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Cardiometabolic factors and breast cancer risk in U.S. black women

  • Epidemiology
  • Published:
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Abstract

Previous studies have suggested that metabolic syndrome may be associated with an increased risk of breast cancer, particularly in postmenopausal women, but U.S. black women have not been assessed. We examined the associations of abdominal obesity, type 2 diabetes, hypertension, and high cholesterol individually and in combination with breast cancer incidence in the Black Women’s Health Study. By means of Cox regression models, we estimated incidence rate ratios (IRR) and 95 % confidence intervals (CI) for the associations of baseline and time-dependent values of self-reported abdominal obesity, type 2 diabetes, hypertension, and high cholesterol with breast cancer incidence. During 516,452 person years of follow-up (mean years = 10.5; standard deviation = 2.9) from 1995 to 2007, 1,228 breast cancer cases were identified. After adjustment for age, education, body mass index at age 18, physical activity, and individual cardiometabolic factors, neither individual nor combinations of cardiometabolic factors were associated with breast cancer incidence overall; the multivariable IRR was 1.04 (95 % CI 0.86–1.25) for the combination of ≥3 factors relative to the absence of all factors, and 1.17 (0.85–1.60) for having all four factors. Among postmenopausal women, however, the comparable IRRs were 1.23 (0.93–1.62) and 1.63 (1.12–2.37), respectively. Our findings provide some support for an association between cardiometabolic factors and breast cancer incidence among postmenopausal U.S. black women.

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Abbreviations

ARIC:

Atherosclerosis Risk in Communities

BMI:

Body mass index

BWHS:

Black Women’s Health Study

CI:

Confidence interval

EPIC:

European Prospective Investigation of Cancer and Nutrition

HDL:

High-density lipoprotein

IRR:

Incidence rate ratio

Me-Can:

MEtabolic syndrome and CANcer Study

mIRR:

Multivariable incidence rate ratio

SHBG:

Sex-hormone binding globulin

WHI:

Women’s Health Initiative

References

  1. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr et al (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 112:2735–2752

    Article  PubMed  Google Scholar 

  2. Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. J Am Med Assoc 287:356–359

    Article  Google Scholar 

  3. Park Y-W, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB (2003) The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 163:427–436

    Article  PubMed  Google Scholar 

  4. Agnoli C, Berrino F, Abagnato CA, Muti P, Panico S, Crosignani P, Krogh V (2010) Metabolic syndrome and postmenopausal breast cancer in the ORDET cohort: a nested case–control study. Nutr Metab Cardiovasc Dis 20:41–48

    Article  PubMed  CAS  Google Scholar 

  5. Kabat GC, Kim M, Chlebowski RT, Khandekar J, Ko MG, McTiernan A, Neuhouser ML, Parker DR, Shikany JM, Stefanick ML et al (2009) A longitudinal study of the metabolic syndrome and risk of postmenopausal breast cancer. Cancer Epidemiol Biomark Prev 18:2046–2053

    Article  CAS  Google Scholar 

  6. Sinagra D, Amato C, Scarpilta AM, Brigandì M, Amato M, Saura G, Latteri MA, Caimi G (2002) Metabolic syndrome and breast cancer risk. Euro Rev Med Pharmacol Sci 6:55–59

    CAS  Google Scholar 

  7. Bjørge T, Lukanova A, Jonsson H, Tretli S, Ulmer H, Manjer J, Stocks T, Selmer R, Nagel G, Almquist M et al (2010) Metabolic syndrome and breast cancer in the Me-Can (MEtabolic syndrome and CANcer) project. Cancer Epidemiol Biomark Prev 19:1737–1745

    Article  Google Scholar 

  8. Rosato V, Bosetti C, Talamini R, Levi F, Montella M, Giacosa A, Negri E, La Vecchia C (2011) Metabolic syndrome and the risk of breast cancer in postmenopausal women. Ann Oncol 22:2687–2692

    Article  PubMed  CAS  Google Scholar 

  9. Porto L, Lora K, Soares J, Costa L (2011) Metabolic syndrome is an independent risk factor for breast cancer. Arch Gynecol Obstet 284:1271–1276

    Article  PubMed  Google Scholar 

  10. Osaki Y, Taniguchi S-i, Tahara A, Okamoto M, Kishimoto T (2012) Metabolic syndrome and incidence of liver and breast cancers in Japan. Cancer Epidemiol 36:141–147

