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Obesity and breast cancer survival in ethnically diverse postmenopausal women: the Multiethnic Cohort Study

  • Epidemiology
  • Published:
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Abstract

Breast cancer survival has been found to be lower in obese women, but few studies have evaluated ethnic variations in this association. This study examined all-cause and breast cancer-specific survival by body mass index (BMI) in the Multiethnic Cohort (MEC) study for African American, Native Hawaiian, Japanese American, Latino, and Caucasian women. Female MEC participants free of breast cancer, aged ≥50 years at cohort entry, and diagnosed with primary invasive breast cancer during follow-up were included in the analyses (n = 3,842). Cox proportional hazards regression was used to estimate the effect of pre-diagnostic adult BMI (<22.5, 22.5–24.9, 25.0–29.9, ≥30 kg/m2) on the risk of mortality. Mean age at diagnosis was 68.8 years (range 50–89 years). During a mean follow-up of 6.2 ± 3.8 years after diagnosis, there were 804 deaths that included 376 breast cancer-specific deaths. After adjustment for breast cancer characteristics, including hormone receptor status, stage at diagnosis, and treatment, obese women had a higher risk of all-cause [hazard ratio (HR) = 1.54; 95% confidence interval (CI): 1.23, 1.91] and breast cancer-specific (HR = 1.45; 95% CI: 1.05, 2.00) mortality compared to women with high-normal BMI; however, being overweight did not affect survival. There was no evidence of ethnic differences in the BMI effect on all-cause (P interaction = 0.87) or breast cancer-specific (P interaction = 0.63) mortality. Our findings are consistent with the literature that maintaining moderate weight throughout adult life may be beneficial for breast cancer survival in women and this appears to hold for all ethnic groups.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

ER:

Estrogen receptor

HR:

Hazard ratio

HRT:

Hormone replacement therapy

MEC:

Multiethnic cohort

PR:

Progesterone receptor

SEER:

Surveillance, epidemiology, and end results

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Acknowledgments

We thank all the participants in the Multiethnic Cohort Study. The Multiethnic Cohort Study has been supported by US Public Health Service (National Cancer Institute) grant R37 CA 54281. SMC was supported by a postdoctoral fellowship on grant R25 CA 90956. The tumor registries are supported by NCI contracts N01-PC-35137 and N01-PC-35139.

Conflict of interest

All authors (Conroy, Maskarinec, Wilkens, White, Henderson, Kolonel) declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Epidemiology Program, University of Hawaii Cancer Center, 1236 Lauhala Street, Honolulu, HI, 96813, USA

    Shannon M. Conroy, Gertraud Maskarinec, Lynne R. Wilkens, Kami K. White & Laurence N. Kolonel

  2. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Brian E. Henderson

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  1. Shannon M. Conroy
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  2. Gertraud Maskarinec
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  3. Lynne R. Wilkens
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  4. Kami K. White
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  5. Brian E. Henderson
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  6. Laurence N. Kolonel
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Correspondence to Shannon M. Conroy.

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Conroy, S.M., Maskarinec, G., Wilkens, L.R. et al. Obesity and breast cancer survival in ethnically diverse postmenopausal women: the Multiethnic Cohort Study. Breast Cancer Res Treat 129, 565–574 (2011). https://doi.org/10.1007/s10549-011-1468-4

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  • DOI: https://doi.org/10.1007/s10549-011-1468-4

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