Skip to main content

Advertisement

Springer Nature Link
Log in

Interactions between Body Mass Index and Hormone Therapy and Postmenopausal Breast Cancer Risk (United States)

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective

To assess interactions between use of estrogen plus progestin hormone therapy (EPHT) and body mass index (BMI) in relation to risks of different types of breast cancer, based on histology and hormone receptor status.

Methods

We conducted a population-based case-control study that compared 975 postmenopausal breast cancer cases to 1,007 controls. Interactions between menopausal hormone therapy (HT) and BMI in relation to risk of different breast cancer types were evaluated using logistic regression.

Results

Obese (BMI ≥30.0 kg/m2) never users of HT had 1.7–fold to 2.3–fold elevated risks of ductal and ER+/PR+ tumors, respectively, compared to thinner women. BMI was not related to breast cancer risk among current HT users. Current EPHT users for ≥5 years had 2.1 to 9.6-fold elevated risks of lobular and ER+/PR+ tumors compared to never users of HT regardless of BMI. Current EPHT users for ≥5 years with a BMI ≤24.9 kg/m2 also had a 2.6-fold elevated risk of ductal carcinoma. However, none of the interactions between BMI and HT use evaluated reached statistical significance.

Conclusions

While interactions between HT and BMI are well established, they appear to only be present among certain breast cancer types. Since obesity is related to breast cancer risk only among never users of HT, as HT use declines the relative impact of obesity on breast cancer incidence may grow.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Canada)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. The Women’s Health Initiative Steering Committee (2004) Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. JAMA 291:1701–1712

    Google Scholar 

  2. Writing Group for the Women’s Health Initiative Investigators (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA 288:321–333

    Google Scholar 

  3. Buist DS, Newton KM, Miglioretti DL, et al. (2004) Hormone therapy prescribing patterns in the United States. Obstet Gynecol 104:1042–1050

    PubMed  Google Scholar 

  4. Feigelson HS, Jonas CR, Teras LR, Thun MJ, Calle EE (2004) Weight gain, body mass index, hormone replacement therapy, and postmenopausal breast cancer in a large prospective study. Cancer Epidemiol Biomarkers Prev 13:220–224

    Article  PubMed  Google Scholar 

  5. Friedenreich CM, Courneya KS, Bryant HE (2002) Case-control study of anthropometric measures and breast cancer risk. Int J Cancer 99:445–452

    Article  CAS  PubMed  Google Scholar 

  6. Huang Z, Willett WC, Colditz GA, et al. (1999) Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses’ Health Study. Am J Epidemiol 150:1316–1324

    CAS  PubMed  Google Scholar 

  7. Lahmann PH, Hoffmann K, Allen N, et al. (2004) Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer 111:762–771

    Article  CAS  PubMed  Google Scholar 

  8. Morimoto LM, White E, Chen Z, et al. (2002) Obesity, body size, and risk of postmenopausal breast cancer: the Women’s Health Initiative (United States). Cancer Causes Control 13:741–751

    Article  PubMed  Google Scholar 

  9. Siiteri PK (1987) Adipose tissue as a source of hormones. Am J Clin Nutr 45:277–282

    CAS  PubMed  Google Scholar 

  10. Chetkowski RJ, Meldrum DR, Steingold KA, et al. (1986) Biologic effects of transdermal estradiol. N Engl J Med 314:1615–1620

    CAS  PubMed  Google Scholar 

  11. Colditz GA, Stampfer MJ, Willett WC, et al. (1992) Type of postmenopausal hormone use and risk of breast cancer: 12-year follow-up from the Nurses’ Health Study. Cancer Causes Control 3:433–439

    Article  CAS  PubMed  Google Scholar 

  12. Collaborative Group on Hormonal Factors in Breast Cancer (1997) Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet 350: 1047–1059

    Google Scholar 

  13. Magnusson C, Baron JA, Correia N, Bergstrom R, Adami HO, Persson I (1999) Breast-cancer risk following long-term oestrogen- and oestrogen-progestin-replacement therapy. Int J Cancer 81:339–344

    Article  CAS  PubMed  Google Scholar 

  14. Schairer C, Lubin J, Troisi R, Sturgeon S, Brinton L, Hoover R (2000) Menopausal estrogen and estrogen–progestin replacement therapy and breast cancer risk. JAMA 283:485–491

    Article  CAS  PubMed  Google Scholar 

  15. Stanford JL, Weiss NS, Voigt LF, Daling JR, Habel LA, Rossing MA (1995) Combined estrogen and progestin hormone replacement therapy in relation to risk of breast cancer in middle-aged women. JAMA 274: 137–142

    Article  CAS  PubMed  Google Scholar 

  16. Newcomb PA, Longnecker MP, Storer BE, et al. (1995) Long-term hormone replacement therapy and risk of breast cancer in postmenopausal women. Am J Epidemiol 142:788–795

    CAS  PubMed  Google Scholar 

  17. Ursin G, Tseng CC, Paganini-Hill A, et al. (2002) Does menopausal hormone replacement therapy interact with known factors to increase risk of breast cancer? J Clin Oncol 20:699–706

