Adiposity, Adult Weight Change, and Postmenopausal Breast Cancer Risk

Ahn, Ji-Young; Schatzkin, Arthur; Lacey, J.; Albanês, Demetrius; Ballard‐Barbash, Rachel; Adams, Kenneth; Kipnis, Victor; Mouw, Traci; Hollenbeck, Albert R.; Leitzmann, Michael F.

doi:10.1001/archinte.167.19.2091

Cited by 264 publications

(245 citation statements)

References 46 publications

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“…Increased BMI has been convincingly associated with increased breast cancer risk in postmenopausal women, specifically ER þ tumors, and with decreased premenopausal breast cancer risk, except in Asian populations characterized by low adiposity. [3][4][5][6][9][10][11] However, it is still unclear as to whether there is a specific effect of abdominal obesity on breast cancer risk. 12,13 WC has often been associated with increased breast cancer risk in postmenopausal women, but not in premenopausal women, 12,13 although this association was often lost when adjusting for BMI, which is highly correlated with WC.…”

Section: Introductionmentioning

confidence: 99%

Hip circumference is associated with the risk of premenopausal ER−/PR− breast cancer

et al. 2011

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Objective: We evaluated the relationship between hip and waist circumferences (HCs, WCs), waist-to-hip ratio, height, weight and body mass index (BMI) and breast cancer risk according to menopausal status of women and cancer hormone receptor status. Design: We used data from the French E3N longitudinal prospective cohort. Subjects: In the total population of 63 726 women who were analyzed, 1887 breast cancer cases were diagnosed during follow-up. Results: Among postmenopausal women, the risk of ER þ /PR þ breast cancer increased with increasing weight, BMI, and both HCs and WCs, although these two associations disappeared after adjustment for BMI. No association was seen with ERÀ/PRÀ breast cancers. Among premenopausal women, among the different factors studied, HC only (no association was observed for any of the different factors studied except for HC) was associated with an increased risk of ER þ /PR þ breast cancer after adjustment for BMI (hazard ratio (HR) ¼ 1.65; (1.04-2.62) when comparing the highest to lowest tertile; P-trend across tertiles ¼ 0.03) and of ERÀ/PRÀ breast cancer both before and after adjustment for BMI (HR ¼ 2.85 (1.33-6.13); P-trend o0.01, and HR ¼ 3.13 (1.19-8.27) P-trend ¼ 0.02, respectively). In the latter group, the association with HC was observed whatever the WC (HR ¼ 2.81 (1.18-6.70) and HR ¼ 2.79 (1.16-6.76) in women with high HC/low WC and high HC/high WC, respectively). Conclusion: The increase in risk of premenopausal breast cancer associated with large HC for both ER þ /PR þ and ERÀ/PRÀ subtypes may provide insight into a specific risk factor for premenopausal breast cancer.

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Section: Introductionmentioning

confidence: 99%

Hip circumference is associated with the risk of premenopausal ER−/PR− breast cancer

et al. 2011

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“…[1][2][3][4][5] Aromatization of androstenedione to estradiol in the peripheral adipose tissue and low levels of sex-hormonebinding globulin have been postulated as the primary biological mechanism; [6][7][8] however, other biological pathways such as increased serum levels of insulin-like growth factors have been proposed as well. 9 Among all the pathological prognostic indicators, the combination of stage and grade of cancer is the best predictor of DFS and OS.…”

Section: Introductionmentioning

confidence: 99%

Body mass index at the time of diagnosis and the risk of advanced stages and poorly differentiated cancers of the breast: findings from a case-series study

et al. 2010

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Introduction: Obesity is a risk factor for postmenopausal breast cancer and is independently associated with shorter disease-free and overall survival. Currently, in clinical settings, the combination of stage and grade of cancer at the initial presentation of the disease is the best prognostic indicator. Objective: To evaluate the association between body mass index (BMI) and risk of advanced stages and poorly differentiated grade of breast cancer. Design: A case-series study of women diagnosed with their first primary invasive breast cancer. Patients include a total of 831 women aged X40 years with a mean BMI of 29.6( ± 6.6) kg m À2 . Pathological, clinical and demographic data were retrieved from electronic medical records. Multinomial logistic regression analysis was preformed to estimate the risk of more advanced stages and poorly differentiated grade of cancer, adjusting for covariates. Results: Obese compared with normal weight women had an 80% increased risk of cancer with more advanced stages (III/IV) and poorly differentiated grade (odds ratio ¼ 1.80, 95% confidence interval 1.13-2.86, P ¼ 0.014). No significant increase in risk was observed for overweight women. Conclusion: Obesity at the time of diagnosis of breast cancer is associated with more advanced stages and poorly differentiated grade of cancers.

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“…Based on the results of cohort [1][2][3][4][5][6][7][8][9][10][11] and case-control studies, [12][13][14][15][16][17] the World Cancer Research Fund states that longterm adult weight gain (i.e., recalled weight gain since age 20) increases the risk of postmenopausal breast cancer and grades this relation as "probable". 18 Most studies investigated the association between longterm weight gain and breast cancer risk without a focus on a particular period in life.…”

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confidence: 99%

Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

et al. 2014

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Long‐term weight gain (i.e., weight gain since age 20) has been related to higher risk of postmenopausal breast cancer, but a lower risk of premenopausal breast cancer. The effect of weight change in middle adulthood is unclear. We investigated the association between weight change in middle adulthood (i.e., women aged 40–50 years) and the risk of breast cancer before and after the age of 50. We included female participants of the European Prospective Investigation into Cancer and Nutrition cohort, with information on anthropometric measures at recruitment and after a median follow‐up of 4.3 years. Annual weight change was categorized using quintiles taking quintile 2 and 3 as the reference category (−0.44 to 0.36 kg/year). Multivariable Cox proportional hazards regression analysis was used to examine the association. 205,723 women were included and 4,663 incident breast cancer cases were diagnosed during a median follow‐up of 7.5 years (from second weight assessment onward). High weight gain (Q5: 0.83–4.98 kg/year) was related to a slightly, but significantly higher breast cancer risk (HRQ5_versus_Q2/3: 1.09, 95% CI: 1.01−1.18). The association was more pronounced for breast cancer diagnosed before or at age 50 (HRQ5_versus_Q2/3: 1.37, 95% CI: 1.02−1.85). Weight loss was not associated with breast cancer risk. There was no evidence for heterogeneity by hormone receptor status. In conclusion, high weight gain in middle adulthood increases the risk of breast cancer. The association seems to be more pronounced for breast cancer diagnosed before or at age 50. Our results illustrate the importance of avoiding weight gain in middle adulthood.

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Adiposity, Adult Weight Change, and Postmenopausal Breast Cancer Risk

Cited by 264 publications

References 46 publications

Hip circumference is associated with the risk of premenopausal ER−/PR− breast cancer

Hip circumference is associated with the risk of premenopausal ER−/PR− breast cancer

Body mass index at the time of diagnosis and the risk of advanced stages and poorly differentiated cancers of the breast: findings from a case-series study

Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study

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