Adult weight change and incidence of premenopausal breast cancer
Corresponding Author
Karin B. Michels
Department of Obstetrics, Gynecology and Reproductive Biology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Epidemiology, Harvard School of Public Health, Boston, MA
Tel.: 617-732-8496, Fax: 617-732-4899
Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USASearch for more papers by this authorKathryn L. Terry
Department of Obstetrics, Gynecology and Reproductive Biology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Search for more papers by this authorA. Heather Eliassen
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Search for more papers by this authorSusan E. Hankinson
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Epidemiology, Harvard School of Public Health, Boston, MA
Search for more papers by this authorWalter C. Willett
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Epidemiology, Harvard School of Public Health, Boston, MA
Department of Nutrition, Harvard School of Public Health, Boston, MA
Search for more papers by this authorCorresponding Author
Karin B. Michels
Department of Obstetrics, Gynecology and Reproductive Biology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Epidemiology, Harvard School of Public Health, Boston, MA
Tel.: 617-732-8496, Fax: 617-732-4899
Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USASearch for more papers by this authorKathryn L. Terry
Department of Obstetrics, Gynecology and Reproductive Biology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Search for more papers by this authorA. Heather Eliassen
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Search for more papers by this authorSusan E. Hankinson
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Epidemiology, Harvard School of Public Health, Boston, MA
Search for more papers by this authorWalter C. Willett
Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Department of Epidemiology, Harvard School of Public Health, Boston, MA
Department of Nutrition, Harvard School of Public Health, Boston, MA
Search for more papers by this authorAbstract
Overweight and obesity are inversely related to the risk of breast cancer among premenopausal women. We assessed the association between adult weight change since age 18 years with the risk of breast cancer among premenopausal women to explore whether weight gain was associated with a decrease in risk and weight loss was associated with an increase in risk. A total of 56,223 premenopausal participants in the Nurses' Health Study and 109,385 premenopausal participants in the Nurses' Health Study II were prospectively followed for up to 32 years and 18 years, respectively, and weight change since age 18 years was assessed biennially. The incidence of invasive breast cancer was assessed throughout follow-up. Weight loss of 5 kg or more since age 18, maintained for at least 4 years, was related to lower incidence of premenopausal breast cancer, compared to maintaining a stable weight, but this relation was of borderline statistical significance (covariate-adjusted HR = 0.75; 95% CI 0.52–1.09). Weight gain since age 18 years was also inversely related to breast cancer incidence among premenopausal women (covariate-adjusted p for trend = 0.01), but the association weakened after controlling for weight at age 18 and did not reach statistical significance (p for trend = 0.08). Although obesity and breast cancer among premenopausal women are inversely related, weight loss since age 18 years did not increase and weight gain did not significantly decrease the risk of premenopausal breast cancer among participants in the large prospective cohorts of NHS and NHS II.
References
- 1 Michels KB, Terry KL, Willett WC. Longitudinal study on the role of body size in premenopausal breast cancer. Arch Intern Med 2006; 166: 2395– 402.
- 2 van den Brandt PA, Spiegelman D, Yaun SS, Adami HO, Beeson L, Folsom AR, Fraser G, Goldbohm RA, Graham S, Kushi L, Marshall JR, Miller AB, et al. Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. Am J Epidemiol 2000; 152: 514–27.
- 3 Eliassen AH, Colditz GA, Rosner B, Willett WC, Hankinson SE. Adult weight change and risk of postmenopausal breast cancer. JAMA 2006; 296: 193–201.
- 4 de Waard F, Poortman J, de Pedro-Alvarez Ferrero M, Baanders-van Halewijn EA. Weight reduction and oestrogen excretion in obese post-menopausal women. Maturitas 1982; 4: 155–62.
- 5 Tworoger SS, Eliassen AH, Missmer SA, Baer H, Rich-Edwards J, Michels KB, Barbieri RL, Dowsett M, Hankinson SE. Birthweight and body size throughout life in relation to sex hormones and prolactin concentrations in premenopausal women. Cancer Epidemiol Biomarkers Prev 2006; 15: 2494–501.
- 6 Dorgan JF, Reichman ME, Judd JT, Brown C, Longcope C, Schatzkin A, Albanes D, Campbell WS, Franz C, Kahle L, et al. The relation of body size to plasma levels of estrogens and androgens in premenopausal women (Maryland, United States). Cancer Causes Control 1995; 6: 3–8.
- 7 Potischman N, Swanson CA, Siiteri P, Hoover RN. Reversal of relation between body mass and endogenous estrogen concentrations with menopausal status. J Natl Cancer Inst 1996; 88: 756–8.
- 8 Troy LM, Hunter DJ, Manson JE, Colditz GA, Stampfer MJ, Willett WC. The validity of recalled weight among younger women. Int J Obes Relat Metab Disord 1995; 19: 570–2.
- 9 Rimm EB, Stampfer MJ, Colditz GA, Chute CG, Litin LB, Willett WC. Validity of self-reported waist and hip circumferences in men and women. Epidemiology 1990; 1: 466–73.
