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Dou Y, Chen B, Yu X, Xin Q, Ma D. Dose response relationship between breast cancer and somatotypes during childhood: a systematic review and meta-analysis. Br J Cancer 2023; 129:1432-1441. [PMID: 37550527 PMCID: PMC10628206 DOI: 10.1038/s41416-023-02376-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 07/07/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES This study aims to evaluate the relationship between breast cancer and somatotypes during early life by meta-analysis and give the corresponding advice. METHODS Observational studies till April 5, 2021, which explore women with/without breast cancer who used the Stunkard Figure Rating Scale/Sørensen Somatotypes to evaluate their somatotype before 18 years of age and distant breast cancer risk were included. Using random/fixed-effect models, the pooled relative risks (RRs) and 95% confidence intervals (CIs) were estimated. Then a nonlinear dose-response meta-analysis was conducted using restricted cubic spline analysis. RESULTS Six articles involving 15,211 breast cancer patients from 341,905 individuals were included for performing a meta-analysis of early somatotype and breast cancer risk. The pooled results showed that the protection became stronger with the increase of somatotype until it reached 6. The restricted cubic spline model indicated a linear relationship between somatotypes and breast cancer (P-nonlinearity = 0.533). Subgroup analysis of menopausal status showed that increasing somatotype during childhood was increasingly protective against postmenopausal breast cancer from somatotype 3 to somatotype 6, with a 0.887-fold (RR = 0.887, 95% CI: 0.842, 0.934) to 0.759-fold (RR = 0.759, 95% CI: 0.631, 0.913) decreased risk of breast cancer (P-nonlinearity = 0.880), but this association was not found in the population with premenopausal breast cancer (P-nonlinearity = 0.757). When stratified by age, among people younger than 10 years of age, an increase in somatotype was associated with a statistically significant reduction in breast cancer risk. From somatotype 3 to somatotype 6, the risk of breast cancer was reduced by 9.7-27.7% (P-nonlinearity = 0.175). CONCLUSIONS With early-life adiposity, our data support an inverse association with breast cancer risk, especially age less than 10 years and in postmenopausal women. Since girls with overweight likely remain overweight or even develop obesity in adulthood. While adults with overweight and obese are at increased risk of breast cancer and other types of cancer and various chronic diseases. Hence, we recommend that children should maintain a normal or slightly fat somatotype throughout all periods of life.
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Affiliation(s)
- Yuqi Dou
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, 100191, Beijing, China
| | - Botian Chen
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, 100191, Beijing, China
| | - Xue Yu
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, 100191, Beijing, China
| | - Qinghua Xin
- Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Defu Ma
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, 100191, Beijing, China.
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2
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Ramírez-Marrero FA, Nazario CM, Rosario-Rosado RV, Schelske-Santos M, Mansilla-Rivera I, Nie J, Hernández-Santiago J, Freudenheim JL. Anthropometric measures and breast cancer risk among Hispanic women in Puerto Rico. Cancer Causes Control 2022; 33:971-981. [PMID: 35507195 DOI: 10.1007/s10552-022-01585-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 04/13/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Increased risk of postmenopausal breast cancer associated with anthropometric measures including Body Mass Index (BMI), adult weight gain, and waist circumference has been observed in North American and European populations, but little evidence is available for Hispanic women. Breast cancer is the leading type of cancer, and leading cause of cancer-related deaths among Hispanic women in Puerto Rico (PR). However, compared with the United States, breast cancer incidence rates are lower but increasing more rapidly. PURPOSE To examine associations between anthropometric characteristics and breast cancer risk in Hispanic women in PR. METHODS Data from a population-based case-control study in the San Juan metropolitan region (cases = 315; controls = 348) were used to examine associations between anthropometric measures and breast cancer risk, also considering menopausal status and hormone therapy (HT). RESULTS Among premenopausal participants, there was a significant trend for lower odds of breast cancer with higher BMI and borderline significant with higher waist to height ratio (WHtR). For postmenopausal participants, a significant trend for lower odds of breast cancer was observed with higher WHtR, and waist to hip ratio (WHR), borderline significant with higher BMI, and higher odds with height. Among postmenopausal participants using HT, a significant trend for lower odds of breast cancer was observed with higher waist circumference, WHtR, WHR, and body shape index. CONCLUSION Our study provides evidence of anthropometric differences in relation to breast cancer risk in PR compared to previous studies. Future studies should include analyses of fat and lean mass distribution, and hormone receptor status to further understand anthropometry and breast cancer risk among Hispanic women.
