Journal
BREAST CANCER RESEARCH
Volume 14, Issue 3, Pages -Publisher
BMC
DOI: 10.1186/bcr3186
Keywords
-
Categories
Funding
- German Research Foundation, Epidemiology of communicable and chronic noncommunicable diseases and their interrelationships [Graduiertenkolleg 793]
- European Commission Directorate General for Health and Consumer Protection (DG-SANCO)
- International Agency for Research on Cancer
- Danish Cancer Society (Denmark)
- Ligue contre le Cancer
- Mutuelle Generale de l'Education Nationale
- Institut National de la Sante et de la Recherche Medicale (France)
- Deutsche Krebshilfe
- Deutsches Krebsforschungszentrum
- Federal Ministry of Education and Research (Germany)
- Hellenic Health Foundation
- Stavros Niarchos Foundation
- Hellenic Ministry of Health and Social Solidarity
- Italian Association for Research on Cancer (AIRC)
- National Research Council (Italy)
- Dutch Ministry of Public Health, Welfare and Sport (VWS)
- Netherlands Cancer Registry (NKR)
- LK Research Funds
- Dutch Prevention Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund (WCRF)
- Statistics Netherlands (The Netherlands)
- Nordforsk
- Nordic Centre of Excellence programme on Food, Nutrition and Health. (Norway)
- Health Research Fund (FIS)
- Regional Government of Andalucia
- Regional Government of Asturias
- Regional Government of Basque Country
- Regional Government of Murcia [6236]
- Regional Government of Navarra
- ISCIII RTICC Red Tematica de Investigacion Cooperativa en Cancer (Spain) [R06/0020]
- Swedish Cancer Society
- Swedish Scientific Council
- Regional Government of Skane
- Vasterbotten (Sweden)
- Cancer Research UK
- Medical Research Council, (United Kingdom)
- [ERC-2009-AdG 232997]
- Medical Research Council [G0401527, G1000143, G0801056B, MC_U106179471] Funding Source: researchfish
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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/m(2) 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 (P-het = 0.035). The association of HRT was significantly stronger in the leaner women (BMI <= 22.5 kg/m(2)) than for more overweight women (BMI >= 25.9 kg/m(2)) 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.
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