancer incidence between 1961 and 2008. We obtained stored tumor tissue from incident breast cancers and used immunohistochemistry and in situ hybridization to classify 825 invasive tumors into three luminal subtypes [Luminal A, Luminal B (HER2-) and Luminal B (HER2+)] and three non-luminal subtypes [human epidermal growth factor receptor 2 (HER2) subtype, basal-like phenotype (BP) and five negative phenotype (5NP)]. We used Cox regression to assess reproductive factors and risk for each subtype.
We found that young age at menarche, old age at first birth and low parity were associated with increased risk for luminal breast cancer subtypes. For the HER2 subtype, we either found no association or associations in the opposite direction compared to the luminal subtypes. The BP subtype appeared to have a similar reproductive risk profile as the luminal subtypes. Breastfeeding was associated with a reduced risk for HER2 and 5NP subtypes, but was not associated with any other subtype.
The results suggest that molecular breast cancer subtypes differ in their reproductive risk factors, but associations with non-luminal subtypes are still poorly understood and warrant further study.
BACKGROUND: Establishing smoke-free hospitals by the end of 1995 was a goal for Norwegian health authorities. The present study reports the smoking status in Norwegian hospitals by the end of the year 2000. MATERIAL AND METHODS: Information was collected by questionnaires sent to all 81 Norwegian hospital directors; 78 (96%) responded. RESULTS: 19 hospitals (27%) were still not smoke-free. The lowest smoke-free rate (60%) was reported from psychiatric institutions. Smoking in all office areas was prohibited while 10% of all hospitals allowed smoking in their cafeterias. Outdoor smoking areas were provided in two thirds of the hospitals. Separate smoking rooms for patients were more common in non-smoke-free hospitals (79%) than in smoke-free institutions. The smoking restrictions were accepted with little resistance, but illicit smoking was not uncommon, even in-house. Sale of tobacco and cigarettes was a widespread practice in the hospitals (63%), irrespective of their smoking policy. INTERPRETATION: It appears that there is still a long way to go before Norwegian hospitals are really smoke-free. Sale of tobacco and cigarettes should be banned and further restrictive measures from the government are required together with active participation from doctors and nurses as role models and not the least from the patients themselves, in their own best interest.