Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study.
INTRODUCTION: Associations of hormone-receptor positive breast cancer with excess adiposity are reasonably well characterized; however, uncertainty remains regarding the association of body mass index (BMI) with hormone-receptor negative malignancies, and possible interactions by hormone replacement...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2012
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| _version_ | 1797054380886720512 |
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| author | Ritte, R Lukanova, A Berrino, F Dossus, L Tjønneland, A Olsen, A Overvad, T Overvad, K Clavel-Chapelon, F Fournier, A Fagherazzi, G Rohrmann, S Teucher, B Boeing, H Aleksandrova, K Trichopoulou, A Lagiou, P Trichopoulos, D Palli, D Sieri, S Panico, S Tumino, R Vineis, P Quirós, JR Buckland, G |
| author_facet | Ritte, R Lukanova, A Berrino, F Dossus, L Tjønneland, A Olsen, A Overvad, T Overvad, K Clavel-Chapelon, F Fournier, A Fagherazzi, G Rohrmann, S Teucher, B Boeing, H Aleksandrova, K Trichopoulou, A Lagiou, P Trichopoulos, D Palli, D Sieri, S Panico, S Tumino, R Vineis, P Quirós, JR Buckland, G |
| author_sort | Ritte, R |
| collection | OXFORD |
| description | INTRODUCTION: Associations of hormone-receptor positive breast cancer with excess adiposity are reasonably well characterized; however, uncertainty remains regarding the association of body mass index (BMI) with hormone-receptor negative malignancies, and possible interactions by hormone replacement therapy (HRT) use. METHODS: Within the European EPIC cohort, Cox proportional hazards models were used to describe the relationship of BMI, waist and hip circumferences with risk of estrogen-receptor (ER) negative and progesterone-receptor (PR) negative (n = 1,021) and ER+PR+ (n = 3,586) breast tumors within five-year age bands. Among postmenopausal women, the joint effects of BMI and HRT use were analyzed. RESULTS: For risk of ER-PR- tumors, there was no association of BMI across the age bands. However, when analyses were restricted to postmenopausal HRT never users, a positive risk association with BMI (third versus first tertile HR = 1.47 (1.01 to 2.15)) was observed. BMI was inversely associated with ER+PR+ tumors among women aged ≤49 years (per 5 kg/m2 increase, HR = 0.79 (95%CI 0.68 to 0.91)), and positively associated with risk among women ≥65 years (HR = 1.25 (1.16 to 1.34)). Adjusting for BMI, waist and hip circumferences showed no further associations with risks of breast cancer subtypes. Current use of HRT was significantly associated with an increased risk of receptor-negative (HRT current use compared to HRT never use HR: 1.30 (1.05 to 1.62)) and positive tumors (HR: 1.74 (1.56 to 1.95)), although this risk increase was weaker for ER-PR- disease (Phet = 0.035). The association of HRT was significantly stronger in the leaner women (BMI ≤22.5 kg/m2) than for more overweight women (BMI ≥25.9 kg/m2) for, both, ER-PR- (HR: 1.74 (1.15 to 2.63)) and ER+PR+ (HR: 2.33 (1.84 to 2.92)) breast cancer and was not restricted to any particular HRT regime. CONCLUSIONS: An elevated BMI may be positively associated with risk of ER-PR- tumors among postmenopausal women who never used HRT. Furthermore, postmenopausal HRT users were at an increased risk of ER-PR- as well as ER+PR+ tumors, especially among leaner women. For hormone-receptor positive tumors, but not for hormone-receptor negative tumors, our study confirms an inverse association of risk with BMI among young women of premenopausal age. Our data provide evidence for a possible role of sex hormones in the etiology of hormone-receptor negative tumors. |
| first_indexed | 2024-03-06T18:56:29Z |
| format | Journal article |
| id | oxford-uuid:12013e1c-5f43-4911-aa69-c664611828ff |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:56:29Z |
| publishDate | 2012 |
