Obesity, body size, and risk of postmenopausal breast cancer: The women's health initiative (United States)

Libby M. Morimoto, Emily White, Z. Chen, Rowan T. Chlebowski, Jennifer Hays, Lewis Kuller, Ana Marie Lopez, Jo Ann Manson, Karen L. Margolis, Paola C. Muti, Marcia L. Stefanick, Anne McTiernan

Research output: Contribution to journalArticle

425 Citations (Scopus)

Abstract

Objective: Body size is an important modifiable risk factor for breast cancer. Although obesity has generally been found to be associated with increased risk for postmenopausal breast cancer, there remain questions concerning the role of body fat distribution, lifetime weight history, and effects within specific subgroups of women. Methods: We assessed the relationship of several anthropometric measures and risk of postmenopausal breast cancer in 85,917 women aged 50-79 at entry in the Women's Health Initiative Observational Study. Women were enrolled during 1993-1998 at 40 clinics in the US and 1030 developed invasive breast cancer by April 2000. Upon entry, trained clinical center staff measured each woman's height, weight, and waist and hip circumference. Results: Anthropometric factors were not associated with breast cancer among women who had ever used hormone replacement therapy (HRT). Among HRT non-users, heavier women (baseline body mass index (BMI) > 31.1) had an elevated risk of postmenopausal breast cancer (relative risk (RR) = 2.52; 95% confidence interval (CI) = 1.62-3.93), compared to slimmer women (baseline BMI ≤ 22.6). The elevation in risk associated with increasing BMI appeared to be most pronounced among younger postmenopausal women. Change in BMI since age 18, maximum BMI, and weight were also associated with breast cancer in HRT non-users. While both waist and hip circumference were associated with breast cancer risk, their ratio, a measure of fat distribution, was not (RR = 1.33; 95 % CI = 0.88-2.01). Conclusions: Our study confirms previously reported findings that generalized obesity is an important risk factor for postmenopausal breast cancer, but only among women who have never taken HRT. Lifetime weight gain is also a strong predictor of breast cancer. Waist to hip ratio, a measure of weight distribution, does not appear to be related to postmenopausal breast cancer risk.

Original languageEnglish
Pages (from-to)741-751
Number of pages11
JournalCancer Causes and Control
Volume13
Issue number8
DOIs
StatePublished - 1 Oct 2002

Fingerprint

Body Size
Women's Health
Obesity
Breast Neoplasms
Hormone Replacement Therapy
Body Mass Index
Weights and Measures
Waist Circumference
Hip
Confidence Intervals
Body Fat Distribution
Waist-Hip Ratio
Weight Gain
Observational Studies
History
Fats
Odds Ratio

Keywords

  • Body size
  • Breast neoplasms
  • Hormone replacement therapy
  • Obesity
  • Weight gain

Cite this

Morimoto, Libby M. ; White, Emily ; Chen, Z. ; Chlebowski, Rowan T. ; Hays, Jennifer ; Kuller, Lewis ; Lopez, Ana Marie ; Manson, Jo Ann ; Margolis, Karen L. ; Muti, Paola C. ; Stefanick, Marcia L. ; McTiernan, Anne. / Obesity, body size, and risk of postmenopausal breast cancer : The women's health initiative (United States). In: Cancer Causes and Control. 2002 ; Vol. 13, No. 8. pp. 741-751.
@article{0727844308494057b022d891ccaea795,
title = "Obesity, body size, and risk of postmenopausal breast cancer: The women's health initiative (United States)",
abstract = "Objective: Body size is an important modifiable risk factor for breast cancer. Although obesity has generally been found to be associated with increased risk for postmenopausal breast cancer, there remain questions concerning the role of body fat distribution, lifetime weight history, and effects within specific subgroups of women. Methods: We assessed the relationship of several anthropometric measures and risk of postmenopausal breast cancer in 85,917 women aged 50-79 at entry in the Women's Health Initiative Observational Study. Women were enrolled during 1993-1998 at 40 clinics in the US and 1030 developed invasive breast cancer by April 2000. Upon entry, trained clinical center staff measured each woman's height, weight, and waist and hip circumference. Results: Anthropometric factors were not associated with breast cancer among women who had ever used hormone replacement therapy (HRT). Among HRT non-users, heavier women (baseline body mass index (BMI) > 31.1) had an elevated risk of postmenopausal breast cancer (relative risk (RR) = 2.52; 95{\%} confidence interval (CI) = 1.62-3.93), compared to slimmer women (baseline BMI ≤ 22.6). The elevation in risk associated with increasing BMI appeared to be most pronounced among younger postmenopausal women. Change in BMI since age 18, maximum BMI, and weight were also associated with breast cancer in HRT non-users. While both waist and hip circumference were associated with breast cancer risk, their ratio, a measure of fat distribution, was not (RR = 1.33; 95 {\%} CI = 0.88-2.01). Conclusions: Our study confirms previously reported findings that generalized obesity is an important risk factor for postmenopausal breast cancer, but only among women who have never taken HRT. Lifetime weight gain is also a strong predictor of breast cancer. Waist to hip ratio, a measure of weight distribution, does not appear to be related to postmenopausal breast cancer risk.",
keywords = "Body size, Breast neoplasms, Hormone replacement therapy, Obesity, Weight gain",
author = "Morimoto, {Libby M.} and Emily White and Z. Chen and Chlebowski, {Rowan T.} and Jennifer Hays and Lewis Kuller and Lopez, {Ana Marie} and Manson, {Jo Ann} and Margolis, {Karen L.} and Muti, {Paola C.} and Stefanick, {Marcia L.} and Anne McTiernan",
year = "2002",
month = "10",
day = "1",
doi = "10.1023/A:1020239211145",
language = "English",
volume = "13",
pages = "741--751",
journal = "Cancer Causes and Control",
issn = "0957-5243",
publisher = "Springer Netherlands",
number = "8",

