Breast Cancer Research and Treatment

, Volume 123, Issue 3, pp 641–649 | Cite as

Adult weight gain in relation to breast cancer risk by estrogen and progesterone receptor status: a meta-analysis

  • Alina Vrieling
  • Katharina Buck
  • Rudolf Kaaks
  • Jenny Chang-Claude


Adult weight gain is positively associated with postmenopausal breast cancer and inversely associated with premenopausal breast cancer risk. To date, no meta-analysis has been conducted to assess this association by estrogen receptor (ER) and progesterone receptor (PR) status. We searched PubMed for relevant studies published through March 2010. Summarized risk estimates (REs) with 95% confidence intervals (CIs) were calculated using random effects or fixed effects models. We retrieved nine articles on weight gain from adulthood to reference age and ER- and/or PR-defined breast cancer risk, reporting on three prospective cohort studies and eight case–control studies. Comparing the highest versus the lowest categories of adult weight gain, risk was increased for ER+PR+ and ER+ tumors combined (11 studies; RE = 2.03; 95% CI 1.62, 2.45). Statistically significant heterogeneity (p heterogeneity = 0.002) was shown between REs for a mixed population of pre- and postmenopausal women combined (4 studies; RE = 1.54; 95% CI 0.86, 2.22) and for postmenopausal women only (7 studies; RE = 2.33; 95% CI 2.05, 2.60). Risk for ERPR tumors among postmenopausal women was also slightly increased (7 studies; RE = 1.34; 95% CI 1.06, 1.63), but statistically significantly different from risk for ER+PR+ tumors (p heterogeneity < 0.0001). No associations were observed for ER+PR tumors whereas risk for ERPR+ tumors could not be assessed. In conclusion, the association between adult weight gain and postmenopausal breast cancer risk is heterogeneous according to ER/PR status and stronger for ER+PR+ than for ERPR tumors.


Adult weight gain Breast cancer Estrogen receptor Progesterone receptor Meta-analysis 



This work was funded by the Deutsche Krebshilfe, project number 108253.

Conflict of interest

The authors had no conflict of interest.