    Article  PubMed  Google Scholar 

  11. Rose DP, Haffner SM, Baillargeon J (2007) Adiposity, the metabolic syndrome, and breast cancer in African-American and white American women. Endocrine Rev 28:763–777

    Article  CAS  Google Scholar 

  12. Huang Z, Willett WC, Colditz GA, Hunter DJ, Manson JE, Rosner B, Speizer FE, Hankinson SE (1999) Waist circumference, waist: hip ratio, and risk of breast cancer in the Nurses’ Health Study. Am J Epidemiol 150:1316–1324

    Article  PubMed  CAS  Google Scholar 

  13. Michels KB, Solomon CG, Hu FB, Rosner BA, Hankinson SE, Colditz GA, Manson JE (2003) Type 2 diabetes and subsequent incidence of breast cancer in the Nurses’™ Health Study. Diabetes Care 26:1752–1758

    Article  PubMed  Google Scholar 

  14. Xue F, Michels KB (2007) Diabetes, metabolic syndrome, and breast cancer: a review of the current evidence. Am J Clin Nutr 86:823S–835S

    CAS  Google Scholar 

  15. Wolf I, Sadetzki S, Catane R, Karasik A, Kaufman B (2005) Diabetes mellitus and breast cancer. Lancet Oncol 6:103–111

    Article  PubMed  CAS  Google Scholar 

  16. Vona-Davis L, Howard-McNatt M, Rose DP (2007) Adiposity, type 2 diabetes and the metabolic syndrome in breast cancer. Obes Rev 8:395–408

    Article  PubMed  CAS  Google Scholar 

  17. Largent JA, McEligot AJ, Ziogas A, Reid C, Hess J, Leighton N, Peel D, Anton-Culver H (2006) Hypertension, diuretics and breast cancer risk. J Hum Hypertens 20:727–732

    Article  PubMed  CAS  Google Scholar 

  18. Soler M, Chatenoud L, Negri E, Parazzini F, Franceschi S, La Vecchia C (1999) Hypertension and hormone-related neoplasms in women. Hypertension 34:320–325

    Article  PubMed  CAS  Google Scholar 

  19. Furberg A-S, Veierod MB, Wilsgaard T, Bernstein L, Thune I (2004) Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk. J Natl Cancer Inst 96:1152–1160

    Article  PubMed  CAS  Google Scholar 

  20. Libby G, Donnelly LA, Donnan PT, Alessi DR, Morris AD, Evans JMM (2009) New users of metformin are at low risk of incident cancer. Diabetes Care 32:1620–1625

    Article  PubMed  CAS  Google Scholar 

  21. Moorman PG, Hulka BS, Hiatt RA, Krieger N, Newman B, Vogelman JH, Orentreich N (1998) Association between high-density lipoprotein cholesterol and breast cancer varies by menopausal status. Cancer Epidemiol Biomark Prev 7:483–488

    CAS  Google Scholar 

  22. Morimoto LM, White E, Chen Z, Chlebowski RT, Hays J, Kuller L, Lopez AM, Manson JE, Margolis KL, Muti P et al (2002) Obesity, body size, and risk of postmenopausal breast cancer: the Women’s Health Initiative (United States). Cancer Causes Control 13:741–751

    Article  PubMed  Google Scholar 

  23. Eliassen AH, Colditz GA, Rosner B, Willett WC, Hankinson SE (2005) Serum lipids, lipid-lowering drugs, and the risk of breast cancer. Arch Intern Med 165:2264–2271

    Article  PubMed  CAS  Google Scholar 

  24. Kucharska-Newton AM, Rosamond WD, Mink PJ, Alberg AJ, Shahar E, Folsom AR (2008) HDL-cholesterol and incidence of breast cancer in the ARIC Cohort Study. Ann Epidemiol 18:671–677

    Article  PubMed  Google Scholar 

  25. 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 Biomark Prev 16:1795–1802

    Article  Google Scholar 

  26. Palmer JR, Rao SR, Adams-Campbell LL, Rosenberg L (2001) Height and breast cancer risk: results from the Black Women’s Health Study (United States). Cancer Causes Control 12:343–348

    Article  PubMed  CAS  Google Scholar 

  27. Wise LA, Palmer JR, Spiegelman D, Harlow BL, Stewart EA, Adams-Campbell LL, Rosenberg L (2005) Influence of body size and body fat distribution on risk of uterine leiomyomata in U.S. black women. Epidemiology 16:346–354

    Article  PubMed  Google Scholar 

  28. Krishan S, Rosenberg L, Djousse L, Cupple LA, Palmer JR (2007) Overall and central obesity and risk of type 2 diabetes. Obesity 15:1860–1866

