Body size and breast cancer risk: Findings from the European prospective investigation into cancer and nutrition (EPIC)

• Published in: International journal of cancer Vol. 111; no. 5; pp. 762 - 771
• Main Authors: Lahmann, Petra H., Hoffmann, Kurt, Allen, Naomi, van Gils, Carla H., Khaw, Kay‐Tee, Tehard, Bertrand, Berrino, Franco, Tjønneland, Anne, Bigaard, Janne, Olsen, Anja, Overvad, Kim, Clavel‐Chapelon, Françoise, Nagel, Gabriele, Boeing, Heiner, Trichopoulos, Dimitrios, Economou, George, Bellos, George, Palli, Domenico, Tumino, Rosario, Panico, Salvatore, Sacerdote, Carlotta, Krogh, Vittorio, Peeters, Petra H.M., Bueno‐de‐Mesquita, H. Bas, Lund, Eiliv, Ardanaz, Eva, Amiano, Pilar, Pera, Guillem, Quirós, José R., Martínez, Carmen, Tormo, María J., Wirfält, Elisabet, Berglund, Göran, Hallmans, Göran, Key, Timothy J., Reeves, Gillian, Bingham, Sheila, Norat, Teresa, Biessy, Carine, Kaaks, Rudolf, Riboli, Elio
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 20-09-2004; Wiley-Liss
• Subjects: Abdomen; Adipose Tissue; Adult; Aged; Biological and medical sciences; Body Composition; Body Height; Body Mass Index; Body Weight; breast neoplasm; Breast Neoplasms - epidemiology; Breast Neoplasms - etiology; Breast Neoplasms/epidemiology/etiology; Cancer and Oncology; Cancer och onkologi; Clinical Medicine; Cohort Studies; Europe - epidemiology; fat distribution; Female; Gynecology. Andrology. Obstetrics; height; Hormone Replacement Therapy; Humans; Incidence; Klinisk medicin; Mammary gland diseases; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Nutritional Status; obesity; Obesity - complications; Postmenopause; Premenopause; Prospective Studies; Risk Factors; Tumors; Europe; Human; Obesity; Anthropometry; Nutrition disorder; Breast cancer; Malignant tumor; Epidemiology; Prospective; Mammary gland diseases; Body mass index; Cancerology; Body size; Risk factor; Public health; Nutritional status
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.20315

The evidence for anthropometric factors influencing breast cancer risk is accumulating, but uncertainties remain concerning the role of fat distribution and potential effect modifiers. We used data from 73,542 premenopausal and 103,344 postmenopausal women from 9 European countries, taking part in the EPIC study. RRs from Cox regression models were calculated, using measured height, weight, BMI and waist and hip circumferences; categorized by cohort‐wide quintiles; and expressed as continuous variables, adjusted for study center, age and other risk factors. During 4.7 years of follow‐up, 1,879 incident invasive breast cancers were identified. In postmenopausal women, current HRT modified the body size–breast cancer association. Among nonusers, weight, BMI and hip circumference were positively associated with breast cancer risk (all ptrend ≤ 0.002); obese women (BMI > 30) had a 31% excess risk compared to women with BMI < 25. Among HRT users, body measures were inversely but nonsignificantly associated with breast cancer. Excess breast cancer risk with HRT was particularly evident among lean women. Pooled RRs per height increment of 5 cm were 1.05 (95% CI 1.00–1.16) in premenopausal and 1.10 (95% CI 1.05–1.16) in postmenopausal women. Among premenopausal women, hip circumference was the only other measure significantly related to breast cancer (ptrend = 0.03), after accounting for BMI. In postmenopausal women not taking exogenous hormones, general obesity is a significant predictor of breast cancer, while abdominal fat assessed as waist–hip ratio or waist circumference was not related to excess risk when adjusted for BMI. Among premenopausal women, weight and BMI showed nonsignificant inverse associations with breast cancer. © 2004 Wiley‐Liss, Inc.