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Affiliation(s)
- F A Ramírez-Marrero
- College of Education, Physical Education and Recreation Department, University of Puerto Rico Río Piedras Campus, San Juan, Puerto Rico.
| | - C M Nazario
- Graduate School of Public Health, Biostatistics and Epidemiology Department, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - R V Rosario-Rosado
- Graduate School of Public Health, Biostatistics and Epidemiology Department, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - M Schelske-Santos
- Natural Sciences, Nutrition and Dietetics Department, University of Puerto Rico Río Piedras Campus, San Juan, Puerto Rico
| | - I Mansilla-Rivera
- Graduate School of Public Health, Department of Environmental Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - J Nie
- School of Public Health and Health Professions, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - J Hernández-Santiago
- Graduate School of Public Health, Biostatistics and Epidemiology Department, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - J L Freudenheim
- School of Public Health and Health Professions, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA
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3
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Shagisultanova E, Gao D, Callihan E, Parris HJ, Risendal B, Hines LM, Slattery ML, Baumgartner K, Schedin P, John EM, Borges VF. Overall survival is the lowest among young women with postpartum breast cancer. Eur J Cancer 2022; 168:119-127. [PMID: 35525161 PMCID: PMC9233962 DOI: 10.1016/j.ejca.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Women diagnosed with breast cancer prior to age 45 years (<45y) and within the first 5 years postpartum (postpartum breast cancer, PPBC) have the greatest risk for distal metastatic recurrence. METHODS Pooling data from the Colorado Young Women Breast Cancer cohort and the Breast Cancer Health Disparities Study (N = 2519 cases), we examined the association of parity, age, and clinical factors with overall survival (OS) of breast cancer over 15 years of follow-up. RESULTS Women with PPBC diagnosed at <45y had the lowest OS (p < 0.0001), while OS of nulliparous cases diagnosed at <45y did not differ from OS of cases diagnosed at 45-65y regardless of parity status. After adjustment for study site, race/ethnicity, clinical stage, year of diagnosis and stratification for oestrogen receptor status, PPBC remained an independent factor associated with poor OS. Among cases diagnosed at <45y, nulliparous cases had 1.6 times better OS (hazard ratio (HR) = 0.61, 95%CI 0.42-0.87) compared to those with PPBC, with a more pronounced survival difference among stage I breast cancers (HR = 0.30, 95%CI 0.11-0.79). Among very young women diagnosed at age ≤35y, nulliparous cases had 2.3 times better OS (HR = 0.44, 95%CI 0.23-0.84) compared to PPBC. CONCLUSION Our results suggest that postpartum status is the main driver of poor prognosis in young women with breast cancer, with the strongest association in patients diagnosed at age ≤35y and in those with stage I disease.
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Affiliation(s)
- Elena Shagisultanova
- Young Women's Breast Cancer Program, University of Colorado Cancer Center, Aurora, CO, USA; Division of Medical Oncology, University of Colorado Denver, Aurora, CO, USA
| | - Dexiang Gao
- Department of Biostatistics and Bioinformatics, University of Colorado Denver, Aurora, CO, USA
| | - Eryn Callihan
- Young Women's Breast Cancer Program, University of Colorado Cancer Center, Aurora, CO, USA; Division of Medical Oncology, University of Colorado Denver, Aurora, CO, USA
| | - Hannah J Parris
- Young Women's Breast Cancer Program, University of Colorado Cancer Center, Aurora, CO, USA; Division of Medical Oncology, University of Colorado Denver, Aurora, CO, USA
| | - Betsy Risendal
- Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
| | - Lisa M Hines
- Department of Biology, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | | | - Kathy Baumgartner
- Department of Epidemiology and Population Health, School of Public Health & Information Sciences, University of Louisville, Louisville, KY, USA
| | - Pepper Schedin
- Young Women's Breast Cancer Program, University of Colorado Cancer Center, Aurora, CO, USA; School of Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Esther M John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA; Department of Medicine (Oncology), Stanford University School of Medicine, Stanford, CA, USA
| | - Virginia F Borges
- Young Women's Breast Cancer Program, University of Colorado Cancer Center, Aurora, CO, USA; Division of Medical Oncology, University of Colorado Denver, Aurora, CO, USA.
