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Body mass index at age 18 years and recent body mass index in relation to risk of breast cancer overall and ER/PR/HER2-defined subtypes in white women and African-American women: a pooled analysis.
Breast Cancer Res 2018; 20(1):5BC

Abstract

BACKGROUND

Although it has been well-documented that obesity is associated with decreased risk of premenopausal breast cancer and increased risk of postmenopausal breast cancer, it is unclear whether these associations differ among breast cancer subtypes defined by the tumor protein expression status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2).

METHODS

We evaluated the associations of body mass index (BMI) at age 18 years and recent BMI in relation to risk of breast cancer overall and ER/PR/HER2-defined subtypes, in 6320 women (3934 case-patient participants, 2386 control participants) aged 35-64 years, who participated in one of three population-based case-control studies. We estimated multivariable-adjusted odd ratios (ORs) and corresponding 95% confidence intervals (CIs) using polychotomous unconditional logistic regression methods for case-control comparisons in premenopausal women and postmenopausal women.

RESULTS

BMI at age 18 years was inversely associated with risk of breast cancer, particularly among premenopausal women (≥ 25 vs. < 20 kg/m2, OR = 0.72, 95% CI = 0.53-0.96; per 5 kg/m2 increase, OR = 0.83, 95% CI = 0.73-0.95). This inverse association did not differ across ER/PR/HER2-defined subtypes or by race (white women, African-American women). Recent BMI was not associated with risk of premenopausal breast cancer after adjustment for BMI at age 18 years; nevertheless, the analysis for the joint effects of BMI at age 18 years and recent BMI showed that premenopausal women in the highest categories of the two BMI measures (≥ 25 kg/m2 at age 18 years and ≥ 30 kg/m2 for recent BMI) had 46% lower risk of breast cancer than premenopausal women in the lowest categories of the two BMI measures (< 20 kg/m2 at age 18 years and < 25 kg/m2 for recent BMI; OR = 0.54, 95% CI = 0.38-0.78). Neither measure of BMI was statistically significantly associated with risk of postmenopausal breast cancer.

CONCLUSION

Our findings indicate that high BMI near the end of adolescence decreases risk of all ER/PR/HER2-defined subtypes of premenopausal breast cancer and also suggest that this benefit could be maximized among premenopausal women who consistently have high BMI during their premenopausal years.

Authors+Show Affiliations

Department of Population Sciences, Beckman Research Institute, City of Hope, 1500 East Duarte Rd., Duarte, CA, 91010, USA. hma@coh.org.Cancer Registry of Norway, Oslo, Norway. Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.Department of Population Sciences, Beckman Research Institute, City of Hope, 1500 East Duarte Rd., Duarte, CA, 91010, USA.Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.Department of Population Sciences, Beckman Research Institute, City of Hope, 1500 East Duarte Rd., Duarte, CA, 91010, USA. Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France.Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA.Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA.College of Health and Social Services, New Mexico State University, Las Cruces, NM, 88003, USA.Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, MI, 48201, USA.Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA.Department of Population Sciences, Beckman Research Institute, City of Hope, 1500 East Duarte Rd., Duarte, CA, 91010, USA.Department of Population Sciences, Beckman Research Institute, City of Hope, 1500 East Duarte Rd., Duarte, CA, 91010, USA.Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.Department of Population Sciences, Beckman Research Institute, City of Hope, 1500 East Duarte Rd., Duarte, CA, 91010, USA.

Pub Type(s)

