Abrahamson Page E, Gammon Marilie D, Lund Mary Jo, Flagg Elaine W, Porter Peggy L, Stevens June, Swanson Christine A, Brinton Louise A, Eley J William, Coates Ralph J
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Cancer Epidemiol Biomarkers Prev. 2006 Oct;15(10):1871-7. doi: 10.1158/1055-9965.EPI-06-0356.
Among postmenopausal women, obesity is linked to increased risk of breast cancer and poorer subsequent survival. For premenopausal women, obesity may reduce incidence, but less is known about its effect on prognosis, particularly for abdominal obesity. This study investigated whether general or abdominal obesity at diagnosis influenced survival in a cohort of young women with breast cancer. A population-based follow-up study was conducted among 1,254 women ages 20 to 54 who were diagnosed with invasive breast cancer between 1990 and 1992 in Atlanta or New Jersey. Women were interviewed within several months of diagnosis and asked about their weight and height at age 20 and in the year before diagnosis. Study personnel did anthropometric measures at the interview. With 8 to 10 years of follow-up, all-cause mortality status was determined using the National Death Index (n = 290 deaths). Increased mortality was observed for women who were obese [body mass index (BMI), > or =30] at the time of interview compared with women of ideal weight [BMI, 18.5-24.9; stage- and income-adjusted hazard ratio (HR), 1.48; 95% confidence interval (95% CI), 1.09-2.01]. A similar result was seen for the highest versus lowest quartile of waist-to-hip ratio (HR, 1.52; 95% CI, 1.05-2.19). Strong associations with mortality were found for women who were obese at age 20 (HR, 2.49; 95% CI, 1.15-5.37) or who were overweight/obese (BMI, > or =25) at both age 20 and the time of interview (HR, 2.22; 95% CI, 1.45-3.40). This study provides evidence that breast cancer survival is reduced among younger women with general or abdominal obesity.
在绝经后女性中，肥胖与乳腺癌风险增加及较差的后续生存率相关。对于绝经前女性，肥胖可能降低发病率，但关于其对预后的影响了解较少，尤其是腹部肥胖。本研究调查了诊断时的总体肥胖或腹部肥胖是否会影响一组年轻乳腺癌女性的生存率。对1990年至1992年在亚特兰大或新泽西被诊断为浸润性乳腺癌的1254名20至54岁女性进行了一项基于人群的随访研究。在诊断后的几个月内对女性进行访谈，并询问她们20岁时以及诊断前一年的体重和身高。研究人员在访谈时进行人体测量。经过8至10年的随访，使用国家死亡指数确定全因死亡状态（n = 290例死亡）。与体重理想的女性相比，访谈时肥胖（体重指数[BMI]≥30）的女性死亡率增加[阶段和收入调整后的风险比（HR），1.48；95%置信区间（95%CI），1.09 - 2.01]。腰臀比最高四分位数与最低四分位数相比也有类似结果（HR，1.52；95%CI，1.05 - 2.19）。发现20岁时肥胖的女性（HR，2.49；95%CI，1.15 - 5.37）或20岁及访谈时均超重/肥胖（BMI≥25）的女性与死亡率有很强的关联（HR，2.22；95%CI，1.45 - 3.40）。本研究提供了证据表明，总体肥胖或腹部肥胖的年轻女性乳腺癌生存率降低。
