Bandera Elisa V, Chandran Urmila, Hong Chi-Chen, Troester Melissa A, Bethea Traci N, Adams-Campbell Lucile L, Haiman Christopher A, Park Song-Yi, Olshan Andrew F, Ambrosone Christine B, Palmer Julie R, Rosenberg Lynn
Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08903, USA,
Breast Cancer Res Treat. 2015 Apr;150(3):655-66. doi: 10.1007/s10549-015-3353-z. Epub 2015 Mar 26.
African American (AA) women are more likely than white women to be obese and to be diagnosed with ER- and triple-negative (TN) breast cancer, but few studies have evaluated the impact of obesity and body fat distribution on breast cancer subtypes in AA women. We evaluated these associations in the AMBER Consortium by pooling data from four large studies. Cases were categorized according to hormone receptor status as ER+, ER-, and TN (ER-, PR-, and HER2-) based on pathology data. A total of 2104 ER+ cases, 1070 ER- cases (including 491 TN cases), and 12,060 controls were included. Odds ratios (OR) and 95 % confidence intervals (CI) were computed using logistic regression, taking into account breast cancer risk factors. In postmenopausal women, higher recent (most proximal value to diagnosis/index date) BMI was associated with increased risk of ER+ cancer (OR 1.31; 95 % CI 1.02-1.67 for BMI ≥ 35 vs. <25 kg/m(2)) and with decreased risk of TN tumors (OR 0.60; 95 % CI 0.39-0.93 for BMI ≥ 35 vs. <25). High young adult BMI was associated with decreased premenopausal ER+ cancer and all subtypes of postmenopausal cancer, and high recent waist-to-hip ratio with increased risk of premenopausal ER+ tumors (OR 1.35; 95 % CI 1.01-1.80) and all tumor subtypes combined in postmenopausal women (OR 1.26; 95 % CI 1.02-1.56). The impact of general and central obesity varies by menopausal status and hormone receptor subtype in AA women. Our findings imply different mechanisms for associations of adiposity with TN and ER+ breast cancers.
非裔美国(AA)女性比白人女性更易肥胖,且更易被诊断出患有雌激素受体(ER)阴性和三阴性(TN)乳腺癌,但很少有研究评估肥胖和体脂分布对AA女性乳腺癌亚型的影响。我们通过汇总四项大型研究的数据,在AMBER联盟中评估了这些关联。根据病理数据,病例按激素受体状态分为ER阳性、ER阴性和TN(ER阴性、孕激素受体阴性和人表皮生长因子受体2阴性)。共纳入2104例ER阳性病例、1070例ER阴性病例(包括491例TN病例)和12060例对照。采用逻辑回归计算比值比(OR)和95%置信区间(CI),同时考虑乳腺癌风险因素。在绝经后女性中,近期(最接近诊断/索引日期的值)较高的体重指数(BMI)与ER阳性癌症风险增加相关(BMI≥35与<25kg/m²相比,OR为1.31;95%CI为1.02 - 1.67),与TN肿瘤风险降低相关(BMI≥35与<25相比,OR为0.60;95%CI为0.39 - 0.93)。年轻时较高的BMI与绝经前ER阳性癌症及绝经后所有癌症亚型风险降低相关,近期较高的腰臀比与绝经前ER阳性肿瘤风险增加相关(OR为1.35;95%CI为1.01 - 1.80),与绝经后女性所有肿瘤亚型合并风险增加相关(OR为1.26;95%CI为1.02 - 1.56)。AA女性中,全身性肥胖和中心性肥胖的影响因绝经状态和激素受体亚型而异。我们的研究结果表明,肥胖与TN和ER阳性乳腺癌的关联机制不同。
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