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Body mass index and risk of second primary breast cancer: The WECARE Study

  • Epidemiology
  • Published:
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Abstract

The identification of potentially modifiable risk factors, such as body size, could allow for interventions that could help reduce the burden of contralateral breast cancer (CBC) among breast cancer survivors. Studies examining the relationship between body mass index (BMI) and CBC have yielded mixed results. From the population-based, case–control, Women’s Environmental, Cancer and Radiation Epidemiology (WECARE) Study, we included 511 women with CBC (cases) and 999 women with unilateral breast cancer (controls) who had never used postmenopausal hormone therapy. Rate ratios (RR) and 95% confidence intervals (CI) were used to assess the relationship between BMI and CBC risk. No associations between BMI at first diagnosis or weight-change between first diagnosis and date of CBC diagnosis (or corresponding date in matched controls) and CBC risk were seen. However, obese (BMI ≥ 30 kg/m2) postmenopausal women with estrogen receptor (ER)-negative first primary tumors (n = 12 cases and 9 controls) were at an increased risk of CBC compared with normal weight women (BMI < 25 kg/m2) (n = 43 cases and 98 controls) (RR = 5.64 (95% CI 1.76, 18.1)). No association between BMI and CBC risk was seen in premenopausal or postmenopausal women with ER-positive first primaries. Overall, BMI is not associated with CBC risk in this population of young breast cancer survivors. Our finding of an over five-fold higher risk of CBC in a small subgroup of obese postmenopausal women with an ER-negative first primary breast cancer is based on limited numbers and requires confirmation in a larger study.

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Abbreviations

BMI:

Body mass index

CBC:

Contralateral breast cancer

CI:

Confidence interval

E1:

Estrone

E2:

Estradiol

ER:

Estrogen receptor

HR:

Hazard ratio

HT:

Postmenopausal hormone therapy

OR:

Odds ratio

PR:

Progesterone receptor

RR:

Rate ratio

SEER:

Surveillance, Epidemiology and End Results program

UBC:

Unilateral breast cancer

WECARE:

Women’s Environmental Cancer and Radiation Epidemiology

WHO:

World Health Organization

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Acknowledgment

This research was funded by the National Cancer Institute at the National Institutes of Health (R01CA114236, U01CA083178).

Conflict of interest

There are no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd Street, 3rd Floor, New York, NY, USA

    Jennifer D. Brooks, Anne S. Reiner & Jonine L. Bernstein

  2. Cancer Prevention Institute of California, Fremont, CA, USA

    Esther M. John

  3. Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

    Lene Mellemkjær

  4. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Kathleen E. Malone

  5. Department of Epidemiology, University of Iowa, Iowa City, IA, USA

    Charles F. Lynch

  6. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Jane C. Figueiredo & Robert W. Haile

  7. Department of Environmental Medicine, New York University, New York, NY, USA

    Roy E. Shore

  8. Radiation Effects Research Foundation, Hiroshima, Japan

    Roy E. Shore

  9. Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute and City of Hope Comprehensive Cancer Center, Duarte, CA, USA

    Leslie Bernstein

Authors
  1. Jennifer D. Brooks
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  2. Esther M. John
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  3. Lene Mellemkjær
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  4. Anne S. Reiner
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  5. Kathleen E. Malone
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  6. Charles F. Lynch
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  7. Jane C. Figueiredo
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  8. Robert W. Haile
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  9. Roy E. Shore
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  10. Jonine L. Bernstein
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  11. Leslie Bernstein
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Consortia

The WECARE Study Collaborative Group

Corresponding author

Correspondence to Jennifer D. Brooks.

Additional information

The WECARE Study Collaborative Group details are given in Appendix.

Appendix: The WECARE Study Collaborative Group

Appendix: The WECARE Study Collaborative Group

Memorial Sloan Kettering Cancer Center (New York, NY): Jonine L. Bernstein Ph.D. (WECARE Study P.I.), Colin Begg. Ph.D., Marinela Capanu Ph.D., Xiaolin Liang M.D., Anne R. Reiner M.P.H., Irene Orlow Ph.D, Tracy Layne M.P.H., Robert Klein Ph.D. (Co-investigator), Ken Offit M.D. (Co-investigator).