    Article  CAS  PubMed  Google Scholar 

  18. Chen CL, Weiss NS, Newcomb P, Barlow W, White E (2002) Hormone replacement therapy in relation to breast cancer. JAMA 287:734–741

    Article  CAS  PubMed  Google Scholar 

  19. Daling JR, Malone KE, Doody DR, et al. (2002) Relation of regimens of combined hormone replacement therapy to lobular, ductal, and other histologic types of breast carcinoma. Cancer 95:2455–2464

    Article  CAS  PubMed  Google Scholar 

  20. Li CI, Weiss NS, Stanford JL, Daling JR (2000) Hormone replacement therapy in relation to risk of lobular and ductal breast carcinoma in middle-aged women. Cancer 88:2570–2577

    CAS  PubMed  Google Scholar 

  21. Li CI, Malone KE, Porter PL, et al. (2003) Relationship between long durations and different regimens of hormone therapy and risk of breast cancer. JAMA 289:3254–3263

    CAS  PubMed  Google Scholar 

  22. Newcomb PA, Titus-Ernstoff L, Egan KM, et al. (2002) Postmenopausal estrogen and progestin use in relation to breast cancer risk. Cancer Epidemiol Biomarkers Prev 11:593–600

    CAS  PubMed  Google Scholar 

  23. Newcomer LM, Newcomb PA, Potter JD, et al. (2003) Postmenopausal hormone therapy and risk of breast cancer by histologic type (United States). Cancer Causes Control 14:225–233

    Article  PubMed  Google Scholar 

  24. Li CI, Malone KE, Porter PL, Weiss NS, Tang MT, Daling JR (2003) Reproductive and anthropometric factors in relation to the risk of lobular and ductal breast carcinoma among women 65–79 years of age. Int J Cancer 107:647–651

    Article  CAS  PubMed  Google Scholar 

  25. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348:1625–1638

    Article  PubMed  Google Scholar 

  26. Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4:579–591

    Article  CAS  PubMed  Google Scholar 

  27. Goodman MT, Nomura AM, Wilkens LR, Kolonel LN (1990) Agreement between interview information and physician records on history of menopausal estrogen use. Am J Epidemiol 131:815–825

    CAS  PubMed  Google Scholar 

  28. Jain MG, Rohan TE, Howe GR (1999) Agreement of self-reported use of menopausal hormone replacement therapy with physician reports. Epidemiology 10:260–263

    CAS  PubMed  Google Scholar 

  29. Paganini-Hill A, Ross RK (1982) Reliability of recall of drug usage and other health-related information. Am J Epidemiol 116:114–122

    CAS  PubMed  Google Scholar 

  30. Persson I, Bergkvist L, Adami HO (1987) Reliability of women’s histories of climacteric oestrogen treatment assessed by prescription forms. Int J Epidemiol 16:222–228

    CAS  PubMed  Google Scholar 

  31. Daling JR, Malone KE, Doody DR, Johnson LG, Gralow JR, Porter PL (2001) Relation of body mass index to tumor markers and survival among young women with invasive ductal breast carcinoma. Cancer 92:720–729

    Article  CAS  PubMed  Google Scholar 

  32. Field RW, Smith BJ, Platz CE, et al. (2004) Lung cancer histologic type in the surveillance, epidemiology, and end results registry versus independent review. J Natl Cancer Inst 96:1105–1107

    CAS  PubMed  Google Scholar 

  33. Li CI, Anderson BO, Daling JR, Moe RE (2003) Trends in incidence rates of invasive lobular and ductal breast carcinoma. JAMA 289:1421–1424

    PubMed  Google Scholar 

  34. Li CI, Daling JR, Malone KE (2003) Incidence of invasive breast cancer by hormone receptor status from 1992 to 1998. J Clin Oncol 21:28–34

    Article  CAS  PubMed  Google Scholar 

  35. Stierer M, Rosen H, Weber R, Hanak H, Spona J, Tuchler H (1993) Immunohistochemical and biochemical measurement of estrogen and progesterone receptors in primary breast cancer correlation of histopathology and prognostic factors. Ann Surg 218:13–21

    CAS  PubMed  Google Scholar 

  36. Lee SA, Ross RK, Pike MC (2005) An overview of menopausal oestrogen-progestin hormone therapy and breast cancer risk. Br J Cancer 92:2049–2058

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by the National Cancer Institute (NCI), through a contract with Fred Hutchinson Cancer Research Center (RO1 CA072787).

Author information

Authors and Affiliations

  1. Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, 1100 Fairview Avenue North, M4-C308, 19024, Seattle, Washington, 98109-1024, USA

    Christopher I. Li, Kathleen E. Malone & Janet R. Daling

Authors
  1. Christopher I. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kathleen E. Malone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Janet R. Daling
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christopher I. Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, C.I., Malone, K.E. & Daling, J.R. Interactions between Body Mass Index and Hormone Therapy and Postmenopausal Breast Cancer Risk (United States). Cancer Causes Control 17, 695–703 (2006). https://doi.org/10.1007/s10552-005-0001-7

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-005-0001-7

Keywords

Search

Navigation