| record_format | dspace |
| spelling | oxford-uuid:12013e1c-5f43-4911-aa69-c664611828ff2022-03-26T10:05:26ZAdiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:12013e1c-5f43-4911-aa69-c664611828ffEnglishSymplectic Elements at Oxford2012Ritte, RLukanova, ABerrino, FDossus, LTjønneland, AOlsen, AOvervad, TOvervad, KClavel-Chapelon, FFournier, AFagherazzi, GRohrmann, STeucher, BBoeing, HAleksandrova, KTrichopoulou, ALagiou, PTrichopoulos, DPalli, DSieri, SPanico, STumino, RVineis, PQuirós, JRBuckland, GINTRODUCTION: Associations of hormone-receptor positive breast cancer with excess adiposity are reasonably well characterized; however, uncertainty remains regarding the association of body mass index (BMI) with hormone-receptor negative malignancies, and possible interactions by hormone replacement therapy (HRT) use. METHODS: Within the European EPIC cohort, Cox proportional hazards models were used to describe the relationship of BMI, waist and hip circumferences with risk of estrogen-receptor (ER) negative and progesterone-receptor (PR) negative (n = 1,021) and ER+PR+ (n = 3,586) breast tumors within five-year age bands. Among postmenopausal women, the joint effects of BMI and HRT use were analyzed. RESULTS: For risk of ER-PR- tumors, there was no association of BMI across the age bands. However, when analyses were restricted to postmenopausal HRT never users, a positive risk association with BMI (third versus first tertile HR = 1.47 (1.01 to 2.15)) was observed. BMI was inversely associated with ER+PR+ tumors among women aged ≤49 years (per 5 kg/m2 increase, HR = 0.79 (95%CI 0.68 to 0.91)), and positively associated with risk among women ≥65 years (HR = 1.25 (1.16 to 1.34)). Adjusting for BMI, waist and hip circumferences showed no further associations with risks of breast cancer subtypes. Current use of HRT was significantly associated with an increased risk of receptor-negative (HRT current use compared to HRT never use HR: 1.30 (1.05 to 1.62)) and positive tumors (HR: 1.74 (1.56 to 1.95)), although this risk increase was weaker for ER-PR- disease (Phet = 0.035). The association of HRT was significantly stronger in the leaner women (BMI ≤22.5 kg/m2) than for more overweight women (BMI ≥25.9 kg/m2) for, both, ER-PR- (HR: 1.74 (1.15 to 2.63)) and ER+PR+ (HR: 2.33 (1.84 to 2.92)) breast cancer and was not restricted to any particular HRT regime. CONCLUSIONS: An elevated BMI may be positively associated with risk of ER-PR- tumors among postmenopausal women who never used HRT. Furthermore, postmenopausal HRT users were at an increased risk of ER-PR- as well as ER+PR+ tumors, especially among leaner women. For hormone-receptor positive tumors, but not for hormone-receptor negative tumors, our study confirms an inverse association of risk with BMI among young women of premenopausal age. Our data provide evidence for a possible role of sex hormones in the etiology of hormone-receptor negative tumors. |
| spellingShingle | Ritte, R Lukanova, A Berrino, F Dossus, L Tjønneland, A Olsen, A Overvad, T Overvad, K Clavel-Chapelon, F Fournier, A Fagherazzi, G Rohrmann, S Teucher, B Boeing, H Aleksandrova, K Trichopoulou, A Lagiou, P Trichopoulos, D Palli, D Sieri, S Panico, S Tumino, R Vineis, P Quirós, JR Buckland, G Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study. |
| title | Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study. |
| title_full | Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study. |
| title_fullStr | Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study. |
| title_full_unstemmed | Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study. |
| title_short | Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study. |
| title_sort | adiposity hormone replacement therapy use and breast cancer risk by age and hormone receptor status a large prospective cohort study |
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