Obesity as risk factor for subtypes of breast cancer: results from a prospective cohort study
Abstract Background Earlier epidemiological studies indicate that associations between obesity and breast cancer risk may not only depend on menopausal status and use of exogenous hormones, but might also differ by tumor subtype. Here, we evaluated whether obesity is differentially associated with t...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-05-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12885-018-4548-6 |
| _version_ | 1818291941813518336 |
|---|---|
| author | Cina J. Nattenmüller Mark Kriegsmann Disorn Sookthai Renée Turzanski Fortner Annika Steffen Britta Walter Theron Johnson Jutta Kneisel Verena Katzke Manuela Bergmann Hans Peter Sinn Peter Schirmacher Esther Herpel Heiner Boeing Rudolf Kaaks Tilman Kühn |
| author_facet | Cina J. Nattenmüller Mark Kriegsmann Disorn Sookthai Renée Turzanski Fortner Annika Steffen Britta Walter Theron Johnson Jutta Kneisel Verena Katzke Manuela Bergmann Hans Peter Sinn Peter Schirmacher Esther Herpel Heiner Boeing Rudolf Kaaks Tilman Kühn |
| author_sort | Cina J. Nattenmüller |
| collection | DOAJ |
| description | Abstract Background Earlier epidemiological studies indicate that associations between obesity and breast cancer risk may not only depend on menopausal status and use of exogenous hormones, but might also differ by tumor subtype. Here, we evaluated whether obesity is differentially associated with the risk of breast tumor subtypes, as defined by 6 immunohistochemical markers (ER, PR, HER2, Ki67, Bcl-2 and p53, separately and combined), in the prospective EPIC-Germany Study (n = 27,012). Methods Formalin-fixed and paraffin-embedded (FFPE) tumor tissues of 657 incident breast cancer cases were used for histopathological analyses. Associations between BMI and breast cancer risk across subtypes were evaluated by multivariable Cox regression models stratified by menopausal status and hormone therapy (HT) use. Results Among postmenopausal non-users of HT, higher BMI was significantly associated with an increased risk of less aggressive, i.e. ER+, PR+, HER2-, Ki67low, Bcl-2+ and p53- tumors (HR per 5 kg/m2: 1.44 [1.10, 1.90], p = 0.009), but not with risk of more aggressive tumor subtypes. Among postmenopausal users of HT, BMI was significantly inversely associated with less aggressive tumors (HR per 5 kg/m2: 0.68 [0.50, 0.94], p = 0.018). Finally, among pre- and perimenopausal women, Cox regression models did not reveal significant linear associations between BMI and risk of any tumor subtype, although analyses by BMI tertiles showed a significantly lower risk of less aggressive tumors for women in the highest tertile (HR: 0.55 [0.33, 0.93]). Conclusion Overall, our results suggest that obesity is related to risk of breast tumors with lower aggressiveness, a finding that requires replication in larger-scale analyses of pooled prospective data. |
| first_indexed | 2024-12-13T02:52:04Z |
| format | Article |
| id | doaj.art-078d95219a714ca8bdaa74c1ed66d2e3 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-13T02:52:04Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-078d95219a714ca8bdaa74c1ed66d2e32022-12-22T00:02:02ZengBMCBMC Cancer1471-24072018-05-011811810.1186/s12885-018-4548-6Obesity as risk factor for subtypes of breast cancer: results from a prospective cohort studyCina J. Nattenmüller0Mark Kriegsmann1Disorn Sookthai2Renée Turzanski Fortner3Annika Steffen4Britta Walter5Theron Johnson6Jutta Kneisel7Verena Katzke8Manuela Bergmann9Hans Peter Sinn10Peter Schirmacher11Esther Herpel12Heiner Boeing13Rudolf Kaaks14Tilman Kühn15Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)Institute of Pathology, University Hospital HeidelbergDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ)Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)Department of Epidemiology, German Institute of Human Nutrition (DIfE) Postdam-RehbrückeInstitute of Pathology, University Hospital HeidelbergDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ)Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)Department of Epidemiology, German Institute of Human Nutrition (DIfE) Postdam-RehbrückeInstitute of Pathology, University Hospital HeidelbergInstitute of Pathology, University Hospital HeidelbergInstitute of Pathology, University Hospital HeidelbergDepartment of Epidemiology, German Institute of Human Nutrition (DIfE) Postdam-RehbrückeDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ)Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)Abstract Background Earlier epidemiological studies indicate that associations between obesity and breast cancer risk may not only depend on menopausal status and use of exogenous hormones, but might also differ by tumor subtype. Here, we evaluated whether obesity is differentially associated with the risk of breast tumor subtypes, as defined by 6 immunohistochemical markers (ER, PR, HER2, Ki67, Bcl-2 and p53, separately and combined), in the prospective EPIC-Germany Study (n = 27,012). Methods Formalin-fixed and paraffin-embedded (FFPE) tumor tissues of 657 incident breast cancer cases were used for histopathological analyses. Associations between BMI and breast cancer risk across subtypes were evaluated by multivariable Cox regression models stratified by menopausal status and hormone therapy (HT) use. Results Among postmenopausal non-users of HT, higher BMI was significantly associated with an increased risk of less aggressive, i.e. ER+, PR+, HER2-, Ki67low, Bcl-2+ and p53- tumors (HR per 5 kg/m2: 1.44 [1.10, 1.90], p = 0.009), but not with risk of more aggressive tumor subtypes. Among postmenopausal users of HT, BMI was significantly inversely associated with less aggressive tumors (HR per 5 kg/m2: 0.68 [0.50, 0.94], p = 0.018). Finally, among pre- and perimenopausal women, Cox regression models did not reveal significant linear associations between BMI and risk of any tumor subtype, although analyses by BMI tertiles showed a significantly lower risk of less aggressive tumors for women in the highest tertile (HR: 0.55 [0.33, 0.93]). Conclusion Overall, our results suggest that obesity is related to risk of breast tumors with lower aggressiveness, a finding that requires replication in larger-scale analyses of pooled prospective data.http://link.springer.com/article/10.1186/s12885-018-4548-6Breast cancerObesityTumor subtypesEstrogen receptorKi-67p53 |
| spellingShingle | Cina J. Nattenmüller Mark Kriegsmann Disorn Sookthai Renée Turzanski Fortner Annika Steffen Britta Walter Theron Johnson Jutta Kneisel Verena Katzke Manuela Bergmann Hans Peter Sinn Peter Schirmacher Esther Herpel Heiner Boeing Rudolf Kaaks Tilman Kühn Obesity as risk factor for subtypes of breast cancer: results from a prospective cohort study BMC Cancer Breast cancer Obesity Tumor subtypes Estrogen receptor Ki-67 p53 |
| title | Obesity as risk factor for subtypes of breast cancer: results from a prospective cohort study |
| title_full | Obesity as risk factor for subtypes of breast cancer: results from a prospective cohort study |
| title_fullStr | Obesity as risk factor for subtypes of breast cancer: results from a prospective cohort study |
| title_full_unstemmed | Obesity as risk factor for subtypes of breast cancer: results from a prospective cohort study |
| title_short | Obesity as risk factor for subtypes of breast cancer: results from a prospective cohort study |
| title_sort | obesity as risk factor for subtypes of breast cancer results from a prospective cohort study |
| topic | Breast cancer Obesity Tumor subtypes Estrogen receptor Ki-67 p53 |
| url | http://link.springer.com/article/10.1186/s12885-018-4548-6 |
| work_keys_str_mv | AT cinajnattenmuller obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT markkriegsmann obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT disornsookthai obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT reneeturzanskifortner obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT annikasteffen obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT brittawalter obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT theronjohnson obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT juttakneisel obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT verenakatzke obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT manuelabergmann obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT hanspetersinn obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT peterschirmacher obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT estherherpel obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT heinerboeing obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT rudolfkaaks obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy AT tilmankuhn obesityasriskfactorforsubtypesofbreastcancerresultsfromaprospectivecohortstudy |