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

Language

eng

PubMed ID

29357906

Citation

Ma, Huiyan, et al. "Body Mass Index at Age 18 Years and Recent Body Mass Index in Relation to Risk of Breast Cancer Overall and ER/PR/HER2-defined Subtypes in White Women and African-American Women: a Pooled Analysis." Breast Cancer Research : BCR, vol. 20, no. 1, 2018, p. 5.
Ma H, Ursin G, Xu X, et al. Body mass index at age 18 years and recent body mass index in relation to risk of breast cancer overall and ER/PR/HER2-defined subtypes in white women and African-American women: a pooled analysis. Breast Cancer Res. 2018;20(1):5.
Ma, H., Ursin, G., Xu, X., Lee, E., Togawa, K., Malone, K. E., ... Bernstein, L. (2018). Body mass index at age 18 years and recent body mass index in relation to risk of breast cancer overall and ER/PR/HER2-defined subtypes in white women and African-American women: a pooled analysis. Breast Cancer Research : BCR, 20(1), p. 5. doi:10.1186/s13058-017-0931-5.
Ma H, et al. Body Mass Index at Age 18 Years and Recent Body Mass Index in Relation to Risk of Breast Cancer Overall and ER/PR/HER2-defined Subtypes in White Women and African-American Women: a Pooled Analysis. Breast Cancer Res. 2018 01 22;20(1):5. PubMed PMID: 29357906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body mass index at age 18 years and recent body mass index in relation to risk of breast cancer overall and ER/PR/HER2-defined subtypes in white women and African-American women: a pooled analysis. AU - Ma,Huiyan, AU - Ursin,Giske, AU - Xu,Xinxin, AU - Lee,Eunjung, AU - Togawa,Kayo, AU - Malone,Kathleen E, AU - Marchbanks,Polly A, AU - McDonald,Jill A, AU - Simon,Michael S, AU - Folger,Suzanne G, AU - Lu,Yani, AU - Sullivan-Halley,Jane, AU - Deapen,Dennis M, AU - Press,Michael F, AU - Bernstein,Leslie, Y1 - 2018/01/22/ PY - 2017/08/23/received PY - 2017/12/28/accepted PY - 2018/1/24/entrez PY - 2018/1/24/pubmed PY - 2019/3/23/medline KW - African-American women KW - Body mass index KW - Body size KW - Breast cancer KW - Luminal-like KW - Triple negative KW - White women SP - 5 EP - 5 JF - Breast cancer research : BCR JO - Breast Cancer Res. VL - 20 IS - 1 N2 - BACKGROUND: Although it has been well-documented that obesity is associated with decreased risk of premenopausal breast cancer and increased risk of postmenopausal breast cancer, it is unclear whether these associations differ among breast cancer subtypes defined by the tumor protein expression status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). METHODS: We evaluated the associations of body mass index (BMI) at age 18 years and recent BMI in relation to risk of breast cancer overall and ER/PR/HER2-defined subtypes, in 6320 women (3934 case-patient participants, 2386 control participants) aged 35-64 years, who participated in one of three population-based case-control studies. We estimated multivariable-adjusted odd ratios (ORs) and corresponding 95% confidence intervals (CIs) using polychotomous unconditional logistic regression methods for case-control comparisons in premenopausal women and postmenopausal women. RESULTS: BMI at age 18 years was inversely associated with risk of breast cancer, particularly among premenopausal women (≥ 25 vs. < 20 kg/m2, OR = 0.72, 95% CI = 0.53-0.96; per 5 kg/m2 increase, OR = 0.83, 95% CI = 0.73-0.95). This inverse association did not differ across ER/PR/HER2-defined subtypes or by race (white women, African-American women). Recent BMI was not associated with risk of premenopausal breast cancer after adjustment for BMI at age 18 years; nevertheless, the analysis for the joint effects of BMI at age 18 years and recent BMI showed that premenopausal women in the highest categories of the two BMI measures (≥ 25 kg/m2 at age 18 years and ≥ 30 kg/m2 for recent BMI) had 46% lower risk of breast cancer than premenopausal women in the lowest categories of the two BMI measures (< 20 kg/m2 at age 18 years and < 25 kg/m2 for recent BMI; OR = 0.54, 95% CI = 0.38-0.78). Neither measure of BMI was statistically significantly associated with risk of postmenopausal breast cancer. CONCLUSION: Our findings indicate that high BMI near the end of adolescence decreases risk of all ER/PR/HER2-defined subtypes of premenopausal breast cancer and also suggest that this benefit could be maximized among premenopausal women who consistently have high BMI during their premenopausal years. SN - 1465-542X UR - https://www.unboundmedicine.com/medline/citation/29357906/Body_mass_index_at_age_18_years_and_recent_body_mass_index_in_relation_to_risk_of_breast_cancer_overall_and_ER/PR/HER2_defined_subtypes_in_white_women_and_African_American_women:_a_pooled_analysis_ L2 - https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-017-0931-5 DB - PRIME DP - Unbound Medicine ER -