Body size and weight change over adulthood and risk of breast cancer by menopausal and hormone receptor status: a pooled analysis of 20 prospective cohort studies

Piet A. van den Brandt*, Regina G. Ziegler, Molin Wang, Tao Hou, Ruifeng Li, Hans-Olov Adami, Claudia Agnoli, Leslie Bernstein, Julie E. Buring, Yu Chen, Avonne E. Connor, A. Heather Eliassen, Jeanine M. Genkinger, Gretchen Gierach, Graham G. Giles, Gary G. Goodman, Niclas Hakansson, Vittorio Krogh, Loic Le Marchand, I-Min LeeLinda M. Liao, M. Elena Martinez, Anthony B. Miller, Roger L. Milne, Marian L. Neuhouser, Alpa V. Patel, Anna Prizment, Kim Robien, Thomas E. Rohan, Norie Sawada, Leo J. Schouten, Rashmi Sinha, Rachael Z. Stolzenberg-Solomon, Lauren R. Teras, Shoichiro Tsugane, Kala Visvanathan, Elisabete Weiderpass, Kami K. White, Walter C. Willett, Alicja Wolk, Anne Zeleniuch-Jacquotte, Stephanie A. Smith-Warner

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Web of Science)

Abstract

Associations between anthropometric factors and breast cancer (BC) risk have varied inconsistently by estrogen and/or progesterone receptor (ER/PR) status. Associations between prediagnostic anthropometric factors and risk of premenopausal and postmenopausal BC overall and ER/PR status subtypes were investigated in a pooled analysis of 20 prospective cohorts, including 36,297 BC cases among 1,061,915 women, using multivariable Cox regression analyses, controlling for reproductive factors, diet and other risk factors. We estimated dose-response relationships and tested for nonlinear associations using restricted cubic splines. Height showed positive, linear associations for premenopausal and postmenopausal BC risk (6-7% RR increase per 5 cm increment), with stronger associations for receptor-positive subtypes. Body mass index (BMI) at cohort baseline was strongly inversely associated with premenopausal BC risk, and strongly positively-and nonlinearly-associated with postmenopausal BC (especially among women who never used hormone replacement therapy). This was primarily observed for receptor-positive subtypes. Early adult BMI (at 18-20 years) showed inverse, linear associations for premenopausal and postmenopausal BC risk (21% and 11% RR decrease per 5 kg/m(2), respectively) with stronger associations for receptor-negative subtypes. Adult weight gain since 18-20 years was positively associated with postmenopausal BC risk, stronger for receptor-positive subtypes, and among women who were leaner in early adulthood. Women heavier in early adulthood generally had reduced premenopausal BC risk, independent of later weight gain. Positive associations between height, baseline (adult) BMI, adult weight gain and postmenopausal BC risk were substantially stronger for hormone receptor-positive versus negative subtypes. Premenopausal BC risk was positively associated with height, but inversely with baseline BMI and weight gain (mostly in receptor-positive subtypes). Inverse associations with early adult BMI seemed stronger in receptor-negative subtypes of premenopausal and postmenopausal BC.

Original languageEnglish
Pages (from-to)37-55
Number of pages19
JournalEuropean Journal of Epidemiology
Volume36
Issue number1
Early online date30 Oct 2020
DOIs
Publication statusPublished - Jan 2021

Keywords

  • Breast neoplasms
  • Body height
  • Body weight
  • Weight change
  • Estrogen receptor
  • Cohort studies
  • MASS INDEX
  • POSTMENOPAUSAL WOMEN
  • REGRESSION-MODELS
  • PHYSICAL-ACTIVITY
  • SEX-HORMONES
  • EARLY-LIFE
  • ESTROGEN
  • PROGESTERONE
  • GROWTH
  • METAANALYSIS

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