This study highlights the complexity of interrelated life-course processes underlying the effect of early-life SES on mortality in later life.

Objectives We examine (1) how breast cancer onset and survival are affected by various dimensions of early-life socioeconomic status (SES), and (2) the extent to which women's characteristics in adulthood mediate the associations between early-life conditions and breast cancer. Methods We apply Cox regression models and a decomposition analysis to the data from the 4,275 women in the Wisconsin Longitudinal Study. Results Higher levels of mothers’ education and early-life family income were associated with a greater risk of breast cancer incidence. The effect of mothers’ education was mediated by women's adult SES and reproductive behaviors. Fathers’ education was related negatively to breast cancer mortality, yet this effect was fully mediated by women's own education. Discussion This study identifies mechanisms linking early-life social environment to breast cancer onset and mortality. The findings emphasize the role of social factors in breast cancer incidence and survival.

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