Body mass index, age at breast cancer diagnosis, and breast cancer subtype: a cross-sectional study

Brouckaert, Olivier; Asten, Kathleen Van; Laenen, Annouschka; Soubry, Adelheid; Smeets, Ann; Nevelstreen, I.; Vergote, Ignace; Wildiers, Hans; Paridaens, Robert; Limbergen, Erik; Weltens, Caroline; Moerman, Philippe; Floris, Giuseppe; Neven, Patrick

doi:10.1007/s10549-017-4579-8

Cited by 13 publications

(13 citation statements)

References 29 publications

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“…We observed that when controlled other variables including menopausal state, Black/African American race and increased BMI was associated with Luminal B carcinoma. Similarly, a consistent relationship between BMI and Luminal B tumors was also demonstrated in a cross-sectional study [ 44 ]. Nevertheless, this linear relationship between BMI and the probability of being diagnosed with Luminal B breast cancer demonstrated by Brouckaert O et al was only seen in postmenopausal women [ 44 ].…”

Section: Discussionsupporting

confidence: 66%

Association between Obesity, Race or Ethnicity, and Luminal Subtypes of Breast Cancer

Menikdiwela

Kahathuduwa

Bolner³

et al. 2022

Biomedicines

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Luminal breast cancers are the most common genomic subtype of breast cancers where Luminal A cancers have a better prognosis than Luminal B. Exposure to sex steroids and inflammatory status due to obesity are key contributors of Luminal tumor development. In this study, 1928 patients with Luminal A breast cancer and 1610 patients with Luminal B breast cancer were compared based on body mass index (BMI), age, race, menopausal status, and expressed receptors (i.e., estrogen (ER), progesterone (PR), and human epidermal growth factor receptor 2 (HER2)). Patients with Luminal B tumors had a significantly higher mean BMI (Δ = 0.69 kgm−2 [0.17, 1.21], p = 0.010) versus Luminal A. Interestingly, the risks of Luminal B tumors were higher among Black/African American patients versus White and Hispanic patients (p < 0.001 and p = 0.001, respectively). When controlled for each other, Black/African American race (p < 0.001) and increased BMI (p = 0.008) were associated with increased risks of Luminal B carcinoma, while postmenopausal status was associated with a decreased risk (p = 0.028). Increased BMI partially mediated the strong association between Black/African American race and the risk of Luminal B carcinoma. Thus, Black/African American race along with obesity seem to be associated with an increased risk of more aggressive Luminal B breast carcinomas.

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Section: Discussionsupporting

confidence: 66%

Association between Obesity, Race or Ethnicity, and Luminal Subtypes of Breast Cancer

Menikdiwela

Kahathuduwa

Bolner³

et al. 2022

Biomedicines

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“…In a cross‐sectional study of 7020 patients, Brouckaert et al. found BMI was linearly related to the probabilities of luminal B and HER2‐like breast cancer subtypes . Phipps et al.…”

Section: Discussionmentioning

confidence: 99%

Comparison of breast cancer risk factors among molecular subtypes: A case‐only study

et al. 2019

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Epidemiological studies have a clear definition of the risk factors for breast cancer. However, it is unknown whether the distribution of these factors differs among breast cancer subtypes. We conducted a hospital‐based case‐only study consisting of 8067 breast cancer patients basing on the Tianjin Cohort of Breast Cancer Cases. Major breast cancer subtypes including luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)‐enriched and basal‐like were defined by estrogen receptor, progesterone receptor, HER2, and Ki‐67 status. Variables including demographic characteristics, reproductive factors, lifestyle habits, imaging examination, and clinicopathologic data were collected for patients. Chi‐square test and one‐way analysis of variance were used to compare the distributions of variables among the four breast cancer subtypes. Multivariate logistic regression was used to estimate the odds ratios and associated 95% confidence intervals where luminal A patients served as the reference group. Overall, more commonality rather than heterogeneity on the distributions of factors was found between the four molecular subtypes of breast cancer. The proportion of overweight and obesity were lower in HER2‐enriched subtype. Women with age at menarche ≤13 years were more likely to be found in basal‐like subtype. Postmenopausal women were more frequent in HER2‐enriched and basal‐like subtypes. Women with benign breast disease and higher breast density were more common in HER2‐enriched subtype. Risk factor scoring showed that total risk scores were similar among the four subtypes. HER2‐enriched and basal‐like subtypes were more frequently diagnosed with large tumors. Calcification was more likely to be found in luminal B and HER2‐enriched subtypes, whereas less distributed in basal‐like subtype. Most of the breast cancer risk factors were similarly distributed among the four major breast cancer subtypes; commonality is predominant.

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“…For example, high BMI, a risk factor for preeclampsia, is inversely associated with premenopausal breast cancer, although it is positively associated with postmenopausal breast cancer. 26,27 Not accounting for high BMI could result in a false inverse association between preeclampsia and premenopausal breast cancer, and a false positive association between preeclampsia and postmenopausal breast cancer. While our results changed little after adjustment for maternal BMI, and for smoking (another putative inverse risk factor for preeclampsia), 28 maternal BMI was only available for the last pregnancy, and there was substantial missing data for both BMI and smoking.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy complications and subsequent breast cancer risk in the mother: a Nordic population‐based case–control study

Troisi

Ording

Grotmol

et al. 2018

Intl Journal of Cancer

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Certain features of pregnancy are important risk factors for breast cancer, such as protection afforded by young age at first birth. Preeclampsia, a pregnancy complication, is associated with reduced maternal breast cancer risk. However, questions remain regarding causality, biological mechanisms and the relation of other hypertensive conditions to risk. We conducted a population-based case-control study of breast cancer cases (n = 116,196) in parous women identified through linkage of birth and cancer registries in Denmark, Finland, Norway and Sweden (1967-2013), including up to 10 matched controls per case (n = 1,147,192) sampled from the birth registries (complete data were not available on all variables). Odds ratios (ORs) with 95% confidence intervals (CIs) were derived from unconditional logistic regression models including matching factors (country, maternal birth year) and parity. Hypertension diagnosed before pregnancy (OR 0.87; 95% CI 0.78-0.97), gestational hypertension (OR 0.90; 95% CI 0.86-0.93) and preeclampsia (OR 0.91; 95% CI 0.88-0.95) were associated with reduced breast cancer risk. Results remained similar after adjustment for smoking and maternal body mass index before first pregnancy, and were generally similar stratified by parity, age at breast cancer diagnosis, time since first and last birth, sex of the offspring and calendar time. Except for retained placenta (OR 1.14; 95% CI 0.98-1.32), no other pregnancy complication appeared associated with breast cancer risk. The mechanisms mediating the modest risk reductions for history of preeclampsia or hypertension preceding or arising during pregnancy, and possible increased risk with history of retained placenta are unknown and warrant further laboratory, clinical and epidemiological investigation.

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Body mass index, age at breast cancer diagnosis, and breast cancer subtype: a cross-sectional study

Cited by 13 publications

References 29 publications

Association between Obesity, Race or Ethnicity, and Luminal Subtypes of Breast Cancer

Association between Obesity, Race or Ethnicity, and Luminal Subtypes of Breast Cancer

Comparison of breast cancer risk factors among molecular subtypes: A case‐only study

Pregnancy complications and subsequent breast cancer risk in the mother: a Nordic population‐based case–control study

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