Breast Cancer Research and Treatment

, Volume 150, Issue 3, pp 655–666 | Cite as

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

  • Elisa V. BanderaEmail author
  • Urmila Chandran
  • Chi-Chen Hong
  • Melissa A. Troester
  • Traci N. Bethea
  • Lucile L. Adams-Campbell
  • Christopher A. Haiman
  • Song-Yi Park
  • Andrew F. Olshan
  • Christine B. Ambrosone
  • Julie R. Palmer
  • Lynn Rosenberg


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.


Obesity Breast cancer subtypes Triple negative African Americans Waist-to-hip ratio 



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


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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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Elisa V. Bandera
    • 1
    • 2
    Email author
  • Urmila Chandran
    • 1
    • 3
  • Chi-Chen Hong
    • 4
  • Melissa A. Troester
    • 5
  • Traci N. Bethea
    • 6
  • Lucile L. Adams-Campbell
    • 7
  • Christopher A. Haiman
    • 8
  • Song-Yi Park
    • 9
  • Andrew F. Olshan
    • 5
  • Christine B. Ambrosone
    • 4
  • Julie R. Palmer
    • 6
  • Lynn Rosenberg
    • 6
  1. 1.Cancer Prevention and ControlRutgers Cancer Institute of New JerseyNew BrunswickUSA
  2. 2.Department of EpidemiologyRutgers School of Public HealthPiscatawayUSA
  3. 3.Janssen PharmaceuticalsJohnson & JohnsonRaritanUSA
  4. 4.Cancer Prevention and ControlRoswell Park Cancer InstituteBuffaloUSA
  5. 5.Cancer EpidemiologyUniversity of North Carolina Lineberger Comprehensive Cancer CenterChapel HillUSA
  6. 6.Slone Epidemiology Center at Boston UniversityBostonUSA
  7. 7.Cancer Prevention and ControlGeorgetown Lombardi Comprehensive Cancer CenterWashingtonUSA
  8. 8.Department of Preventive Medicine and Norris Comprehensive Cancer CenterUniversity of Southern California Keck School of MedicineLos AngelesUSA
  9. 9.Cancer EpidemiologyUniversity of Hawaii Cancer CenterHonoluluUSA

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