Canchola Alison J, Anton-Culver Hoda, Bernstein Leslie, Clarke Christina A, Henderson Katherine, Ma Huiyan, Ursin Giske, Horn-Ross Pamela L
Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94538, USA,
Cancer Causes Control. 2012 Jan 28. doi: 10.1007/s10552-012-9897-x.
To evaluate how the association between body size and breast cancer risk varies by tumor receptor subtype, host factors, and other exposures among women in the California Teachers Study cohort. METHODS: Among 52,642 postmenopausal women, 2,321 developed invasive breast cancer with known estrogen- and progesterone-receptor status (1,652 ER+PR+, 338 ER+PR-, and 312 ER-PR-) between 1995 and 2007. In a subset of 35,529 with waist circumference data, 1,377 developed invasive breast cancer with known ERPR status (991 ER+PR+, 208 ER+PR-, 169 ER-PR-) between 1997 and 2007. Multivariate Cox regression was performed to estimate relative risks (RR) and 95% confidence intervals (CI). RESULTS: Obesity, adult weight gain of ≥40 pounds, greater abdominal adiposity, and greater height increased the risk of ER+PR+ breast cancer. The increased risk associated with postmenopausal obesity was limited to those who did not use hormone therapy (HT) at cohort entry (RR = 1.37; 95% CI, 1.05-1.78 for BMI ≥ 30 vs. < 25 kg/m(2); p-interaction = 0.14) and those who were not overweight or obese at age 18 (p-interaction = 0.06). The increased risk associated with greater abdominal adiposity was limited to those who were not also overweight or obese (p-interaction = 0.01). Neither obesity, abdominal adiposity, nor height was associated with the risk of ER-PR- tumors. CONCLUSIONS: The effects of body size on postmenopausal breast cancer risk differed by hormone receptor subtype, and among women with ER+PR+ tumors, by HT use and early adult body size.
在加利福尼亚教师研究队列的女性中，评估体型与乳腺癌风险之间的关联如何因肿瘤受体亚型、宿主因素及其他暴露因素而有所不同。方法：在52642名绝经后女性中，1995年至2007年间有2321人患浸润性乳腺癌，其雌激素和孕激素受体状态已知（1652人雌激素受体阳性且孕激素受体阳性，338人雌激素受体阳性且孕激素受体阴性，312人雌激素受体阴性且孕激素受体阴性）。在有腰围数据的35529名女性亚组中，1997年至2007年间有1377人患浸润性乳腺癌，其雌激素受体和孕激素受体状态已知（991人雌激素受体阳性且孕激素受体阳性，208人雌激素受体阳性且孕激素受体阴性，169人雌激素受体阴性且孕激素受体阴性）。采用多变量Cox回归来估计相对风险（RR）和95%置信区间（CI）。结果：肥胖、成年后体重增加≥40磅、腹部脂肪增多及身高增加会增加雌激素受体阳性且孕激素受体阳性乳腺癌的风险。绝经后肥胖相关的风险增加仅限于队列入组时未使用激素疗法（HT）的女性（体重指数≥30与<25kg/m²相比，RR = 1.37；95%CI，1.05 - 1.78；p交互作用 = 0.14）以及18岁时非超重或肥胖的女性（p交互作用 = 0.06）。腹部脂肪增多相关的风险增加仅限于非超重或肥胖的女性（p交互作用 = 0.01）。肥胖、腹部脂肪及身高均与雌激素受体阴性且孕激素受体阴性肿瘤的风险无关。结论：体型对绝经后乳腺癌风险的影响因激素受体亚型而异，在雌激素受体阳性且孕激素受体阳性肿瘤的女性中，还因激素疗法使用情况及成年早期体型而异。
