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Breast Cancer Research and Treatment

, Volume 129, Issue 2, pp 565–574 | Cite as

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

  • Shannon M. ConroyEmail author
  • Gertraud Maskarinec
  • Lynne R. Wilkens
  • Kami K. White
  • Brian E. Henderson
  • Laurence N. Kolonel
Epidemiology

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.

Keywords

Breast carcinoma Ethnicity Obesity Survival Prognosis 

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

Notes

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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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Shannon M. Conroy
    • 1
    Email author
  • Gertraud Maskarinec
    • 1
  • Lynne R. Wilkens
    • 1
  • Kami K. White
    • 1
  • Brian E. Henderson
    • 2
  • Laurence N. Kolonel
    • 1
  1. 1.Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluUSA
  2. 2.Department of Preventive Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA

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