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

被引：91

作者：

Ritte, Rebecca ^{[1
]}

Lukanova, Annekatrin ^{[1
]}

Berrino, Franco ^{[2
]}

Dossus, Laure ^{[1
]}

Tjonneland, Anne ^{[3
]}

Olsen, Anja ^{[3
]}

Overvad, Thure Filskov ^{[4
]}

Overvad, Kim ^{[5
]}

Clavel-Chapelon, Francoise ^{[6
,7
]}

Fournier, Agnes ^{[6
,7
]}

Fagherazzi, Guy ^{[6
,7
]}

Rohrmann, Sabine ^{[1
,8
]}

Teucher, Birgit ^{[1
]}

Boeing, Heiner ^{[9
]}

Aleksandrova, Krasimira ^{[9
]}

Trichopoulou, Antonia ^{[10
,11
]}

Lagiou, Pagona ^{[10
]}

Trichopoulos, Dimitrios ^{[12
,13
]}

Palli, Domenico ^{[14
]}

Sieri, Sabina ^{[15
]}

Panico, Salvatore ^{[16
]}

Tumino, Rosario ^{[17
,39
]}

Vineis, Paolo ^{[18
,19
]}

Ramon Quiros, Jose ^{[20
]}

Buckland, Genevieve ^{[21
]}

Sanchez, Maria-Jose ^{[22
,23
]}

Amiano, Pilar ^{[23
,24
]}

Chirlaque, Maria-Dolores ^{[23
,25
]}

Ardanaz, Eva ^{[23
,26
]}

Sund, Malin ^{[38
]}

Lenner, Per ^{[27
]}

Bueno-de-Mesquita, Bas ^{[28
,29
]}

van Gils, Carla H. ^{[30
]}

Peeters, Petra H. M. ^{[30
,31
]}

Krum-Hansen, Sanda ^{[32
]}

Gram, Inger Torhild ^{[32
]}

Lund, Eiliv ^{[32
]}

Khaw, Kay-Tee ^{[33
]}

Wareham, Nick ^{[34
]}

Allen, Naomi E. ^{[35
]}

Key, Timothy J. ^{[35
]}

Romieu, Isabelle ^{[36
]}

Rinaldi, Sabina ^{[36
]}

Siddiq, Afshan ^{[31
,37
]}

Cox, David ^{[31
]}

Riboli, Elio ^{[18
]}

Kaaks, Rudolf ^{[1
]}

机构：

[1] German Canc Res Ctr, Div Canc Epidemiol, D-69120 Heidelberg, Germany

[2] Fdn IRCCS Ist Nazl Tumori, Dept Prevent & Predict Med, I-20133 Milan, Italy

[3] Danish Canc Soc, Inst Canc Epidemiol, DK-2100 Copenhagen, Denmark

[4] Aarhus Univ Hosp, Aalborg Hosp, Dept Cardiol, DK-9100 Aalborg, Denmark

[5] Aarhus Univ, Sch Publ Hlth, Dept Epidemiol, DK-8000 Aarhus, Denmark

[6] Inst Gustave Roussy, INSERM, Ctr Res Epidemiol & Populat Hlth, F-94805 Villejuif, France

[7] Paris S Univ, UMRS 1018, F-94805 Villejuif, France

[8] Inst Social & Prevent Med, Div Canc Epidemiol & Prevent, CH-8001 Zurich, Switzerland

[9] German Inst Human Nutr, Dept Epidemiol, D-14558 Nuthetal, Germany

[10] Univ Athens, Sch Med, WHO Collaborating Ctr Food & Nutr Policies, Dept Hyg Epidemiol & Med Stat, GR-11527 Athens, Greece

[11] Hellen Hlth Fdn, GR-11527 Athens, Greece

[12] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA

[13] Acad Athens, Bur Epidemiol Res, GR-10679 Athens, Greece

[14] Sci Inst Tuscany, Canc Res & Prevent Inst ISPO, Mol & Nutr Epidemiol Unit, I-50139 Florence, Italy

[15] Fdn IRCCS Ist Nazl Tumori, Nutr Epidemiol Unit, I-20133 Milan, Italy

[16] Univ Naples Federico II, Sch Med, Dept Clin & Expt Med, I-80131 Naples, Italy

[17] Civile MP Arezzo Hosp ASP 7, Canc Registry, I-97100 Ragusa, Italy

[18] Univ London Imperial Coll Sci Technol & Med, Sch Publ Hlth, Ctr Environm & Hlth, London SW7 2AZ, England

[19] Human Genet Fdn HuGeF, I-10126 Turin, Italy

[20] Publ Hlth & Hlth Planning Directorate, Asturias 33006, Spain

[21] Catalan Inst Oncol ICO IDIBELL, Canc Epidemiol Res Programme, Unit Nutr Environm & Canc, Barcelona 08907, Spain

[22] Andalusian Sch Publ Hlth, E-1801 Granada, Spain

[23] CIBERESP, Madrid 28029, Spain

[24] Inst BIO Donostia, Dept Hlth, Publ Hlth Div Gipuzkoa, Gipuzkoa 20013, Basque Region, Spain

[25] Murcia Reg Hlth Author, Dept Epidemiol, Murcia 30008, Spain

[26] Navarra Publ Hlth Inst, Pamplona 31003, Spain

[27] Umea Univ Hosp, Dept Oncol & Radiat Sci, SE-90187 Umea, Sweden

[28] Natl Inst Publ Hlth & Environm, NL-3721 MA Bilthoven, Netherlands

[29] Univ Med Ctr, Dept Gastroenterol & Hepatol, NL-3584 CX Utrecht, Netherlands

[30] Univ Med Ctr, Julius Ctr Hlth Sci & Primary Care, NL-3508 GA Utrecht, Netherlands

[31] Univ London Imperial Coll Sci Technol & Med, Fac Med, Sch Publ Hlth, Dept Epidemiol & Biostat, London SW7 2AZ, England

[32] Univ Tromso, Inst Community Med, N-9037 Tromso, Norway

[33] Univ Cambridge, Old Sch, Sch Clin Med, Cambridge CB2 1TN, England

[34] Addenbrookes Hosp, Epidemiol Unit, MRC, Cambridge CB2 0QQ, England

[35] Univ Oxford, Canc Epidemiol Unit, Oxford OX3 7LF, England

[36] IARC, Sect Nutr & Metab, Nutr Epidemiol Grp, F-69372 Lyon, France

[37] Univ London Imperial Coll Sci Technol & Med, Sch Publ Hlth, Dept Genom Common Dis, London SW7 2AZ, England

[38] Umea Univ Hosp, Dept Surg & Perioperat Sci, SE-90185 Umea, Sweden

[39] Civile MP Arezzo Hosp ASP 7, Histopathol Unit, I-97100 Ragusa, Italy

来源：

BREAST CANCER RESEARCH | 2012年 / 14卷 / 03期

基金：

英国医学研究理事会;

关键词：

BODY-MASS INDEX; ESTROGEN-RECEPTOR; PHYSICAL-ACTIVITY; FAT DISTRIBUTION; SIZE; WEIGHT; IMPACT; STANDARDIZATION; MENOPAUSE; VALIDITY;

D O I：

10.1186/bcr3186

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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.

引用

页数：14

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