- 10
Cox D.
Regression models and life-tables.
J R Statist Soc
1972;
34:
187–
220.
10.1111/j.2517-6161.1972.tb00899.x Google Scholar
- 11 Marshall RJ, Chisholm EM. Hypothesis testing in the polychotomous logistic model with an application to detecting gastrointestinal cancer. Statist Med 1985; 4: 337–44.
- 12 Baer H, Colditz G, Rosner B, Michels K, Rich-Edwards J, Hunter D, Willett W. Body fatness during childhood and adolescence and incidence of breast cancer in premenopausal women. Breast Cancer Res 2005; 7: R314–25.
- 13 Magnusson CM, Roddam AW, Pike MC, Chilvers C, Crossley B, Hermon C, McPherson K, Peto J, Vessey M, Beral V. Body fatness and physical activity at young ages and the risk of breast cancer in premenopausal women. Br J Cancer 2005; 93: 817–24.
- 14 Michels KB, Willett WC, Graubard BI, Vaidya RL, Cantwell MM, Sansbury LB, Forman MR. A longitudinal study of infant feeding and obesity throughout life course. Int J Obes (Lond) 2007; 31: 1078–85.
- 15 Weiderpass E, Braaten T, Magnusson C, Kumle M, Vainio H, Lund E, Adami HO. A prospective study of body size in different periods of life and risk of premenopausal breast cancer. Cancer Epidemiol Biomarkers Prev 2004; 13: 1121–7.
- 16 van den Brandt PA, Dirx MJ, Ronckers CM, van den Hoogen P, Goldbohm RA. Height, weight weight change, and postmenopausal breast cancer risk: The Netherlands Cohort Study. Cancer Causes Control 1997; 8: 39–47.
- 17 Huang Z, Hankinson SE, Colditz GA, Stampfer MJ, Hunter DJ, Manson JE, Hennekens CH, Rosner B, Speizer FE, Willett WC. Dual effects of weight and weight gain on breast cancer risk. JAMA 1997; 278: 1407–11.
- 18 Lahmann PH, Schulz M, Hoffmann K, Boeing H, Tjonneland A, Olsen A, Overvad K, Key TJ, Allen NE, Khaw KT, Bingham S, Berglund G, et al. Long-term weight change and breast cancer risk: the European prospective investigation into cancer and nutrition (EPIC). Br J Cancer 2005; 93: 582–9.
- 19 Coates RJ, Uhler RJ, Hall HI, Potischman N, Brinton LA, Ballard-Barbash R, Gammon MD, Brogan DR, Daling JR, Malone KE, Schoenberg JB, Swanson CA. Risk of breast cancer in young women in relation to body size and weight gain in adolescence and early adulthood. Br J Cancer 1999; 81: 167–74.
- 20 Friedenreich CM, Courneya KS, Bryant HE. Case-control study of anthropometric measures and breast cancer risk. Int J Cancer 2002; 99: 445–52.
- 21 Le Marchand L, Kolonel LN, Earle ME, Mi MP. Body size at different periods of life and breast cancer risk. Am J Epidemiol 1988; 128: 137–52.
- 22 Peacock SL, White E, Daling JR, Voigt LF, Malone KE. Relation between obesity and breast cancer in young women. Am J Epidemiol 1999; 149: 339–46.
- 23 Verla-Tebit E, Chang-Claude J. Anthropometric factors and the risk of premenopausal breast cancer in Germany. Eur J Cancer Prev 2005; 14: 419–26.
- 24 Key TJ, Pike MC. The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer. Eur J Cancer Clin Oncol 1988; 24: 29–43.
- 25 Turcato E, Zamboni M, De Pergola G, Armellini F, Zivelonghi A, Bergamo-Andreis IA, Giorgino R, Bosello O. Interrelationships between weight loss, body fat distribution and sex hormones in pre- and postmenopausal obese women. J Intern Med 1997; 241: 363–72.
- 26 Leenen R, van der Kooy K, Seidell JC, Deurenberg P, Koppeschaar HP. Visceral fat accumulation in relation to sex hormones in obese men and women undergoing weight loss therapy. J Clin Endocrinol Metab 1994; 78: 1515–20.
- 27 Pasquali R, Antenucci D, Casimirri F, Venturoli S, Paradisi R, Fabbri R, Balestra V, Melchionda N, Barbara L. Clinical and hormonal characteristics of obese amenorrheic hyperandrogenic women before and after weight loss. J Clin Endocrinol Metab 1989; 68: 173–9.
- 28 Del Giudice ME, Fantus IG, Ezzat S, McKeown-Eyssen G, Page D, Goodwin PJ. Insulin and related factors in premenopausal breast cancer risk. Breast Cancer Res Treat 1998; 47: 111–20.
- 29 Lawlor DA, Smith GD, Ebrahim S. Hyperinsulinaemia and increased risk of breast cancer: findings from the British Women's Heart and Health Study. Cancer Causes Control 2004; 15: 267–75.
Citing Literature
