BMI and breast cancer risk around age at menopause
Published by Elsevier Ltd..
BACKGROUND: A high body mass index (BMI, kg/m2) is associated with decreased risk of breast cancer before menopause, but increased risk after menopause. Exactly when this reversal occurs in relation to menopause is unclear. Locating that change point could provide insight into the role of adiposity in breast cancer etiology.
METHODS: We examined the association between BMI and breast cancer risk in the Premenopausal Breast Cancer Collaborative Group, from age 45 up to breast cancer diagnosis, loss to follow-up, death, or age 55, whichever came first. Analyses included 609,880 women in 16 prospective studies, including 9956 who developed breast cancer before age 55. We fitted three BMI hazard ratio (HR) models over age-time: constant, linear, or nonlinear (via splines), applying piecewise exponential additive mixed models, with age as the primary time scale. We divided person-time into four strata: premenopause; postmenopause due to natural menopause; postmenopause because of interventional loss of ovarian function (bilateral oophorectomy (BO) or chemotherapy); postmenopause due to hysterectomy without BO. Sensitivity analyses included stratifying by BMI in young adulthood, or excluding women using menopausal hormone therapy.
RESULTS: The constant BMI HR model provided the best fit for all four menopausal status groups. Under this model, the estimated association between a five-unit increment in BMI and breast cancer risk was HR=0.87 (95% CI: 0.85, 0.89) before menopause, HR=1.00 (95% CI: 0.96, 1.04) after natural menopause, HR=0.99 (95% CI: 0.93, 1.05) after interventional loss of ovarian function, and HR=0.88 (95% CI: 0.76, 1.02) after hysterectomy without BO.
CONCLUSION: The BMI breast cancer HRs remained less than or near one during the 45-55 year age range indicating that the transition to a positive association between BMI and risk occurs after age 55.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:89 |
|---|---|
| Enthalten in: |
Cancer epidemiology - 89(2024) vom: 17. Apr., Seite 102545 |
| Sprache: |
Englisch |
|---|
| Links: |
|---|
| Themen: |
Body mass index |
|---|
| Anmerkungen: |
Date Completed 18.03.2024 Date Revised 20.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.canep.2024.102545 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36867973X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36867973X | ||
| 003 | DE-627 | ||
| 005 | 20240420232259.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240222s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.canep.2024.102545 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1381.xml |
| 035 | |a (DE-627)NLM36867973X | ||
| 035 | |a (NLM)38377945 | ||
| 035 | |a (PII)S1877-7821(24)00024-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Von Holle, Ann |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a BMI and breast cancer risk around age at menopause |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 18.03.2024 | ||
| 500 | |a Date Revised 20.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Elsevier Ltd. | ||
| 520 | |a BACKGROUND: A high body mass index (BMI, kg/m2) is associated with decreased risk of breast cancer before menopause, but increased risk after menopause. Exactly when this reversal occurs in relation to menopause is unclear. Locating that change point could provide insight into the role of adiposity in breast cancer etiology | ||
| 520 | |a METHODS: We examined the association between BMI and breast cancer risk in the Premenopausal Breast Cancer Collaborative Group, from age 45 up to breast cancer diagnosis, loss to follow-up, death, or age 55, whichever came first. Analyses included 609,880 women in 16 prospective studies, including 9956 who developed breast cancer before age 55. We fitted three BMI hazard ratio (HR) models over age-time: constant, linear, or nonlinear (via splines), applying piecewise exponential additive mixed models, with age as the primary time scale. We divided person-time into four strata: premenopause; postmenopause due to natural menopause; postmenopause because of interventional loss of ovarian function (bilateral oophorectomy (BO) or chemotherapy); postmenopause due to hysterectomy without BO. Sensitivity analyses included stratifying by BMI in young adulthood, or excluding women using menopausal hormone therapy | ||
