Table 1.

Literature used to support the conceptual model

Arrow startArrow endStrengthQualityReference
Socio/cultural
 Country of birthBreast feeding22(12, 13)
 Country of birthEducation11(14, 15)
 Country of birthLatitude11(16)
 Country of birthPhytoestrogens22(17, 18)
 Country of birthRace/ethnicity11(19, 20)
 EducationAge at first birth, parity22(21)
 EducationIncome11(22, 23)
 EducationOccupation11(24, 25)
 EducationPhysical activity22(26)
 EducationTobacco use22(27, 28)
 IncomeAge at menarche32(29)
 IncomeAlcohol33(30, 31)
 IncomeEnvironmental tobacco13(32, 33)
 IncomeHT22(34)
 IncomeObesity23(35, 36)
 IncomePhysical activity23(26, 37)
 IncomeTobacco use23(38)
 IncomeHeight32(39, 40)
 OccupationAlcohol32(41)
 OccupationEnvironmental tobacco32(42)
 OccupationHT22(34)
 OccupationSleep disturbance33(43)
 Race/ethnicityAge at menarche22(29)
 Race/ethnicityBreast feeding33(13, 44)
 Race/ethnicityEducation22(45, 46)
 Race/ethnicityEndocrine disrupting chemicals22(47, 48)
 Race/ethnicityEndogenous hormones23(49–51)
 Race/ethnicityEnvironmental tobacco22(52, 53)
 Race/ethnicityIncome22(46)
 Race/ethnicityObesity32(35)
 Race/ethnicityOccupation22(46, 54)
 Race/ethnicityTobacco use22(27)
Physical
 Endocrine disrupting chemicalsIncidence22(55, 56)
 Environmental tobaccoIncidence33(42, 57)
 LatitudeVitamin D33(58, 59)
 RadiationIncidence22(60, 61)
 Sleep disturbanceIncidence32(62, 63)
Behavioral
 Age at first birth, parityBreast density33(64)
 Age at first birth, parityEndogenous hormones22(65)
 Age at first birth, parityIncidence22(66, 67)
 AlcoholIncidence32(68–71)
 AlcoholIncome33(72)
 Breast feedingIncidence32(73)
 HTIncidence21(74, 75)
 ObesityAge at menarche22(76)
 ObesityImmune function33(77, 78)
 ObesityIncidence22(68, 69, 79, 80)
 ObesityIncome33(36, 81)
 ObesityInsulin resistance22(82)
 ObesityPhysical activity22(83)
 Physical activityIncidence22(68, 69)
 Physical activityObesity21(84, 85)
 PhytoestrogensIncidence32(86–88)
 Tobacco useEndogenous hormones32(89)
 Tobacco useIncidence32(90, 91)
Biologic
 AgeIncidence11(66)
 Age at menarcheEndogenous hormones32(65, 66)
 Age at menarcheIncidence32(66, 92)
 Age at menopauseBreast density22(93, 94)
 Age at menopauseEndogenous hormones32(65)
 Age at menopauseIncidence22(66)
 AncestryHigh-penetrance genes11(95–98)
 AncestryLow-penetrance genes11(99–104)
 AncestryRace/ethnicity11(19, 105)
 Breast densityIncidence22(106–109)
 Endogenous hormonesAge at menarche13(110–112)
 Endogenous hormonesAge at menopause11(113)
 Endogenous hormonesObesity21(113)
 Endogenous hormonesIncidence33(65)
 GenotoxinsIncidence33(56, 114)
 HeightIncidence33(115, 116)
 High-penetrance genesIncidence31(100, 117, 118)
 Immune functionIncidence33(119)
 Immune functionInsulin resistance22(120, 121)
 Insulin resistanceImmune function22(120, 121)
 Insulin resistanceIncidence33(122, 123)
 Insulin resistanceObesity32(124, 125)
 Low-penetrance genesBreast density32(126, 127)
 Low-penetrance genesHeight31(128, 129)
 Low-penetrance genesIncidence21(99, 100, 102, 103, 130, 131)
 Low-penetrance genesInsulin resistance21(132, 133)
 Low-penetrance genesObesity31(134–136)
 Vitamin DIncidence22(137, 138)

NOTE: The starting point for an arrow is the independent variable and the ending point is the dependent variable. Strength of the relationship is categorized as (1) strong (RR > 3.0), (2) modest (RR >1.8–3.0), or (3) weak (1.1–1.8). Quality of the evidence is categorized as (1) strong, (2) moderate, or (3) weak.