}

Morimoto, LM, White, E, Chen, Z, Chlebowski, RT, Hays, J, Kuller, L, Lopez, AM, Manson, JA, Margolis, KL, Muti, PC, Stefanick, ML & McTiernan, A 2002, 'Obesity, body size, and risk of postmenopausal breast cancer: The women's health initiative (United States)', Cancer Causes and Control, vol. 13, no. 8, pp. 741-751. https://doi.org/10.1023/A:1020239211145

Obesity, body size, and risk of postmenopausal breast cancer : The women's health initiative (United States). / Morimoto, Libby M.; White, Emily; Chen, Z.; Chlebowski, Rowan T.; Hays, Jennifer; Kuller, Lewis; Lopez, Ana Marie; Manson, Jo Ann; Margolis, Karen L.; Muti, Paola C.; Stefanick, Marcia L.; McTiernan, Anne.

In: Cancer Causes and Control, Vol. 13, No. 8, 01.10.2002, p. 741-751.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Obesity, body size, and risk of postmenopausal breast cancer

T2 - The women's health initiative (United States)

AU - Morimoto, Libby M.

AU - White, Emily

AU - Chen, Z.

AU - Chlebowski, Rowan T.

AU - Hays, Jennifer

AU - Kuller, Lewis

AU - Lopez, Ana Marie

AU - Manson, Jo Ann

AU - Margolis, Karen L.

AU - Muti, Paola C.

AU - Stefanick, Marcia L.

AU - McTiernan, Anne

PY - 2002/10/1

Y1 - 2002/10/1

N2 - Objective: Body size is an important modifiable risk factor for breast cancer. Although obesity has generally been found to be associated with increased risk for postmenopausal breast cancer, there remain questions concerning the role of body fat distribution, lifetime weight history, and effects within specific subgroups of women. Methods: We assessed the relationship of several anthropometric measures and risk of postmenopausal breast cancer in 85,917 women aged 50-79 at entry in the Women's Health Initiative Observational Study. Women were enrolled during 1993-1998 at 40 clinics in the US and 1030 developed invasive breast cancer by April 2000. Upon entry, trained clinical center staff measured each woman's height, weight, and waist and hip circumference. Results: Anthropometric factors were not associated with breast cancer among women who had ever used hormone replacement therapy (HRT). Among HRT non-users, heavier women (baseline body mass index (BMI) > 31.1) had an elevated risk of postmenopausal breast cancer (relative risk (RR) = 2.52; 95% confidence interval (CI) = 1.62-3.93), compared to slimmer women (baseline BMI ≤ 22.6). The elevation in risk associated with increasing BMI appeared to be most pronounced among younger postmenopausal women. Change in BMI since age 18, maximum BMI, and weight were also associated with breast cancer in HRT non-users. While both waist and hip circumference were associated with breast cancer risk, their ratio, a measure of fat distribution, was not (RR = 1.33; 95 % CI = 0.88-2.01). Conclusions: Our study confirms previously reported findings that generalized obesity is an important risk factor for postmenopausal breast cancer, but only among women who have never taken HRT. Lifetime weight gain is also a strong predictor of breast cancer. Waist to hip ratio, a measure of weight distribution, does not appear to be related to postmenopausal breast cancer risk.

AB - Objective: Body size is an important modifiable risk factor for breast cancer. Although obesity has generally been found to be associated with increased risk for postmenopausal breast cancer, there remain questions concerning the role of body fat distribution, lifetime weight history, and effects within specific subgroups of women. Methods: We assessed the relationship of several anthropometric measures and risk of postmenopausal breast cancer in 85,917 women aged 50-79 at entry in the Women's Health Initiative Observational Study. Women were enrolled during 1993-1998 at 40 clinics in the US and 1030 developed invasive breast cancer by April 2000. Upon entry, trained clinical center staff measured each woman's height, weight, and waist and hip circumference. Results: Anthropometric factors were not associated with breast cancer among women who had ever used hormone replacement therapy (HRT). Among HRT non-users, heavier women (baseline body mass index (BMI) > 31.1) had an elevated risk of postmenopausal breast cancer (relative risk (RR) = 2.52; 95% confidence interval (CI) = 1.62-3.93), compared to slimmer women (baseline BMI ≤ 22.6). The elevation in risk associated with increasing BMI appeared to be most pronounced among younger postmenopausal women. Change in BMI since age 18, maximum BMI, and weight were also associated with breast cancer in HRT non-users. While both waist and hip circumference were associated with breast cancer risk, their ratio, a measure of fat distribution, was not (RR = 1.33; 95 % CI = 0.88-2.01). Conclusions: Our study confirms previously reported findings that generalized obesity is an important risk factor for postmenopausal breast cancer, but only among women who have never taken HRT. Lifetime weight gain is also a strong predictor of breast cancer. Waist to hip ratio, a measure of weight distribution, does not appear to be related to postmenopausal breast cancer risk.

KW - Body size

KW - Breast neoplasms

KW - Hormone replacement therapy

KW - Obesity

KW - Weight gain

UR - http://www.scopus.com/inward/record.url?scp=0036798987&partnerID=8YFLogxK

U2 - 10.1023/A:1020239211145

DO - 10.1023/A:1020239211145

M3 - Article

C2 - 12420953

AN - SCOPUS:0036798987

VL - 13

SP - 741

EP - 751

JO - Cancer Causes and Control

JF - Cancer Causes and Control

SN - 0957-5243

IS - 8

ER -