City of Hope (Duarte, CA): Leslie Bernstein Ph.D. (sub-contract P.I.), Laura Donnelly-Allen (some work performed at University of Southern California, Los Angeles CA).

Danish Cancer Society (Copenhagen, Denmark): Jørgen H. Olsen M.D. DMSc. (Sub-contract P.I.), Michael Andersson M.D. DMSc., Lisbeth Bertelsen MD., Per Guldberg Ph.D., Lene Mellemkjær Ph.D.

Fred Hutchinson Cancer Research Center (Seattle, WA): Kathleen E. Malone Ph.D. (Sub-contract P.I.), Noemi Epstein.

International Epidemiology Institute (Rockville, MD) and Vanderbilt University (Nashville, TN): John D. Boice Jr. Sc.D. (Sub-contract P.I.)

Lund University (Lund, Sweden): Åke Borg Ph.D. (Sub-contract P.I.),Theresa Sandberg Ph.D.

National Cancer Institute (Bethesda, MD): Daniela Seminara Ph.D. M.P·H.

New York University (New York, NY): Roy E. Shore Ph.D., Dr. P·H. (Sub-contract P.I.)

Cancer Prevention Institute of California (Fremont, CA): Esther M. John Ph.D. (Sub-contract P.I.)

Norwegian Radium Hospital (Oslo, Norway): Anne-Lise Børresen-Dale Ph.D. (Sub-contract P.I.), Laila Jansen.

Samuel Lunenfeld Research Institute, MSH (Toronto, Canada): Julia Knight, Ph.D. (Sub-contract P.I.), Anna Chiarelli Ph.D. (Co-Investigator).

Stanford University School of Medicine (Stanford, CA): Alice Whittemore Ph.D.

Translational Genomics Research Institute (T-Gen) (Phoenix, AZ): David Duggan Ph.D. (Sub-contract P.I.)

University of California at Irvine (Irvine, CA): Hoda Anton-Culver Ph.D. (Sub-contract P.I.), Joan Largent Ph.D. M.P.H. (Co-Investigator).

University of California at Los Angeles (Los Angeles, CA): Richard A. Gatti Ph.D. (Co-Investigator).

University of Iowa (Iowa City, IA): Charles F. Lynch M.D., Ph.D. (Sub-contract P.I.), Jeanne DeWall M.A.

University of Southern California (Los Angeles, CA): Robert W. Haile Dr.P·H. (Sub-contract P.I.), Graham Casey, Ph.D. (CO-Investigator), Bryan M. Langholz Ph.D. (Co-Investigator), Daniel Stram Ph.D.(Co-Investigator), Duncan C. Thomas Ph.D. (Co-Investigator), Anh T. Diep (Co-Investigator), Shanyan Xue M.D., Nianmin Zhou, M.D, Yong Liu M.D., Evgenia Ter-Karapetova, Andre Hernandez.

University of Southern Maine (Portland, ME): W. Douglas Thompson Ph.D. (Sub-contract P.I.)

University of Texas, M.D. Anderson Cancer Center (Houston, TX): Marilyn Stovall Ph.D. (Sub-contract P.I.), Susan Smith M.P·H. (Co-Investigator).

University of Virginia (Charlottesville, VA): Patrick Concannon, Ph.D. (Sub-contract P.I.), Sharon Teraoka, Ph.D. (Co-Investigator), Eric R. Olson, Ph.D, V. Anne Morrison;, Lemuel Navarro, Karen M. Cerosaletti, Ph.D., Jocyndra Wright (some work performed at Benaroya Research Institute at Virginia Mason,Seattle, WA).

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Brooks, J.D., John, E.M., Mellemkjær, L. et al. Body mass index and risk of second primary breast cancer: The WECARE Study. Breast Cancer Res Treat 131, 571–580 (2012). https://doi.org/10.1007/s10549-011-1743-4

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  • DOI: https://doi.org/10.1007/s10549-011-1743-4

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