  1. 1.
    World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington, DCGoogle Scholar
  2. 2.
    Potischman N, Swanson CA, Siiteri P, Hoover RN (1996) Reversal of relation between body mass and endogenous estrogen concentrations with menopausal status. J Natl Cancer Inst 88:756–758CrossRefPubMedGoogle Scholar
  3. 3.
    Suzuki R, Orsini N, Saji S, Key TJ, Wolk A (2009) Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status—a meta-analysis. Int J Cancer 124:698–712. doi: 10.1002/ijc.23943 CrossRefPubMedGoogle Scholar
  4. 4.
    Ballard-Barbash R, Schatzkin A, Taylor PR, Kahle LL (1990) Association of change in body mass with breast cancer. Cancer Res 50:2152–2155PubMedGoogle Scholar
  5. 5.
    Magnusson C, Baron J, Persson I, Wolk A, Bergstrom R, Trichopoulos D, Adami HO (1998) Body size in different periods of life and breast cancer risk in post-menopausal women. Int J Cancer 76:29–34. doi: 10.1002/(SICI)1097-0215(19980330)76:1<29:AID-IJC6>3.0.CO;2-# CrossRefPubMedGoogle Scholar
  6. 6.
    Trentham-Dietz A, Newcomb PA, Egan KM, Titus-Ernstoff L, Baron JA, Storer BE, Stampfer M, Willett WC (2000) Weight change and risk of postmenopausal breast cancer (United States). Cancer Causes Control 11:533–542. doi: 10.1023/A:1008961931534 CrossRefPubMedGoogle Scholar
  7. 7.
    Le Marchand L, Kolonel LN, Earle ME, Mi MP (1988) Body size at different periods of life and breast cancer risk. Am J Epidemiol 128:137–152PubMedGoogle Scholar
  8. 8.
    Brinton LA, Swanson CA (1992) Height and weight at various ages and risk of breast cancer. Ann Epidemiol 2:597–609CrossRefPubMedGoogle Scholar
  9. 9.
    Huang Z, Hankinson SE, Colditz GA, Stampfer MJ, Hunter DJ, Manson JE, Hennekens CH, Rosner B, Speizer FE, Willett WC (1997) Dual effects of weight and weight gain on breast cancer risk. JAMA 278:1407–1411CrossRefPubMedGoogle Scholar
  10. 10.
    Feigelson HS, Jonas CR, Teras LR, Thun MJ, Calle EE (2004) Weight gain, body mass index, hormone replacement therapy, and postmenopausal breast cancer in a large prospective study. Cancer Epidemiol Biomarkers Prev 13:220–224. doi: 10.1158/1055-9965.EPI-03-0301 CrossRefPubMedGoogle Scholar
  11. 11.
    IARC (2002) Weight control and physical activity. IARC handbooks of cancer prevention, vol 6. IARC Press, Lyon, FranceGoogle Scholar
  12. 12.
    Feigelson HS, Patel AV, Teras LR, Gansler T, Thun MJ, Calle EE (2006) Adult weight gain and histopathologic characteristics of breast cancer among postmenopausal women. Cancer 107:12–21. doi: 10.1002/cncr.21965 CrossRefPubMedGoogle Scholar
  13. 13.
    Ahn J, Schatzkin A, Lacey JV Jr, Albanes D, Ballard-Barbash R, Adams KF, Kipnis V, Mouw T, Hollenbeck AR, Leitzmann MF (2007) Adiposity, adult weight change, and postmenopausal breast cancer risk. Arch Intern Med 167:2091–2102. doi: 10.1001/archinte.167.19.2091 CrossRefPubMedGoogle Scholar
  14. 14.
    Palmer JR, Adams-Campbell LL, Boggs DA, Wise LA, Rosenberg L (2007) A prospective study of body size and breast cancer in black women. Cancer Epidemiol Biomarkers Prev 16:1795–1802. doi: 10.1158/1055-9965.EPI-07-0336 CrossRefPubMedGoogle Scholar
  15. 15.
    Enger SM, Ross RK, Paganini-Hill A, Carpenter CL, Bernstein L (2000) Body size, physical activity, and breast cancer hormone receptor status: results from two case–control studies. Cancer Epidemiol Biomarkers Prev 9:681–687PubMedGoogle Scholar
  16. 16.
    Wenten M, Gilliland FD, Baumgartner K, Samet JM (2002) Associations of weight, weight change, and body mass with breast cancer risk in Hispanic and non-Hispanic white women. Ann Epidemiol 12:435–444. doi: S1047279701002939 CrossRefPubMedGoogle Scholar
  17. 17.
    Eng SM, Gammon MD, Terry MB, Kushi LH, Teitelbaum SL, Britton JA, Neugut AI (2005) Body size changes in relation to postmenopausal breast cancer among women on Long Island, New York. Am J Epidemiol 162:229–237. doi: 10.1093/aje/kwi195 CrossRefPubMedGoogle Scholar
  18. 18.
    Han D, Nie J, Bonner MR, McCann SE, Muti P, Trevisan M, Ramirez-Marrero FA, Vito D, Freudenheim JL (2006) Lifetime adult weight gain, central adiposity, and the risk of pre- and postmenopausal breast cancer in the Western New York exposures and breast cancer study. Int J Cancer 119:2931–2937. doi: 10.1002/ijc.22236 CrossRefPubMedGoogle Scholar
  19. 19.
    Rosenberg LU, Einarsdottir K, Friman EI, Wedren S, Dickman PW, Hall P, Magnusson C (2006) Risk factors for hormone receptor-defined breast cancer in postmenopausal women. Cancer Epidemiol Biomarkers Prev 15:2482–2488. doi: 10.1158/1055-9965.EPI-06-0489 CrossRefPubMedGoogle Scholar
  20. 20.
    Slattery ML, Sweeney C, Edwards S, Herrick J, Baumgartner K, Wolff R, Murtaugh M, Baumgartner R, Giuliano A, Byers T (2007) Body size, weight change, fat distribution and breast cancer risk in Hispanic and non-Hispanic white women. Breast Cancer Res Treat 102:85–101. doi: 10.1007/s10549-006-9292-y CrossRefPubMedGoogle Scholar
  21. 21.
    Colditz GA, Rosner BA, Chen WY, Holmes MD, Hankinson SE (2004) Risk factors for breast cancer according to estrogen and progesterone receptor status. J Natl Cancer Inst 96:218–228. doi: 10.1093/jnci/djh025 CrossRefPubMedGoogle Scholar
  22. 22.
    R Development Core Team (2008) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, AustriaGoogle Scholar
  23. 23.
    Huedo-Medina TB, Sanchez-Meca J, Marin-Martinez F, Botella J (2006) Assessing heterogeneity in meta-analysis: Q statistic or I 2 index? Psychol Methods 11:193–206. doi: 10.1037/1082-989X.11.2.193 CrossRefPubMedGoogle Scholar
  24. 24.
    Hedges LV, Olkin I (1985) Statistical methods for meta-analysis. Academic Press, New YorkGoogle Scholar
  25. 25.
    Whitehead A, Whitehead J (1991) A general parametric approach to the meta-analysis of randomized clinical trials. Stat Med 10:1665–1677CrossRefPubMedGoogle Scholar
  26. 26.
    DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188. doi: 0197-2456(86)90046-2 CrossRefPubMedGoogle Scholar
  27. 27.
    Light RJ, Pillemer DB (1984) Summing up. The science of reviewing research. Harvard University Press, CambridgeGoogle Scholar
  28. 28.
    Sterne JA, Egger M (2001) Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 54:1046–1055. doi: S0895-4356(01)00377-8 CrossRefPubMedGoogle Scholar
  29. 29.
    Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMedGoogle Scholar
  30. 30.
    Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4:579–591. doi: 10.1038/nrc1408 CrossRefPubMedGoogle Scholar
  31. 31.
    Stoll BA (1995) Timing of weight gain in relation to breast cancer risk. Ann Oncol 6:245–248PubMedGoogle Scholar
  32. 32.
    Willett WC (1998) Nutritional epidemiology. Oxford University Press, New YorkCrossRefGoogle Scholar
  33. 33.
    Rose DP, Vona-Davis L (2009) Influence of obesity on breast cancer receptor status and prognosis. Expert Rev Anticancer Ther 9:1091–1101. doi: 10.1586/era.09.71 CrossRefPubMedGoogle Scholar
  34. 34.
    Harvie M, Howell A, Vierkant RA, Kumar N, Cerhan JR, Kelemen LE, Folsom AR, Sellers TA (2005) Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa women’s health study. Cancer Epidemiol Biomarkers Prev 14:656–661. doi: 10.1158/1055-9965.EPI-04-0001 CrossRefPubMedGoogle Scholar
  35. 35.
    Eliassen AH, Colditz GA, Rosner B, Willett WC, Hankinson SE (2006) Adult weight change and risk of postmenopausal breast cancer. JAMA 296:193–201. doi: 10.1001/jama.296.2.193 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Alina Vrieling
    • 1
  • Katharina Buck
    • 1
  • Rudolf Kaaks
    • 1
  • Jenny Chang-Claude
    • 1
  1. 1.Division of Cancer EpidemiologyGerman Cancer Research Center DKFZHeidelbergGermany

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