Breast Cancer

, Volume 22, Issue 4, pp 399–405

Association of body mass index with risk of luminal A but not luminal B estrogen receptor-positive and HER2-negative breast cancer for postmenopausal Japanese women

  • Yoshimasa Miyagawa
  • Tomohiro Miyake
  • Ayako Yanai
  • Keiko Murase
  • Michiko Imamura
  • Shigetoshi Ichii
  • Yuichi Takatsuka
  • Takashi Ito
  • Seiichi Hirota
  • Masaru Saito
  • Yoshinao Kotoura
  • Keisuke Miyauchi
  • Yasuhisa Fujimoto
  • Takuya Hatada
  • Mitsunori Sasa
  • Yasuo Miyoshi
Original Article

Abstract

Background

The impact of body mass index (BMI) on the risk of postmenopausal estrogen receptor (ER)-positive breast cancers has been well documented. However, the mechanism for the impact of BMI on the etiology of luminal A and luminal B subtypes has not yet been identified.

Methods

We analyzed associations between BMI and breast cancers stratified by immunohistochemically defined intrinsic subtypes, and 1,297 Japanese women (615 breast cancer patients and 682 healthy women from a breast cancer screening program) were enrolled in a case–control study. ER-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancers were classified into luminal A and B subtypes according to Ki67 expression levels.

Results

Higher BMI was significantly positively associated with postmenopausal breast cancer risk for one-unit increase in BMI (adjusted odds ratio (aOR) 1.09, 95 % confidence interval (CI) 1.04–1.15; P = 0.0008). Analyses of postmenopausal women revealed that BMI was consistently and exclusively associated with luminal A incidence (aOR 1.18, 95 % CI 1.10–1.26; P < 0.0001). When BMI was divided into three categories corresponding to those of controls, among postmenopausal women, the observed positive association was confined to luminal A (high vs low, aOR 2.98, 95 % CI 1.53–5.80; P < 0.005), but not luminal B (aOR 0.95, 95 % CI 0.47–1.91) subtypes.

Conclusions

We observed that BMI was significantly positively associated with increased risk of postmenopausal breast cancer for Japanese women with luminal A, but not with luminal B tumor subtype.