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4
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Rodríguez-Valentín R, Torres-Mejía G, Martínez-Matsushita L, Angeles-Llerenas A, Gómez-Flores-Ramos L, Wolff RK, Baumgartner KB, Hines LM, Ziv E, Flores-Luna L, Sánchez-Zamorano LM, Ortiz-Panozo E, Slattery ML. Energy homeostasis genes modify the association between serum concentrations of IGF-1 and IGFBP-3 and breast cancer risk. Sci Rep 2022; 12:1837. [PMID: 35115550 PMCID: PMC8813998 DOI: 10.1038/s41598-022-05496-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 12/17/2021] [Indexed: 02/08/2023] Open
Abstract
Breast cancer is a multifactorial disease in which the interplay among multiple risk factors remains unclear. Energy homeostasis genes play an important role in carcinogenesis and their interactions with the serum concentrations of IGF-1 and IGFBP-3 on the risk of breast cancer have not yet been investigated. The aim of this study was to assess the modifying effect of the genetic variation in some energy homeostasis genes on the association of serum concentrations of IGF-1 and IGFBP-3 with breast cancer risk. We analyzed 78 SNPs from 10 energy homeostasis genes in premenopausal women from the 4-Corner’s Breast Cancer Study (61 cases and 155 controls) and the Mexico Breast Cancer Study (204 cases and 282 controls). After data harmonization, 71 SNPs in HWE were included for interaction analysis. Two SNPs in two genes (MBOAT rs13272159 and NPY rs16131) showed an effect modification on the association between IGF-1 serum concentration and breast cancer risk (Pinteraction < 0.05, adjusted Pinteraction < 0.20). In addition, five SNPs in three genes (ADIPOQ rs182052, rs822391 and rs7649121, CARTPT rs3846659, and LEPR rs12059300) had an effect modification on the association between IGFBP-3 serum concentration and breast cancer risk (Pinteraction < 0.05, adjusted Pinteraction < 0.20). Our findings showed that variants of energy homeostasis genes modified the association between the IGF-1 or IGFBP-3 serum concentration and breast cancer risk in premenopausal women. These findings contribute to a better understanding of this multifactorial pathology.
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Affiliation(s)
- Rocío Rodríguez-Valentín
- Center for Population Health Research, National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Gabriela Torres-Mejía
- Center for Population Health Research, National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico.
| | | | - Angélica Angeles-Llerenas
- Center for Population Health Research, National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Liliana Gómez-Flores-Ramos
- Cátedras CONACYT-Center for Population Health Research, National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Roger K Wolff
- Department of Medicine, University of Utah, Salt Lake City, UT, 84108, USA
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, 40202, USA
| | - Lisa M Hines
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, CO, 80918, USA
| | - Elad Ziv
- Department of Medicine, Institute of Human Genetics, University of California San Francisco, San Francisco, CA, 94158, USA
| | - Lourdes Flores-Luna
- Center for Population Health Research, National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Luisa Ma Sánchez-Zamorano
- Center for Population Health Research, National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Eduardo Ortiz-Panozo
- Center for Population Health Research, National Institute of Public Health, 62100, Cuernavaca, Morelos, Mexico
| | - Martha L Slattery
- Department of Medicine, University of Utah, Salt Lake City, UT, 84108, USA
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5
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Cole SE, John EM, Hines LM, Phipps AI, Koo J, Ingles SA, Baumgartner KB, Slattery ML, McKean-Cowden R, Wu AH. Cumulative menstrual months and breast cancer risk by hormone receptor status and ethnicity: The Breast Cancer Etiology in Minorities Study. Int J Cancer 2021; 150:208-220. [PMID: 34469597 DOI: 10.1002/ijc.33791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/20/2021] [Accepted: 08/04/2021] [Indexed: 11/05/2022]
Abstract
Reproductive and hormonal factors may influence breast cancer risk via endogenous estrogen exposure. Cumulative menstrual months (CMM) can be used as a surrogate measure of this exposure. Using harmonized data from four population-based breast cancer studies (7284 cases and 7242 controls), we examined ethnicity-specific associations between CMM and breast cancer risk using logistic regression, adjusting for menopausal status and other risk factors. Higher CMM was associated with increased breast cancer risk in non-Hispanic Whites, Hispanics and Asian Americans regardless of menopausal status (all FDR adjusted P trends = .0004), but not in African Americans. In premenopausal African Americans, there was a suggestive trend of lower risk with higher CMM. Stratification by body mass index (BMI) among premenopausal African American women showed a nonsignificant positive association with CMM in nonobese (BMI <30 kg/m2 ) women and a significant inverse association in obese women (OR per 50 CMM = 0.56, 95% CI 0.37-0.87, Ptrend = .03). Risk patterns were similar for hormone receptor positive (HR+; ER+ or PR+) breast cancer; a positive association was found in all premenopausal and postmenopausal ethnic groups except in African Americans. HR- (ER- and PR-) breast cancer was not associated with CMM in all groups combined, except for a suggestive positive association among premenopausal Asian Americans (OR per 50 CMM = 1.33, P = .07). In summary, these results add to the accumulating evidence that established reproductive and hormonal factors impact breast cancer risk differently in African American women compared to other ethnic groups, and also differently for HR- breast cancer than HR+ breast cancer.
