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Adult body size and physical activity in relation to risk of breast cancer according to tumor androgen receptor status.

Abstract

BACKGROUND

Obesity and physical activity have been hypothesized to affect breast cancer risk partly via the androgen signaling pathway. We conducted the first study to evaluate these associations by tumor androgen receptor (AR) status.

METHODS

Height, weight, and physical activity were assessed using questionnaires in the Nurses' Health Study. AR, estrogen receptor (ER), and progesterone receptor (PR) status were determined using immunohistochemistry on tumor tissue and medical/pathology reports.

RESULTS

A total of 1,701 AR(+) and 497 AR(-) cases were documented during 26 years of follow-up of 103,577 women. After adjusting for ER/PR status and other risk factors, the relative risks (RR) and 95% confidence intervals (95% CI) for every 5 kg/m(2) increase in body mass index (BMI) were 1.07 (1.01-1.13) for AR(+) and 1.16 (1.05-1.29) for AR(-) tumors (P-heterogeneity = 0.17). The RRs (95% CIs) per 5 hours of brisk walking/week were 0.87 (0.73-1.04) for AR(+) and 0.67 (0.45-0.99) for AR(-) tumors (P-heterogeneity = 0.22). Further, BMI, but not physical activity, associations differed significantly across ER/PR/AR subtypes (P-heterogeneity = 0.04 and 0.63, respectively). The RRs (95% CIs) for 5 kg/m(2) increase in BMI were 1.23 (1.04-1.45) for ER(+)PR(+)AR(-), 1.19 (1.01-1.39) for ER(-)PR(-)AR(-), 1.15 (1.08-1.23) for ER(+)PR(+)AR(+), and 0.88 (0.75-1.03) for ER(+)PR(-)AR(+) tumors.

CONCLUSIONS

Higher BMI was associated with an increased risk of both AR(+) and AR(-) breast tumors in postmenopausal women, whereas physical activity, including brisk walking, was associated with a reduced risk of both subtypes. In addition, a significant positive association was observed between higher BMI and ER(-)PR(-)AR(-) tumors.

IMPACT

The similar associations observed by AR status suggest that mechanisms other than androgen signaling underlie these two breast cancer risk factors.

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  • Authors+Show Affiliations

    ,

    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. poxue@channing.harvard.edu.

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    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.

    ,

    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.

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    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.

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    Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.

    ,

    Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts.

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    Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.

    ,

    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.

    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts. Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts.

    Source

    MeSH

    Adult
    Age Factors
    Biomarkers, Tumor
    Body Size
    Body Weight
    Breast Neoplasms
    Exercise
    Female
    Follow-Up Studies
    Humans
    Immunoenzyme Techniques
    Middle Aged
    Motor Activity
    Neoplasm Staging
    Nursing Staff
    Obesity
    Postmenopause
    Prognosis
    Receptors, Androgen
    Receptors, Estrogen
    Receptors, Progesterone
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25855627

    Citation

    Zhang, Xuehong, et al. "Adult Body Size and Physical Activity in Relation to Risk of Breast Cancer According to Tumor Androgen Receptor Status." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 24, no. 6, 2015, pp. 962-8.
    Zhang X, Eliassen AH, Tamimi RM, et al. Adult body size and physical activity in relation to risk of breast cancer according to tumor androgen receptor status. Cancer Epidemiol Biomarkers Prev. 2015;24(6):962-8.
    Zhang, X., Eliassen, A. H., Tamimi, R. M., Hazra, A., Beck, A. H., Brown, M., ... Hankinson, S. E. (2015). Adult body size and physical activity in relation to risk of breast cancer according to tumor androgen receptor status. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 24(6), pp. 962-8. doi:10.1158/1055-9965.EPI-14-1429.
    Zhang X, et al. Adult Body Size and Physical Activity in Relation to Risk of Breast Cancer According to Tumor Androgen Receptor Status. Cancer Epidemiol Biomarkers Prev. 2015;24(6):962-8. PubMed PMID: 25855627.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Adult body size and physical activity in relation to risk of breast cancer according to tumor androgen receptor status. AU - Zhang,Xuehong, AU - Eliassen,A Heather, AU - Tamimi,Rulla M, AU - Hazra,Aditi, AU - Beck,Andrew H, AU - Brown,Myles, AU - Collins,Laura C, AU - Rosner,Bernard, AU - Hankinson,Susan E, Y1 - 2015/04/08/ PY - 2014/12/29/received PY - 2015/03/23/accepted PY - 2015/4/10/entrez PY - 2015/4/10/pubmed PY - 2016/2/26/medline SP - 962 EP - 8 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 24 IS - 6 N2 - BACKGROUND: Obesity and physical activity have been hypothesized to affect breast cancer risk partly via the androgen signaling pathway. We conducted the first study to evaluate these associations by tumor androgen receptor (AR) status. METHODS: Height, weight, and physical activity were assessed using questionnaires in the Nurses' Health Study. AR, estrogen receptor (ER), and progesterone receptor (PR) status were determined using immunohistochemistry on tumor tissue and medical/pathology reports. RESULTS: A total of 1,701 AR(+) and 497 AR(-) cases were documented during 26 years of follow-up of 103,577 women. After adjusting for ER/PR status and other risk factors, the relative risks (RR) and 95% confidence intervals (95% CI) for every 5 kg/m(2) increase in body mass index (BMI) were 1.07 (1.01-1.13) for AR(+) and 1.16 (1.05-1.29) for AR(-) tumors (P-heterogeneity = 0.17). The RRs (95% CIs) per 5 hours of brisk walking/week were 0.87 (0.73-1.04) for AR(+) and 0.67 (0.45-0.99) for AR(-) tumors (P-heterogeneity = 0.22). Further, BMI, but not physical activity, associations differed significantly across ER/PR/AR subtypes (P-heterogeneity = 0.04 and 0.63, respectively). The RRs (95% CIs) for 5 kg/m(2) increase in BMI were 1.23 (1.04-1.45) for ER(+)PR(+)AR(-), 1.19 (1.01-1.39) for ER(-)PR(-)AR(-), 1.15 (1.08-1.23) for ER(+)PR(+)AR(+), and 0.88 (0.75-1.03) for ER(+)PR(-)AR(+) tumors. CONCLUSIONS: Higher BMI was associated with an increased risk of both AR(+) and AR(-) breast tumors in postmenopausal women, whereas physical activity, including brisk walking, was associated with a reduced risk of both subtypes. In addition, a significant positive association was observed between higher BMI and ER(-)PR(-)AR(-) tumors. IMPACT: The similar associations observed by AR status suggest that mechanisms other than androgen signaling underlie these two breast cancer risk factors. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/25855627/Adult_body_size_and_physical_activity_in_relation_to_risk_of_breast_cancer_according_to_tumor_androgen_receptor_status_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=25855627 DB - PRIME DP - Unbound Medicine ER -