Warner Erica T, Hu Rong, Collins Laura C, Beck Andrew H, Schnitt Stuart, Rosner Bernard, Eliassen A Heather, Michels Karin B, Willett Walter C, Tamimi Rulla M
Clinical Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Cancer Prev Res (Phila). 2016 Sep;9(9):732-8. doi: 10.1158/1940-6207.CAPR-16-0085.
Height and body size in childhood and young adulthood have been consistently associated with breast cancer risk; whether associations differ across molecular subtypes is unclear. In a pooled analysis of the Nurses' Health Studies, we prospectively examined the association of four exposures: height, body mass index (BMI) at the age of 18 years, childhood and adolescent somatotypes, with breast cancer risk according to molecular subtypes defined by immunohistochemical markers. We used multivariable-adjusted Cox proportional hazards regression to estimate HRs and 95% confidence intervals (CI). We identified 2,983 luminal A, 1,281 luminal B, 318 HER2-enriched, 408 basal-like, and 128 unclassified tumors. Height was positively associated with all subtypes (Pheterogeneity = 0.78). BMI at the age of 18 (Pheterogeneity = 0.001), childhood (Pheterogeneity = 0.51), and adolescent somatotype (Pheterogeneity = 0.046) were inversely associated, but with differences in magnitude of association. BMI at the age of 18 of ≥25 kg/m(2) (compared with 20-21.9 kg/m(2)) was associated with a 52% decreased risk of HER2-enriched (HR, 0.48; 95% CI, 0.26-0.91; Ptrend < 0.0001) and 39% reduced risk of basal-like tumors (HR, 0.61; 95% CI, 0.36-1.02; Ptrend = 0.008). Compared with the lowest category, women in the highest adolescent body size category were 71% less likely to develop HER2-enriched (HR, 0.29; 95% CI, 0.10-0.85; Ptrend = 0.0005) and 60% less likely to develop basal-like (HR, 0.40; 95% CI, 0.17-0.95; Ptrend = 0.0008). Height was positively associated with risk of all breast cancer molecular subtypes. BMI at 18 years and childhood and adolescent were inversely associated with risk of most breast cancer molecular subtypes with somewhat stronger associations with HER2-enriched and basal-like subtypes. Cancer Prev Res; 9(9); 732-8. ©2016 AACR.
儿童期和青年期的身高及体型一直与乳腺癌风险相关;但这些关联在不同分子亚型之间是否存在差异尚不清楚。在一项对护士健康研究的汇总分析中,我们前瞻性地研究了四种暴露因素:身高、18岁时的体重指数(BMI)、儿童期和青春期的体型,与根据免疫组化标志物定义的分子亚型的乳腺癌风险之间的关联。我们使用多变量调整的Cox比例风险回归来估计风险比(HR)和95%置信区间(CI)。我们识别出2983例腔面A型、1281例腔面B型、318例HER2富集型、408例基底样型和128例未分类肿瘤。身高与所有亚型均呈正相关(异质性P = 0.78)。18岁时的BMI(异质性P = 0.001)、儿童期(异质性P = 0.51)和青春期体型(异质性P = 0.046)与乳腺癌风险呈负相关,但关联程度存在差异。18岁时BMI≥25kg/m²(与20 - 21.9kg/m²相比)与HER2富集型乳腺癌风险降低52%(HR,0.48;95%CI,0.26 - 0.91;趋势P < 0.0001)以及基底样型肿瘤风险降低39%(HR,0.61;95%CI,0.36 - 1.02;趋势P = 0.008)相关。与最低类别相比,青春期体型最高类别的女性发生HER2富集型乳腺癌的可能性降低71%(HR,0.29;95%CI,0.10 - 0.85;趋势P = 0.0005),发生基底样型乳腺癌的可能性降低60%(HR,0.40;95%CI,0.17 - 0.95;趋势P = 0.0008)。身高与所有乳腺癌分子亚型的风险呈正相关。18岁时以及儿童期和青春期的BMI与大多数乳腺癌分子亚型的风险呈负相关,与HER2富集型和基底样型亚型的关联稍强。《癌症预防研究》;9(9);732 - 738。©2016美国癌症研究协会