Abstract
Cumulating evidence in Caucasian women suggests a positive association between height and premenopausal breast cancer risk and a negative association with overall adiposity; however data from Latin America are scarce. We investigated the associations between excess adiposity, body shape evolution across life, and risk of premenopausal breast cancer among 406 cases (women aged 20–45) and 406 matched population-based controls from Chile, Colombia, Costa Rica, and Mexico. Negative associations between adult adiposity and breast cancer risk were observed in adjusted models (body mass index (BMI): Odds ratio (OR) per 1 kg/m2 = 0.93; 95% confidence interval = 0.89–0.96; waist circumference (WC): OR per 10 cm = 0.81 (0.69–0.96); hip circumference (HC): OR per 10 cm = 0.80 (0.67–0.95)). Height and leg length were not associated with risk. In normal weight women (18.5 ≤ BMI < 25), women with central obesity (WC > 88 cm) had an increased risk compared to women with normal WC (OR = 3.60(1.47–8.79)). Residuals of WC over BMI showed positive associations when adjusted for BMI (OR per 10 cm = 1.38 (0.98–1.94)). Body shape at younger ages and body shape evolution were not associated with risk. No heterogeneity was observed by receptor status. In this population of Latin American premenopausal women, different fat distributions in adulthood were differentially associated with risk of breast cancer.
Highlights
Breast cancer is the most commonly diagnosed cancer among women worldwide[1], the age distribution of the cases varies between different regions of the world
In normal weight women (18.5 ≤ body mass index (BMI) < 25 kg/m2) women with central obesity (WC > 88 cm) had an increased risk of breast cancer compared to women with normal WC (Model 1: Odds ratios (OR) = 2.84, 95% confidence intervals (CI) = 1.44–5.61; Model 2: OR = 3.60, 95% CI = 1.47–8.79)
No heterogeneity was observed for any of the anthropometric factors when stratifying the analyses by tumor size (≤2 cm, >2 cm) (P-homogeneity ≥0.09 for model 2, results not shown). In this population of premenopausal women from 4 Latin American countries, weight, waist and hip circumference, and BMI were negatively associated with risk of breast cancer, as was body shape from age 26 to study enrollment
Summary
Breast cancer is the most commonly diagnosed cancer among women worldwide[1], the age distribution of the cases varies between different regions of the world. Studies from Caucasian populations indicate that the risk of breast cancer in premenopausal women increases with height[4,5] and decreases with excess adiposity in adulthood[4], as well as during childhood/puberty, with less consistent results[6,7]. These associations are observed mostly for hormone receptor positive tumors[5,8]. We investigated the associations between several anthropometric factors assessed during adulthood, and changes in body shape during the life course, with the risk of premenopausal breast cancer, overall and by subtypes. This study was designed within the framework of the PRECAMA project, an ongoing multicentric population-based case-control study initiated in four countries in Latin America, coordinated by the International Agency for Research on Cancer (IARC)
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