Adult weight change and the risk of pre- and postmenopausal breast cancer in the Chinese Wuxi Exposure and Breast Cancer Study

Abstract

Purpose

The accumulating evidence indicates that weight gain in adulthood is more predictive of breast cancer risk than absolute body weight. However, the relative impact of timing of weight gain in adulthood on breast cancer as well as other characteristics of the association between weight and breast cancer has not been well documented.

Methods

This population-based case–control study of breast cancer included 818 patients with newly diagnosed primary breast cancer and 935 residence and age-matched healthy controls. The body weight values at 18 years old, 1 year before diagnosis, and at menopause were obtained during in-person interviews. Unconditional logistic regression was used to estimate the effects of the weight change over adulthood on breast cancer risk. Linear mixed-effects regression was also applied as a secondary analysis.

Results

We found that the increased risk of breast cancer was associated with the weight gain in adulthood among postmenopausal women (OR 1.23; 95% CI 1.10–1.37 per 5 kg increase) but not in the premenopausal women. The risk associated with weight gain since menopause (OR 1.65; 95% CI 1.28–2.14 a 5-kg increase) was higher than that from age 18 to menopause (OR 1.14; 95% CI 1.02, 1.28 a 5-kg increase). The association tended to be stronger in those with higher waist circumference and who had never used hormone replacement therapy (HRT). Women who had never used HRT, the increased risk of breast cancer associated with weight gain was more consistent in leaner women at age 18 (BMI < 18.5) or at menopause (BMI < 24).

Conclusions

Our findings indicated that weight gain has significant impact on postmenopausal breast cancer risk. The time periods of weight gain, central body fat, and HRT may affect the observed association, which should be further studied.

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Acknowledgements

We are grateful to all study participants for their contributions. We thank the entire data collection team. Incident breast cancer cases and controls for this study were collected by Wuxi Center for Disease Control, Jiangsu Center for Disease Control.

Funding

This study was supported by World Cancer Research Fund (2011/RFA/473).

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Correspondence to Ming Wu.

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The authors declare that they have no competing interests.

Ethical approval

This study was approved by the ethical review committee of the Jiangsu Center for Disease Control and Prevention (Jiangsu, China).

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Cao, S., Zhou, J., Zhu, Z. et al. Adult weight change and the risk of pre- and postmenopausal breast cancer in the Chinese Wuxi Exposure and Breast Cancer Study. Breast Cancer Res Treat 173, 647–655 (2019). https://doi.org/10.1007/s10549-018-5016-3

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Keywords

  • Breast cancer
  • Weight gain
  • Central obesity
  • Hormone replacement therapy
  • Case–control study