Abstract
Obesity is an established risk factor for postmenopausal breast cancer in the general population. However, it is still unclear whether this association also exists in BRCA1/2 mutation carriers. We investigated the association between self-reported anthropometric measures and breast cancer risk in a nationwide retrospective cohort study, including 719 BRCA1/2 carriers, of whom 218 had been diagnosed with breast cancer within 10 years prior to questionnaire completion. All time-varying Cox proportional hazards analyses were stratified by menopausal status. For premenopausal breast cancer, no statistically significant associations were observed for any of the anthropometric measures. The association between body mass index (BMI) at age 18 and premenopausal breast cancer risk suggested a trend of decreasing risk with increasing BMI (HR22.50–24.99 vs. 18.50–22.49 = 0.83, 95% CI = 0.47–1.44 and HR≥25.00 vs. 18.50–22.49 = 0.41, 95% CI = 0.13–1.27). For postmenopausal breast cancer, being 1.67 m and taller increased the risk 1.7-fold (HR = 1.67, 95% CI = 1.01–2.74) when compared to a height <1.67 m. Compared with a current body weight <72 kg, a current body weight of ≥72 kg increased the risk of postmenopausal breast cancer 2.1-fold (95% CI = 1.23–3.59). A current BMI of ≥25.0 kg/m2, an adult weight gain of 5 kg or more, and a relative adult weight gain of 20% or more were all non-significantly associated with a 50–60% increased risk of postmenopausal breast cancer [HR = 1.46 (0.86–2.51), HR = 1.56 (95% CI = 0.85–2.87), and HR = 1.60 (95% CI = 0.97–2.63), respectively], when compared with having a healthy or stable weight. No associations for body weight or BMI at age 18 were observed. In conclusion, menopausal status seemed to modify the association between body weight and breast cancer risk among BRCA1/2 carriers. We observed no clear association between body weight and premenopausal breast cancer, while overweight and weight gain increased postmenopausal breast cancer risk. Carriers may reduce their risk of postmenopausal breast cancer by maintaining a healthy body weight throughout life.
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This work was financially supported by the Dutch Cancer Society (grants NKI1998-1854, NKI2004-3088, NKI 2007-3756).
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The members of The Netherlands Collaborative Group on Hereditary Breast Cancer (HEBON) are given in Appendix.
P. Manders and A. Pijpe contributed equally to this work.
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The Netherlands Collaborative Group on Hereditary Breast Cancer (HEBON): Coordinating center: Netherlands Cancer Institute, Amsterdam: Senno Verhoef, Anouk Pijpe, Richard Brohet, Frans Hogervorst, Laura van ‘t Veer, Flora van Leeuwen, Matti Rookus; Erasmus Medical Center, Rotterdam: Margriet Collée, Ans van den Ouweland, Agnes Jager, Madeleine Tilanus-Linthorst, Maartje Hooning, Caroline Seynaeve; Leiden University Medical Center, Leiden: Rob Tollenaar, Christi van Asperen, Juul Wijnen, Peter Devilee; Radboud University Nijmegen Medical Centre, Nijmegen: Nicoline Hoogerbrugge, Marjolijn Ligtenberg; University Medical Center Utrecht, Utrecht: Margreet Ausems, Rob van der Luijt; Amsterdam Medical Center: Cora Aalfs, Theo van Os; VU University Medical Center, Amsterdam: Hanne Meijers-Heijboer, Hans Gille; Maastricht University Medical Center, Maastricht: Encarna Gomez-Garcia, Rien Blok; University Medical Center Groningen, Groningen: Jan Oosterwijk, Annemiek van der Hout; Netherlands Foundation for Detection of Hereditary Tumours, Leiden: Hans Vasen, Inge van Leeuwen.
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Manders, P., Pijpe, A., Hooning, M.J. et al. Body weight and risk of breast cancer in BRCA1/2 mutation carriers. Breast Cancer Res Treat 126, 193–202 (2011). https://doi.org/10.1007/s10549-010-1120-8
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DOI: https://doi.org/10.1007/s10549-010-1120-8