Rosner Bernard, Eliassen A Heather, Toriola Adetunji T, Hankinson Susan E, Willett Walter C, Natarajan Loki, Colditz Graham A
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA,
Breast Cancer Res Treat. 2015 Apr;150(3):643-53. doi: 10.1007/s10549-015-3344-0. Epub 2015 Mar 22.
Obesity is well established as a cause of postmenopausal breast cancer incidence and mortality. In contrast, adiposity in early life reduces breast cancer incidence. However, whether short-term weight change influences breast cancer risk is not well known. We followed a cohort of 77,232 women from 1980 to 2006 (1,445,578 person-years), with routinely updated risk factor information, documenting 4196 incident cases of invasive breast cancer. ER and PR status were obtained from pathology reports and medical records yielding a total of 2033 ER+/PR+ tumors, 595 ER-/PR- tumors, 512 ER+/PR- tumors. The log incidence breast cancer model was used to assess the association of short-term weight gain (over past 4 years) while controlling for average BMI before and after menopause. Short-term weight change was significantly associated with breast cancer risk (RR 1.20; 95 % CI 1.09-1.33) for a 4-year weight gain of ≥15 lbs versus no change (≤5 lbs) (P_trend < 0.001). The association was stronger for premenopausal women (RR 1.38; 95 % CI 1.13-1.69) (P_trend = 0.004) than for postmenopausal women (RR 1.10; 95 % CI 0.97-1.25) (P_trend = 0.063). Short-term weight gain during premenopause had a stronger association for ER+/PR- (RR per 25 lb weight gain = 2.19; 95 % CI 1.33-3.61, P = 0.002) and ER-/PR- breast cancer (RR per 25 lb weight gain = 1.61; 95 % CI 1.09-2.38, P = 0.016) than for ER+/PR+ breast cancer (RR per 25 lb weight gain = 1.13; 95 % CI 0.89-1.43, P = 0.32). There are deleterious effects of short-term weight gain, particularly during pre-menopause, even after controlling for average BMI before and after menopause. The association was stronger for ER+/PR- and ER-/PR- than for ER+/PR+ breast cancer.
肥胖已被确认为绝经后乳腺癌发病率和死亡率的一个原因。相比之下，早年肥胖会降低乳腺癌发病率。然而，短期体重变化是否会影响乳腺癌风险尚不清楚。我们对77232名女性进行了1980年至2006年的队列研究（1445578人年），定期更新风险因素信息，记录了4196例浸润性乳腺癌发病病例。雌激素受体（ER）和孕激素受体（PR）状态从病理报告和医疗记录中获取，共得到2033例ER+/PR+肿瘤、595例ER-/PR-肿瘤、512例ER+/PR-肿瘤。采用对数发病率乳腺癌模型评估短期体重增加（过去4年）与乳腺癌风险的关联，同时控制绝经前后的平均体重指数（BMI）。与体重无变化（≤5磅）相比，4年体重增加≥15磅时，短期体重变化与乳腺癌风险显著相关（风险比[RR]1.20；95%置信区间[CI]1.09 - 1.33）（趋势P值<0.001）。绝经前女性的关联更强（RR 1.38；95%CI 1.13 - 1.69）（趋势P值 = 0.004），高于绝经后女性（RR 1.10；95%CI 0.97 - 没找到完整内容，无法准确翻译）（趋势P值 = 0.063）。绝经前短期体重增加与ER+/PR-（每增加25磅体重RR = 2.19；95%CI 1.33 - 3.61，P = 0.002）和ER-/PR-乳腺癌（每增加25磅体重RR = 1.61；95%CI 1.09 - 2.38，P = 0.016）的关联比与ER+/PR+乳腺癌（每增加25磅体重RR = 1.13；95%CI 0.89 - 1.43，P = 0.32）更强。即使在控制绝经前后的平均BMI后，短期体重增加仍有有害影响，尤其是在绝经前。ER+/PR-和ER-/PR-乳腺癌的关联比ER+/PR+乳腺癌更强。 （注：原文中“95%CI 0.97 - 没找到完整内容，无法准确翻译”部分，因原文此处缺失完整信息，所以译文也无法完整呈现）