    Article  Google Scholar 

  29. Cozier Y, Palmer JR, Horton NJ, Fredman L, Wise LA, Rosenberg L (2006) Racial discrimination and the incidence of hypertension in US black women. Ann Epidemiol 16:681–687

    Article  PubMed  Google Scholar 

  30. Stephenson GD, Rose DP (2003) Breast cancer and obesity: an update. Nutr Cancer 45:1–6

    Article  PubMed  CAS  Google Scholar 

  31. Monninkhof EM, Elias SG, Vlems FA, van der Tweel I, Schuit AJ, Voskuil DW, van Leeuwen FE, on behalf of TFPAC (2007) Physical activity and breast cancer: a systematic review. Epidemiology 18:137–157

    Article  PubMed  Google Scholar 

  32. Band PR, Le ND, Fang R, Deschamps M (2002) Carcinogenic and endocrine disrupting effects of cigarette smoke and risk of breast cancer. Lancet 360:1044–1049

    Article  PubMed  CAS  Google Scholar 

  33. Boffetta P, Hashibe M (2006) Alcohol and cancer. Lancet Oncol 7:149–156

    Article  PubMed  CAS  Google Scholar 

  34. Kelsey JL (1993) Breast cancer epidemiology: summary and future directions. Epidemiol Rev 15:256–263

    PubMed  CAS  Google Scholar 

  35. Kelsey JL, Gammon MD, John EM (1993) Reproductive factors and breast cancer. Epidemiol Rev 15:36–47

    PubMed  CAS  Google Scholar 

  36. Kelsey JL, Horn-Ross PL (1993) Breast cancer: magnitude of the problem and descriptive epidemiology. Epidemiol Rev 15:7–16

    PubMed  CAS  Google Scholar 

  37. Carter-Nolan PL, Adams-Campbell LL, Makambi K, Lewis S, Palmer JR, Rosenberg L (2006) Validation of physical activity instruments: Black Women’s Health Study. Ethn Dis 16:943–947

    PubMed  Google Scholar 

  38. Cox DR (1972) Regression models and life-tables. J R Stat Soc B (Methodol) 34:187–220

    Google Scholar 

  39. Therneau TM, Grambsch PM (2000) Modeling survival data: extending the Cox model. Springer, New York

    Google Scholar 

  40. Rose DP, Komninou D, Stephenson G (2004) Obesity, adipocytokines, and insulin resistance in breast cancer. Obes Rev 5:153–165

    Article  PubMed  CAS  Google Scholar 

  41. Kabat GC, Kim M, Caan BJ, Chlebowski RT, Gunter MJ, Ho GY, Rodriguez BL, Shikany JM, Strickler HD, Vitolins MZ et al (2009) Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer. Int J Cancer 125:2704–2710

    Article  PubMed  CAS  Google Scholar 

  42. Lorincz AM, Sukumar S (2006) Molecular links between obesity and breast cancer. Endocr Relat Cancer 13:279–292

    Article  PubMed  CAS  Google Scholar 

  43. Mink PJ, Shahar E, Rosamond WD, Alberg AJ, Folsom AR (2002) Serum insulin and glucose levels and breast cancer incidence. Am J Epidemiol 156:349–352

    Article  PubMed  Google Scholar 

  44. Pollak M (2008) Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer 8:915–928

    Article  PubMed  CAS  Google Scholar 

  45. Bruning PF (1987) Endogenous estrogens and breast cancer a possible relationship between body fat distribution and estrogen availability. J Steroid Biochem Mol Biol 27:487–492

    CAS  Google Scholar 

  46. Tworoger SS, Eliassen AH, Kelesidis T, Colditz GA, Willett WC, Mantzoros CS, Hankinson SE (2007) Plasma adiponectin concentrations and risk of incident breast cancer. J Clin Endocrinol Metab 92:1510–1516

    Article  PubMed  CAS  Google Scholar 

  47. Fast Stats: an interactive tool for access to SEER cancer statistics. http://seer.cancer.gov/faststats. Last accessed 21 Nov 2010

  48. Kaaks R, Van Noord PAH, Den Tonkelaar I, Peeters PHM, Riboli E, Grobbee DE (1998) Breast-cancer incidence in relation to height, weight and body-fat distribution in the Dutch “DOM” cohort. Int J Cancer 76:647–651

