Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study. - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue Breast Cancer Research Année : 2012

Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study.

1 Division of Cancer Epidemiology
2 Department of Preventive and Predictive Medicine
3 Cancer Epidemiology Institute
4 Department of Cardiology
5 Department of Epidemiology
6 CESP - Centre de recherche en épidémiologie et santé des populations
7 Division of Cancer Epidemiology and Prevention
8 Department of Epidemiology
9 Hellenic Health Foundation
10 WHO Collaborating Center for Food and Nutrition Policies
11 Department of Epidemiology
12 Bureau of Epidemiologic Research
13 Molecular and Nutritional Epidemiology Unit
14 Nutritional Epidemiology Unit
15 Department of Clinical and Experimental Medicine
16 Cancer Registry and Histopathology Unit
17 Centre for Environment and Health
18 HuGeF - Human Genetics Foundation
19 Public Health and Health Planning Directorate
20 Unit of Nutrition, Environment and Cancer
21 Granada Cancer Registry
22 CIBERESP - Consorcio de Investigación Biomédica en Red especializado en Epidemiología y Salud Pública
23 Public Health Division of Gipuzkoa
24 Department of Epidemiology
25 Navarra Public Health Institute
26 Department of Surgery and Perioperative Sciences
27 Department of Oncology and Radiation Sciences, Oncology
28 RIVM - National Institute for Public Health and the Environment [Bilthoven]
29 Department of Gastroenterology and Hepatology
30 Julius Center for Health Sciences and Primary Care
31 Department of Epidemiology and Biostatistics
32 Institute of Community Medicine
33 School of Clinical Medicine
34 Medical Research Council
35 Cancer Epidemiology Unit
36 Unité d'épidémiologie nutritionnelle
37 Department of Genomics of Common Disease
Rebecca Ritte
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Annekatrin Lukanova
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Laure Dossus
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Anne Tjønneland
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Anja Olsen
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Thure Filskov Overvad
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Kim Overvad
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Birgit Teucher
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Heiner Boeing
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Krasimira Aleksandrova
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Domenico Palli
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Sabina Sieri
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Rosario Tumino
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Malin Sund
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Sanda Krum-Hansen
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Inger Torhild Gram
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Eiliv Lund
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Kay-Tee Khaw
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Nick Wareham
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Naomi Allen
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Timothy Key
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Isabelle Romieu
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Sabina Rinaldi
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David Cox
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Elio Riboli
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Résumé

ABSTRACT: 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)-progesterone receptor (PR)- (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 (3rd versus 1st tertile HR=1.47[1.01-2.15]) was observed. BMI was inversely associated with ER+PR+ tumors among women aged [less than or equal to]49 years (per 5kg/m2 increase, HR=0.79[95%CI 0.68-0.91]), and positively associated with risk among women [greater than or equal to]65 years (HR=1.25[1.16-1.34]). 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[1.05-1.62]) and positive tumors (HR: 1.74[1.56-1.95]), although this risk increase was weaker for ER-PR- disease (Phet=0.035). The association of HRT was significantly stronger in the leaner women (BMI [less than or equal to]22.5kg/m2) than for more overweight women (BMI [greater than or equal to]25.9kg/m2) for, both, ER-PR- (HR: 1.74[1.15-2.63]) and ER+PR+ (HR: 2.33[1.84-2.92]) 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 HR-positive tumors, but not for HR-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 HR-negative tumors.

Domaines

Cancer
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Dates et versions

inserm-00704067 , version 1 (04-06-2012)

Identifiants

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Rebecca Ritte, Annekatrin Lukanova, Franco Berrino, Laure Dossus, Anne Tjønneland, et al.. Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study.. Breast Cancer Research, 2012, 14 (3), pp.R76. ⟨10.1186/bcr3186⟩. ⟨inserm-00704067⟩
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