Keywords

Body mass index Breast cancer risk Estrogen receptor Luminal A 

References

  1. 1.
    Althuis MD, Fergenbaum JH, Garcia-Closas M, et al. Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomarkers Prev. 2004;13:1558–68.PubMedGoogle Scholar
  2. 2.
    Ma H, Bernstein L, Pike MC, Ursin G. Reproductive factors and breast cancer risk according to joint estrogen and progesterone receptor status: a meta-analysis of epidemiological studies. Breast Cancer Res. 2006;8:R43.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Toniolo PG, Levitz M, Zeleniuch-Jacquotte A, et al. A prospective study of endogenous estrogens and breast cancer in postmenopausal women. J Natl Cancer Inst. 1995;87:190–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Thomas HV, Key TJ, Allen DS, et al. A prospective study of endogenous serum hormone concentrations and breast cancer risk in premenopausal women on the island of Guernsey. Br J Cancer. 1997;75:1075–9.Google Scholar
  5. 5.
    Hankinson SE, Willett WC, Manson JE, et al. Plasma sex steroid hormone levels and risk of breast cancer in postmenopausal women. J Natl Cancer Inst. 1998;90:1292–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Renehan AG, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371:569–1578.PubMedCrossRefGoogle Scholar
  7. 7.
    Harvie M, Hooper L, Howell AH. Central obesity and breast cancer risk: a systematic review. Obes Rev. 2003;4:157–73.PubMedCrossRefGoogle Scholar
  8. 8.
    Schatzkin A, Palmer JR, Rosenberg L, et al. Risk factors for breast cancer in black women. J Natl Cancer Inst. 1987;78:213–7.PubMedGoogle Scholar
  9. 9.
    Phipps AI, Malone KE, Porter PL, et al. Body size and risk of luminal, HER2-overexpressing, and triple-negative breast cancer in postmenopausal women. Cancer Epidemiol Biomarkers Prev. 2008;17:2078–86.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Suzuki R, Orsini N, Saji S, et al. Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status–a meta-analysis. Int J Cancer. 2009;124:698–712.PubMedCrossRefGoogle Scholar
  11. 11.
    Perou CM, Sørlie T, Eisen MB, et al. Molecular portraits of human breast tumours. Nature. 2000;406:747–52.PubMedCrossRefGoogle Scholar
  12. 12.
    Toi M, Saji S, Masuda N, et al. Ki67 index changes, pathological response and clinical benefits in primary breast cancer patients treated with 24 weeks of aromatase inhibition. Cancer Sci. 2011;102:858–65.PubMedCrossRefGoogle Scholar
  13. 13.
    Key TJ, Appleby PN, Reeves GK, et al. Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. Endogenous Hormones Breast Cancer Collaborative Group. J Natl Cancer Inst. 2003;95:1218–26.PubMedCrossRefGoogle Scholar
  14. 14.
    Verkasalo PK, Thomas HV, Appleby PN, et al. Circulating levels of sex hormones and their relation to risk factors for breast cancer: a cross-sectional study in 1092 pre- and postmenopausal women (United Kingdom). Cancer Causes Control. 2001;12:47–59.PubMedCrossRefGoogle Scholar
  15. 15.
    Furberg AS, Veierød MB, Wilsgaard T, et al. Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk. J Natl Cancer Inst. 2004;96:1152–60.PubMedCrossRefGoogle Scholar
  16. 16.
    Gunter MJ, Hoover DR, Yu H, et al. Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst. 2009;101:48–60.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Nishimura R, Arima N. Is triple negative a prognostic factor in breast cancer? Breast Cancer. 2008;15:303–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Cheang MC, Chia SK, Voduc D, et al. Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst. 2009;101:736–50.PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Creighton CJ. The molecular profile of luminal B breast cancer. Biologics. 2012;6:289–97.PubMedCentralPubMedGoogle Scholar
  20. 20.
    Ellis MJ, Suman VJ, Hoog J, et al. Randomized phase II neoadjuvant comparison between letrozole, anastrozole, and exemestane for postmenopausal women with estrogen receptor-rich stage 2 to 3 breast cancer: clinical and biomarker outcomes and predictive value of the baseline PAM50-based intrinsic subtype–ACOSOG Z1031. J Clin Oncol. 2011;29:2342–9.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Murase K, Yanai A, Saito M, et al. Biological characteristics of luminal subtypes in pre- and postmenopausal estrogen receptor-positive and HER2-negative breast cancers. Breast Cancer. 2012. doi:10.1007/s12282-012-0348-z.
  22. 22.
    Ritte R, Lukanova A, Berrino F, et al. Adiposity, hormone replacement therapy use and breast cancer risk by age and hormone receptor status: a large prospective cohort study. Breast Cancer Res. 2012;14:R76.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Suzuki R, Iwasaki M, Inoue M, et al. Body weight at age 20 years, subsequent weight change and breast cancer risk defined by estrogen and progesterone receptor status–the Japan public health center-based prospective study. Int J Cancer. 2011;129:1214–24.PubMedCrossRefGoogle Scholar
  24. 24.
    Yang XR, Chang-Claude J, Goode EL, et al. Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies. J Natl Cancer Inst. 2011;103:250–63.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 2013

Authors and Affiliations

  • Yoshimasa Miyagawa
    • 1
  • Tomohiro Miyake
    • 1
  • Ayako Yanai
    • 1
  • Keiko Murase
    • 1
  • Michiko Imamura
    • 1
  • Shigetoshi Ichii
    • 1
  • Yuichi Takatsuka
    • 1
  • Takashi Ito
    • 2
  • Seiichi Hirota
    • 2
  • Masaru Saito
    • 3
  • Yoshinao Kotoura
    • 3
  • Keisuke Miyauchi
    • 4
  • Yasuhisa Fujimoto
    • 5
  • Takuya Hatada
    • 6
  • Mitsunori Sasa
    • 7
  • Yasuo Miyoshi
    • 1
  1. 1.Division of Breast and Endocrine, Department of SurgeryHyogo College of MedicineNishinomiyaJapan
  2. 2.Surgical PathologyHyogo College of MedicineNishinomiyaJapan
  3. 3.Maikodai HospitalKobeJapan
  4. 4.Miyauchi ClinicAmagasakiJapan
  5. 5.Tachibana HospitalAmagasakiJapan
  6. 6.Uminosato ClinicMinamiawajiJapan
  7. 7.Tokushima Breast Care ClinicTokushimaJapan

Personalised recommendations