    Article  PubMed  CAS  Google Scholar 

  49. Hall IJ, Newman B, Millikan RC, Moorman PG (2000) Body size and breast cancer risk in black women and white women: the Carolina Breast Cancer Study. Am J Epidemiol 151:754–764

    Article  PubMed  CAS  Google Scholar 

  50. Lahmann PH, Hoffmann K, Allen N, van Gils CH, Khaw K-T, Tehard B, Berrino F, Tjønneland A, Bigaard J, Olsen A et al (2004) Body size and breast cancer risk: findings from the European prospective investigation into cancer and nutrition (EPIC). Int J Cancer 111:762–771

    Article  PubMed  CAS  Google Scholar 

  51. Adebamowo C, Ogundiran T, Adenipekun A, Oyesegun R, Campbell O, Akang E, Rotimi C, Olopade O (2003) Waist-hip ratio and breast cancer risk in urbanized Nigerian women. Breast Cancer Res 5:R18–R24

    Article  PubMed  Google Scholar 

  52. Ballard-Barbash R, Schatzkin A, Carter CL, Kannel WB, Kreger BE, D’Agostino RB, Splansky GL, Anderson KM, Helsel WE (1990) Body fat distribution and breast cancer in the Framingham Study. J Natl Cancer Inst 82:286–290

    Article  PubMed  CAS  Google Scholar 

  53. Folsom AR, Kaye SA, Prineas RJ, Potter JD, Gapstur SM, Wallace RB (1990) Increased incidence of carcinoma of the breast associated with abdominal adiposity in postmenopausal women. Am J Epidemiol 131:794–803

    PubMed  CAS  Google Scholar 

  54. Sonnenschein E, Toniolo P, Terry MB, Bruning PF, Kato I, Koenig KL, Shore RE (1999) Body fat distribution and obesity in pre- and postmenopausal breast cancer. Int J Epidemiol 28:1026–1031

    Article  PubMed  CAS  Google Scholar 

  55. Lipscombe LL, Goodwin PJ, Zinman B, mclaughlin JR, Hux JE (2006) Diabetes mellitus and breast cancer: a retrospective population-based cohort study. Breast Cancer Res Treat 98:349–356

    Article  PubMed  Google Scholar 

  56. Weiderpass E, Gridley G, Persson I, Nyrén O, Ekbom A, Adami H-O (1997) Risk of endometrial and breast cancer in patients with diabetes mellitus. Int J Cancer 71:360–363

    Article  PubMed  CAS  Google Scholar 

  57. Baron J, Weiderpass E, Newcomb P, Stampfer M, Titus-Ernstoff L, Egan K, Greenberg ER (2001) Metabolic disorders and breast cancer risk (United States). Cancer Causes Control 12:875–880

    Article  PubMed  CAS  Google Scholar 

  58. Talamini R, Franceschi S, Favero A, Negri E, Parazzini F, La Vecchia C (1997) Selected medical conditions and risk of breast cancer. Br J Cancer 75:1699–1703

    Article  PubMed  CAS  Google Scholar 

  59. Franceschi S, La Vecchia C, Negri E, Parazzini F, Boyle P (1990) Breast cancer risk and history of selected medical conditions linked with female hormones. Eur J Cancer 26:781–785

    Article  PubMed  CAS  Google Scholar 

  60. Sellers T, Sprafka J, Gapstur S, Rich S, Potter J, Ross J, McGovern P, Nelson C, Folsom A (1994) Does body fat distribution promote familial aggregation of adult onset diabetes mellitus and postmenopausal breast cancer? Epidemiology 5:102–108

    Article  PubMed  CAS  Google Scholar 

  61. Swerdlow AJ, Laing SP, Qiao Z, Slater SD, Burden AC, Botha JL, Waugh NR, Morris AD, Gatling W, Gale EA et al (2005) Cancer incidence and mortality in patients with insulin-treated diabetes: a UK cohort study. Br J Cancer 92:2070–2075

    Article  PubMed  CAS  Google Scholar 

  62. Inoue M, Iwasaki M, Otani T, Sasazuki S, Noda M, Tsugane S, for the Japan Public Health Center-Based Prospective Study Group (2006) Diabetes mellitus and the risk of cancer: results from a large-scale population-based cohort study in Japan. Arch Intern Med 166:1871–1877

    Google Scholar 

  63. Lindgren A, Pukkala E, Tuomilehto J, Nissinen A (2007) Incidence of breast cancer among postmenopausal, hypertensive women. Int J Cancer 121:641–644

