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Obesity, body fat distribution, and risk of breast cancer subtypes in African American women participating in the AMBER Consortium

  • Epidemiology
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Abstract

African American (AA) women are more likely than white women to be obese and to be diagnosed with ER− and triple-negative (TN) breast cancer, but few studies have evaluated the impact of obesity and body fat distribution on breast cancer subtypes in AA women. We evaluated these associations in the AMBER Consortium by pooling data from four large studies. Cases were categorized according to hormone receptor status as ER+, ER−, and TN (ER−, PR−, and HER2−) based on pathology data. A total of 2104 ER+ cases, 1070 ER− cases (including 491 TN cases), and 12,060 controls were included. Odds ratios (OR) and 95 % confidence intervals (CI) were computed using logistic regression, taking into account breast cancer risk factors. In postmenopausal women, higher recent (most proximal value to diagnosis/index date) BMI was associated with increased risk of ER+ cancer (OR 1.31; 95 % CI 1.02–1.67 for BMI ≥35 vs. <25 kg/m2) and with decreased risk of TN tumors (OR 0.60; 95 % CI 0.39–0.93 for BMI ≥35 vs. <25). High young adult BMI was associated with decreased premenopausal ER+ cancer and all subtypes of postmenopausal cancer, and high recent waist-to-hip ratio with increased risk of premenopausal ER+ tumors (OR 1.35; 95 % CI 1.01–1.80) and all tumor subtypes combined in postmenopausal women (OR 1.26; 95 % CI 1.02–1.56). The impact of general and central obesity varies by menopausal status and hormone receptor subtype in AA women. Our findings imply different mechanisms for associations of adiposity with TN and ER+ breast cancers.

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Acknowledgments

We thank participants and staff of the contributing studies. We wish also to acknowledge the late Robert Millikan, DVM, MPH, PhD, who was instrumental in the creation of this consortium. Pathology data were obtained from numerous state cancer registries (Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Illinois, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia). The results reported do not necessarily represent their views or the views of the NIH.

Conflict of interest

None

Financial support

This research was funded by the National Cancer Institute: P01CA151135 (all investigators), R01CA058420 and UM1CA164974 (T.N. Bethea, J.R. Palmer, L. Rosenberg), R01CA100598 (C.B. Ambrosone, E.V. Bandera), and P50CA58223 (A.F. Olshan, M.A. Troester); the University Cancer Research Fund of North Carolina (A.F. Olshan, M.A. Troester) and the Breast Cancer Research Foundation (C.B. Ambrosone). The results do not necessarily reflect the views of the sponsors, who had no role in study design; data collection, analysis, or interpretation; or writing and submission of the manuscript.

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Authors and Affiliations

  1. Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08903, USA

    Elisa V. Bandera & Urmila Chandran

  2. Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA

    Elisa V. Bandera

  3. Janssen Pharmaceuticals, Johnson & Johnson, Raritan, NJ, USA

    Urmila Chandran

  4. Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA

    Chi-Chen Hong & Christine B. Ambrosone

  5. Cancer Epidemiology, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA

    Melissa A. Troester & Andrew F. Olshan

  6. Slone Epidemiology Center at Boston University, Boston, MA, USA

    Traci N. Bethea, Julie R. Palmer & Lynn Rosenberg

  7. Cancer Prevention and Control, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA

    Lucile L. Adams-Campbell

  8. Department of Preventive Medicine and Norris Comprehensive Cancer Center, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    Christopher A. Haiman

  9. Cancer Epidemiology, University of Hawaii Cancer Center, Honolulu, HI, USA

    Song-Yi Park

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  1. Elisa V. Bandera
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Correspondence to Elisa V. Bandera.

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Bandera, E.V., Chandran, U., Hong, CC. et al. Obesity, body fat distribution, and risk of breast cancer subtypes in African American women participating in the AMBER Consortium. Breast Cancer Res Treat 150, 655–666 (2015). https://doi.org/10.1007/s10549-015-3353-z

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