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Affiliation(s)
- Sarah E Cole
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Esther M John
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, California, USA.,Department of Medicine (Oncology), Stanford University School of Medicine, Stanford, California, USA.,Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California, USA
| | - Lisa M Hines
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
| | - Amanda I Phipps
- Department of Epidemiology, University of Washington, Seattle, Washington, USA.,Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Jocelyn Koo
- Department of Medicine (Oncology), Stanford University School of Medicine, Stanford, California, USA
| | - Sue A Ingles
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, School of Public Health & Information Sciences, Brown Cancer Center, University of Louisville, Louisville, Kentucky, USA
| | - Martha L Slattery
- Department of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Roberta McKean-Cowden
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Anna H Wu
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
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6
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Bandera EV, Alfano CM, Qin B, Kang DW, Friel CP, Dieli-Conwright CM. Harnessing Nutrition and Physical Activity for Breast Cancer Prevention and Control to Reduce Racial/Ethnic Cancer Health Disparities. Am Soc Clin Oncol Educ Book 2021; 41:1-17. [PMID: 33989021 DOI: 10.1200/edbk_321315] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
There are well-known racial/ethnic disparities in the prevalence of obesity and physical inactivity, as well as breast cancer risk and survival. However, most of the current scientific evidence that serves as a foundation for nutrition and physical activity guidelines is based on studies conducted in predominantly non-Hispanic White populations. Similarly, exercise, diet, or lifestyle intervention trials for breast cancer prevention and survivorship are scarce in racial/ethnic minority populations. We review the current evidence for racial/ethnic disparities in obesity and breast cancer risk and survival (we are focusing on obesity, because this is considered an ASCO priority, and studies conducted in the United States), discuss the evolution of nutrition/physical activity guidelines for cancer prevention and control, and provide an overview of lifestyle interventions, including barriers and facilitators in implementation and dissemination science among minority populations underrepresented in research. There is a critical need to include racially/ethnically diverse populations in cancer prevention and control research or to specifically target minority populations in which disparities are known to exist to achieve much needed health equity.
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Affiliation(s)
- Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Catherine M Alfano
- Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, NY.,Northwell Health Cancer Institute, New York, NY.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY
| | - Bo Qin
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Dong-Woo Kang
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Ciarán P Friel
- Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, NY
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7
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Wang J, Peng C, Guranich C, Heng YJ, Baker GM, Rubadue CA, Glass K, Eliassen AH, Tamimi RM, Polyak K, Hankinson S. Early-Life Body Adiposity and the Breast Tumor Transcriptome. J Natl Cancer Inst 2020; 113:778-784. [PMID: 33136151 DOI: 10.1093/jnci/djaa169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/21/2020] [Accepted: 10/19/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Cumulative epidemiologic evidence has shown that early-life adiposity is strongly inversely associated with breast cancer risk throughout life, independent of adult obesity. However, the molecular mechanisms remain poorly understood. METHODS We assessed the association of early-life adiposity, defined as self-reported body size during ages 10-20 years from a validated 9-level pictogram, with the transcriptome of breast tumor (N = 835) and tumor-adjacent histologically normal tissue (N = 663) in the Nurses' Health Study. We conducted multivariable linear regression analysis to identify differentially expressed genes in tumor and tumor-adjacent tissue, respectively. Molecular pathway analysis using Hallmark gene sets (N = 50) was further performed to gain biological insights. Analysis was stratified by tumor estrogen receptor (ER) protein expression status (n = 673 for ER+ and 162 for ER- tumors). RESULTS No gene was statistically significantly differentially expressed by early-life body size after multiple comparison adjustment. However, pathway analysis revealed several statistically significantly (false discovery rate < 0.05) upregulated or downregulated gene sets. In stratified analyses by tumor ER status, larger body size during ages 10-20 years was associated with decreased cellular proliferation pathways, including MYC target genes, in both ER+ and ER- tumors. In ER+ tumors, larger body size was also associated with upregulation in genes involved in TNFα/NFkB signaling. In ER- tumors, larger body size was additionally associated with downregulation in genes involved in interferon α and interferon γ immune response and Phosphatidylinositol 3-kinase (PI3K)/AKT/mammalian target of rapamycin (mTOR) signaling; the INFγ response pathway was also downregulated in ER- tumor-adjacent tissue, though at borderline statistical significance (false discovery rate = 0.1). CONCLUSIONS These findings provide new insights into the biological and pathological underpinnings of the early-life adiposity and breast cancer association.