| 520 | |a RESULTS: The constant BMI HR model provided the best fit for all four menopausal status groups. Under this model, the estimated association between a five-unit increment in BMI and breast cancer risk was HR=0.87 (95% CI: 0.85, 0.89) before menopause, HR=1.00 (95% CI: 0.96, 1.04) after natural menopause, HR=0.99 (95% CI: 0.93, 1.05) after interventional loss of ovarian function, and HR=0.88 (95% CI: 0.76, 1.02) after hysterectomy without BO | ||
| 520 | |a CONCLUSION: The BMI breast cancer HRs remained less than or near one during the 45-55 year age range indicating that the transition to a positive association between BMI and risk occurs after age 55 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Body mass index | |
| 650 | 4 | |a Breast neoplasms | |
| 650 | 4 | |a Middle aged | |
| 650 | 4 | |a Postmenopause | |
| 650 | 4 | |a Premenopause | |
| 700 | 1 | |a Adami, Hans-Olov |e verfasserin |4 aut | |
| 700 | 1 | |a Baglietto, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Berrington de Gonzalez, Amy |e verfasserin |4 aut | |
| 700 | 1 | |a Bertrand, Kimberly A |e verfasserin |4 aut | |
| 700 | 1 | |a Blot, William |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a DeHart, Jessica Clague |e verfasserin |4 aut | |
| 700 | 1 | |a Dossus, Laure |e verfasserin |4 aut | |
| 700 | 1 | |a Eliassen, A Heather |e verfasserin |4 aut | |
| 700 | 1 | |a Fournier, Agnes |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Closas, Montse |e verfasserin |4 aut | |
| 700 | 1 | |a Giles, Graham |e verfasserin |4 aut | |
| 700 | 1 | |a Guevara, Marcela |e verfasserin |4 aut | |
| 700 | 1 | |a Hankinson, Susan E |e verfasserin |4 aut | |
| 700 | 1 | |a Heath, Alicia |e verfasserin |4 aut | |
| 700 | 1 | |a Jones, Michael E |e verfasserin |4 aut | |
| 700 | 1 | |a Joshu, Corinne E |e verfasserin |4 aut | |
| 700 | 1 | |a Kaaks, Rudolf |e verfasserin |4 aut | |
| 700 | 1 | |a Kirsh, Victoria A |e verfasserin |4 aut | |
| 700 | 1 | |a Kitahara, Cari M |e verfasserin |4 aut | |
| 700 | 1 | |a Koh, Woon-Puay |e verfasserin |4 aut | |
| 700 | 1 | |a Linet, Martha S |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Hannah Lui |e verfasserin |4 aut | |
| 700 | 1 | |a Masala, Giovanna |e verfasserin |4 aut | |
| 700 | 1 | |a Mellemkjaer, Lene |e verfasserin |4 aut | |
| 700 | 1 | |a Milne, Roger L |e verfasserin |4 aut | |
| 700 | 1 | |a O'Brien, Katie M |e verfasserin |4 aut | |
| 700 | 1 | |a Palmer, Julie R |e verfasserin |4 aut | |
| 700 | 1 | |a Riboli, Elio |e verfasserin |4 aut | |
| 700 | 1 | |a Rohan, Thomas E |e verfasserin |4 aut | |
| 700 | 1 | |a Shrubsole, Martha J |e verfasserin |4 aut | |
| 700 | 1 | |a Sund, Malin |e verfasserin |4 aut | |
| 700 | 1 | |a Tamimi, Rulla |e verfasserin |4 aut | |
| 700 | 1 | |a Tin Tin, Sandar |e verfasserin |4 aut | |
| 700 | 1 | |a Visvanathan, Kala |e verfasserin |4 aut | |
| 700 | 1 | |a Vermeulen, Roel Ch |e verfasserin |4 aut | |
| 700 | 1 | |a Weiderpass, Elisabete |e verfasserin |4 aut | |
| 700 | 1 | |a Willett, Walter C |e verfasserin |4 aut | |
| 700 | 1 | |a Yuan, Jian-Min |e verfasserin |4 aut | |
| 700 | 1 | |a Zeleniuch-Jacquotte, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Nichols, Hazel B |e verfasserin |4 aut | |
| 700 | 1 | |a Sandler, Dale P |e verfasserin |4 aut | |
| 700 | 1 | |a Swerdlow, Anthony J |e verfasserin |4 aut | |
| 700 | 1 | |a Schoemaker, Minouk J |e verfasserin |4 aut | |
| 700 | 1 | |a Weinberg, Clarice R |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cancer epidemiology |d 2009 |g 89(2024) vom: 17. Apr., Seite 102545 |w (DE-627)NLM18889912X |x 1877-783X |7 nnns |
| 773 | 1 | 8 | |g volume:89 |g year:2024 |g day:17 |g month:04 |g pages:102545 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.canep.2024.102545 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 89 |j 2024 |b 17 |c 04 |h 102545 | ||