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Dual effects of weight and weight gain on breast cancer risk.

Abstract

CONTEXT

Breast cancer is a major cause of mortality among women. It is important to identify modifiable risk factors for this disease.

OBJECTIVE

To examine body mass index (BMI) at the age of 18 years and at midlife and adult weight change in relation to breast cancer incidence and mortality.

DESIGN

Cohort study.

SETTING

A cohort of 95256 US female nurses aged 30 to 55 years who were followed up for 16 years.

MAIN OUTCOME MEASURE

Incident and fatal breast cancer.

RESULTS

During 1203498 person-years, 2517 incident breast cancers (60% postmenopausal) were documented. Higher current BMI was associated with lower breast cancer incidence before menopause and was minimally associated with incidence after menopause. However, a stronger positive relationship was seen among postmenopausal women who never used hormone replacement (relative risk=1.59 for BMI >31 kg/m2 vs < or = 20 kg/m2; 95% confidence interval, 1.09-2.32; P for trend <.001). Higher BMI at the age of 18 years was associated with lower breast cancer incidence both before and after menopause. Weight gain after the age of 18 years was unrelated to breast cancer incidence before menopause, but was positively associated with incidence after menopause. This increased risk with weight gain was limited to women who never used postmenopausal hormones; among these women, the relative risk was 1.99 (95% confidence interval, 1.43-2.76) for weight gain of more than 20 kg vs unchanged weight (P for trend <.001). Current BMI and weight gain were even more strongly associated with fatal postmenopausal breast cancer. In this population, the percentage of postmenopausal breast cancer accounted for by weight gain alone was approximately 16% and by hormone replacement therapy alone was 5%, but when the interaction between these variables was considered, together they accounted for about one third of postmenopausal breast cancers.

CONCLUSIONS

Avoiding adult weight gain may contribute importantly to the prevention of breast cancer after menopause, particularly among women who do not use postmenopausal hormones.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.

    , , , , , , , ,

    Source

    JAMA 278:17 1997 Nov 05 pg 1407-11

    MeSH

    Adolescent
    Adult
    Body Mass Index
    Breast Neoplasms
    Cohort Studies
    Estrogen Replacement Therapy
    Female
    Humans
    Incidence
    Longitudinal Studies
    Menopause
    Middle Aged
    Multivariate Analysis
    Obesity
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Weight Gain

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    9355998

    Citation

    Huang, Z, et al. "Dual Effects of Weight and Weight Gain On Breast Cancer Risk." JAMA, vol. 278, no. 17, 1997, pp. 1407-11.
    Huang Z, Hankinson SE, Colditz GA, et al. Dual effects of weight and weight gain on breast cancer risk. JAMA. 1997;278(17):1407-11.
    Huang, Z., Hankinson, S. E., Colditz, G. A., Stampfer, M. J., Hunter, D. J., Manson, J. E., ... Willett, W. C. (1997). Dual effects of weight and weight gain on breast cancer risk. JAMA, 278(17), pp. 1407-11.
    Huang Z, et al. Dual Effects of Weight and Weight Gain On Breast Cancer Risk. JAMA. 1997 Nov 5;278(17):1407-11. PubMed PMID: 9355998.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dual effects of weight and weight gain on breast cancer risk. AU - Huang,Z, AU - Hankinson,S E, AU - Colditz,G A, AU - Stampfer,M J, AU - Hunter,D J, AU - Manson,J E, AU - Hennekens,C H, AU - Rosner,B, AU - Speizer,F E, AU - Willett,W C, PY - 1997/11/14/pubmed PY - 1997/11/14/medline PY - 1997/11/14/entrez SP - 1407 EP - 11 JF - JAMA JO - JAMA VL - 278 IS - 17 N2 - CONTEXT: Breast cancer is a major cause of mortality among women. It is important to identify modifiable risk factors for this disease. OBJECTIVE: To examine body mass index (BMI) at the age of 18 years and at midlife and adult weight change in relation to breast cancer incidence and mortality. DESIGN: Cohort study. SETTING: A cohort of 95256 US female nurses aged 30 to 55 years who were followed up for 16 years. MAIN OUTCOME MEASURE: Incident and fatal breast cancer. RESULTS: During 1203498 person-years, 2517 incident breast cancers (60% postmenopausal) were documented. Higher current BMI was associated with lower breast cancer incidence before menopause and was minimally associated with incidence after menopause. However, a stronger positive relationship was seen among postmenopausal women who never used hormone replacement (relative risk=1.59 for BMI >31 kg/m2 vs < or = 20 kg/m2; 95% confidence interval, 1.09-2.32; P for trend <.001). Higher BMI at the age of 18 years was associated with lower breast cancer incidence both before and after menopause. Weight gain after the age of 18 years was unrelated to breast cancer incidence before menopause, but was positively associated with incidence after menopause. This increased risk with weight gain was limited to women who never used postmenopausal hormones; among these women, the relative risk was 1.99 (95% confidence interval, 1.43-2.76) for weight gain of more than 20 kg vs unchanged weight (P for trend <.001). Current BMI and weight gain were even more strongly associated with fatal postmenopausal breast cancer. In this population, the percentage of postmenopausal breast cancer accounted for by weight gain alone was approximately 16% and by hormone replacement therapy alone was 5%, but when the interaction between these variables was considered, together they accounted for about one third of postmenopausal breast cancers. CONCLUSIONS: Avoiding adult weight gain may contribute importantly to the prevention of breast cancer after menopause, particularly among women who do not use postmenopausal hormones. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/9355998/Dual_effects_of_weight_and_weight_gain_on_breast_cancer_risk_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/278/pg/1407 DB - PRIME DP - Unbound Medicine ER -