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Adiposity and breast cancer risk in postmenopausal women: Results from the UK Biobank prospective cohort.

Abstract

Body size is an important modifiable risk factor for postmenopausal breast cancer. However, it remains unclear whether direct measures of fat mass are better indicators of risk than anthropometric measures, or whether central adiposity may contribute to risk beyond overall adiposity. We analyzed data from 162,691 postmenopausal women in UK Biobank followed from 2006 to 2014. Body size was measured by trained technicians. Multivariable-adjusted Cox regression was used to estimate relative risks. Analyses were stratified by age at recruitment, region and socioeconomic status, and adjusted for family history of breast cancer, age at menarche, age at first birth, parity, age at menopause, previous hormone replacement therapy use, smoking, alcohol intake, height, physical activity and ethnicity. We observed 2,913 incident invasive breast cancers during a mean 5.7 years of follow-up. There was a continuous increase in risk of postmenopausal breast cancer with increasing adiposity, across all measures. The point estimate, comparing women in the top (median 37.6 kg) to bottom (median 17.6 kg) quartile of body fat mass was 1.70 (95% confidence interval 1.52-1.90). The magnitudes of the associations between per SD increase in BMI and body fat mass with breast cancer risk were similar, suggesting impedance measures of fat were not substantially better indicators of risk than anthropometric measures. After adjusting for body fat mass, the associations between anthropometric measures of central adiposity and breast cancer risk were attenuated. The magnitude of risk, across all measures of adiposity, was greater in women who had been postmenopausal for 12 or more years.

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  • Authors+Show Affiliations

    ,

    Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

    ,

    Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

    Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

    Source

    International journal of cancer 143:5 2018 09 01 pg 1037-1046

    MeSH

    Adiposity
    Adult
    Aged
    Biological Specimen Banks
    Body Mass Index
    Breast Neoplasms
    Female
    Follow-Up Studies
    Humans
    Middle Aged
    Obesity
    Postmenopause
    Prognosis
    Prospective Studies
    Risk Factors
    Waist-Hip Ratio

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    29569713

    Citation

    Guo, Wenji, et al. "Adiposity and Breast Cancer Risk in Postmenopausal Women: Results From the UK Biobank Prospective Cohort." International Journal of Cancer, vol. 143, no. 5, 2018, pp. 1037-1046.
    Guo W, Key TJ, Reeves GK. Adiposity and breast cancer risk in postmenopausal women: Results from the UK Biobank prospective cohort. Int J Cancer. 2018;143(5):1037-1046.
    Guo, W., Key, T. J., & Reeves, G. K. (2018). Adiposity and breast cancer risk in postmenopausal women: Results from the UK Biobank prospective cohort. International Journal of Cancer, 143(5), pp. 1037-1046. doi:10.1002/ijc.31394.
    Guo W, Key TJ, Reeves GK. Adiposity and Breast Cancer Risk in Postmenopausal Women: Results From the UK Biobank Prospective Cohort. Int J Cancer. 2018 09 1;143(5):1037-1046. PubMed PMID: 29569713.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Adiposity and breast cancer risk in postmenopausal women: Results from the UK Biobank prospective cohort. AU - Guo,Wenji, AU - Key,Timothy J, AU - Reeves,Gillian K, Y1 - 2018/04/10/ PY - 2018/01/03/received PY - 2018/03/05/revised PY - 2018/03/13/accepted PY - 2018/3/24/pubmed PY - 2019/1/15/medline PY - 2018/3/24/entrez KW - UK Biobank KW - adiposity KW - bioelectrical impedance KW - breast cancer KW - obesity SP - 1037 EP - 1046 JF - International journal of cancer JO - Int. J. Cancer VL - 143 IS - 5 N2 - Body size is an important modifiable risk factor for postmenopausal breast cancer. However, it remains unclear whether direct measures of fat mass are better indicators of risk than anthropometric measures, or whether central adiposity may contribute to risk beyond overall adiposity. We analyzed data from 162,691 postmenopausal women in UK Biobank followed from 2006 to 2014. Body size was measured by trained technicians. Multivariable-adjusted Cox regression was used to estimate relative risks. Analyses were stratified by age at recruitment, region and socioeconomic status, and adjusted for family history of breast cancer, age at menarche, age at first birth, parity, age at menopause, previous hormone replacement therapy use, smoking, alcohol intake, height, physical activity and ethnicity. We observed 2,913 incident invasive breast cancers during a mean 5.7 years of follow-up. There was a continuous increase in risk of postmenopausal breast cancer with increasing adiposity, across all measures. The point estimate, comparing women in the top (median 37.6 kg) to bottom (median 17.6 kg) quartile of body fat mass was 1.70 (95% confidence interval 1.52-1.90). The magnitudes of the associations between per SD increase in BMI and body fat mass with breast cancer risk were similar, suggesting impedance measures of fat were not substantially better indicators of risk than anthropometric measures. After adjusting for body fat mass, the associations between anthropometric measures of central adiposity and breast cancer risk were attenuated. The magnitude of risk, across all measures of adiposity, was greater in women who had been postmenopausal for 12 or more years. SN - 1097-0215 UR - https://www.unboundmedicine.com/medline/citation/29569713/Adiposity_and_breast_cancer_risk_in_postmenopausal_women:_Results_from_the_UK_Biobank_prospective_cohort_ L2 - https://doi.org/10.1002/ijc.31394 DB - PRIME DP - Unbound Medicine ER -