    Article  PubMed  CAS  Google Scholar 

  64. Furberg A-S, Jasienska G, Bjurstam N, Torjesen PA, Emaus A, Lipson SF, Ellison PT, Thune I (2005) Metabolic and hormonal profiles: HDL cholesterol as a plausible biomarker of breast cancer risk. The Norwegian EBBA Study. Cancer Epidemiol Biomark Prev 14:33–40

    CAS  Google Scholar 

  65. Rimm EB, Stampfer MJ, Colditz GA, Chute CG, Litin LB, Willett WC (1990) Validity of self-reported waist and hip circumferences in men and women. Epidemiology 1:466–473

    Article  PubMed  CAS  Google Scholar 

  66. Rose DP, Vona-Davis L (2010) Interaction between menopausal status and obesity in affecting breast cancer risk. Maturitas 66:33–38

    Article  PubMed  Google Scholar 

  67. White KK, Park S-Y, Kolonel LN, Henderson BE, Wilkens LR (2012) Body size and breast cancer risk: the Multiethnic Cohort. Int J Cancer. doi:10.1002/ijc.27373

  68. Rollison DE, Giuliano AR, Sellers TA, Laronga C, Sweeney C, Risendal B, Baumgartner KB, Byers T, Slattery ML (2008) Population-based case-control study of diabetes and breast cancer risk in Hispanic and non-Hispanic white women living in US Southwestern States. Am J Epidemiol 167:447–456

    Article  PubMed  Google Scholar 

  69. Bodmer M, Meier C, Krähenbühl S, Jick SS, Meier CR (2010) Long-term metformin use is associated with decreased risk of breast cancer. Diabetes Care 33:1304–1308

    Article  PubMed  CAS  Google Scholar 

  70. Jonasson JM, Ljung R, Talbäck M, Haglund B, Gudbjörnsdòttir S, Steineck G (2009) Insulin glargine use and short-term incidence of malignancies—a population-based follow-up study in Sweden. Diabetologia 52:1745–1754

    Article  PubMed  CAS  Google Scholar 

  71. Bosco JLF, Antonsen S, Sørensen HT, Pedersen L, Lash TL (2011) Metformin and incident breast cancer among diabetic women: a population-based case–control study in Denmark. Cancer Epidemiol Biomark Prev 20:101–111

    Article  CAS  Google Scholar 

  72. Moysich KB, Beehler GP, Zirpoli G, Choi J-Y, Baker JA (2008) Use of common medications and breast cancer risk. Cancer Epidemiol Biomark Prev 17:1564–1595

    Article  Google Scholar 

  73. Rose DP, Royak-Schaler R (2001) Tumor biology and prognosis in black breast cancer patients: a review. Cancer Detect Prev 25:16–31

    PubMed  CAS  Google Scholar 

  74. Adams-Campbell LL, Rosenberg L, Rao RS, Palmer JR (2001) Strenuous physical activity and breast cancer risk in African-American women. J Natl Med Assoc 93:267–275

    PubMed  CAS  Google Scholar 

  75. Cozier Y, Palmer JR, Rosenberg L, Adams-Campbell LL (2001) Recent mammography use among African-American women. Ethn Dis 11:188–191

    PubMed  CAS  Google Scholar 

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Acknowledgments

The authors gratefully acknowledge the contributions of the participants and the staff of the BWHS. This study was supported by the National Institutes of Health, and the National Cancer Institute grant R01 CA058420. The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Cancer Institute or the National Institutes of Health. Although data on breast cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, and VA), the results reported do not necessarily represent their views.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Dana-Farber Cancer Institute, 450 Brookline Avenue LW519, Boston, MA, 02215, USA

    Jaclyn L. F. Bosco

  2. Section of Geriatrics, Department of Medicine, Boston University School of Medicine, 88 East Newton Street, Robinson 2, Boston, MA, 02118, USA

    Jaclyn L. F. Bosco

  3. Slone Epidemiology Center at Boston University, 1010 Commonwealth Avenue, Boston, MA, 02215, USA

    Julie R. Palmer, Deborah A. Boggs & Lynn Rosenberg

  4. Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, T3E, Boston, MA, 02118, USA

    Elizabeth E. Hatch

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  1. Jaclyn L. F. Bosco
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Correspondence to Jaclyn L. F. Bosco.

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Bosco, J.L.F., Palmer, J.R., Boggs, D.A. et al. Cardiometabolic factors and breast cancer risk in U.S. black women. Breast Cancer Res Treat 134, 1247–1256 (2012). https://doi.org/10.1007/s10549-012-2131-4

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