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Affiliation(s)
- Jun Wang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Cheng Peng
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine Guranich
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Yujing J Heng
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Cancer Research Institute, Beth Israel Deaconess Cancer Center, Boston, MA, USA
| | - Gabrielle M Baker
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Christopher A Rubadue
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kimberly Glass
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Healthcare Policy and Research, Weill Cornell Medicine, USC, New York, NY, USA
| | - Kornelia Polyak
- Department of Medical Oncology, Dana-Farber Cancer Institute Boston, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Susan Hankinson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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8
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Shatila H, Fatfat Z, Talhouk R, Naalbandian S, Forman MR, Nasr R, Naja F. Nutrition and Breast Cancer Research in Arab Countries: Gaps, Opportunities, and Recommendations. Nutr Cancer 2020; 73:2113-2129. [PMID: 32972248 DOI: 10.1080/01635581.2020.1823435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
According to the WHO, Arab countries have the highest relative increase in Breast Cancer (BC) rates worldwide. Current shifts in dietary patterns in these countries are postulated as important modifiable risk factors of the disease. The objectives of this review were to examine the gaps and opportunities in the extent, range and nature of nutrition-related BC research in Arab countries. Studies (n = 286) were identified through searching 14 electronic databases. Among the gaps identified were limited international collaborations, preponderance of laboratory-based research at the expense of population-based research, focus on single supplement/nutrient/food research, limited use of dietary assessment tools, and studying nutrition in isolation of other environmental factors. Despite these gaps, several opportunities appeared. The distribution of papers among Arab countries suggested that collaboration between high and middle income countries could create a positive synergy between research expertise and wealth. In addition, the steady increase in the number of articles published during the last two decades reflected a promising momentum in nutrition and BC research in the Arab world. These gaps and opportunities constituted context-specific evidence to orient nutrition and BC research in Arab countries which could ultimately lead to development of effective interventions for prevention of BC in these countries.
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Affiliation(s)
- Hibeh Shatila
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Zaynab Fatfat
- Department of Biology, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Rabih Talhouk
- Department of Biology, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Salpy Naalbandian
- University Libraries, American University of Beirut, Beirut, Lebanon
| | - Michele R Forman
- Nutrition Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Rihab Nasr
- Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon.,Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
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9
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His M, Biessy C, Torres-Mejía G, Ángeles-Llerenas A, Alvarado-Cabrero I, Sánchez GI, Borrero M, Porras C, Rodriguez AC, Garmendia ML, Olivier M, Porter PL, Lin M, Gunter MJ, Romieu I, Rinaldi S. Anthropometry, body shape in early-life and risk of premenopausal breast cancer among Latin American women: results from the PRECAMA study. Sci Rep 2020; 10:2294. [PMID: 32042008 PMCID: PMC7010745 DOI: 10.1038/s41598-020-59056-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/17/2019] [Indexed: 12/24/2022] Open
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.
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Affiliation(s)
- Mathilde His
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Carine Biessy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Gabriela Torres-Mejía
- Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Isabel Alvarado-Cabrero
- Servicio de Patología del Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, Mexico
| | - Gloria Inés Sánchez
- Group Infection and Cancer, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Mauricio Borrero
- Group Infection and Cancer, School of Medicine, University of Antioquia, Medellín, Colombia
- Department of Gynecology and Obstetrics, School of Medicine, University or Antioquia, Medellín, Colombia
- Cinica Vida Fundacion, Medellín, Colombia
| | - Carolina Porras
- Agencia Costarricense de Investigaciones Biomédicas (ACIB)-Fundación INCIENSA, San José, Costa Rica
| | - Ana Cecilia Rodriguez
- Agencia Costarricense de Investigaciones Biomédicas (ACIB)-Fundación INCIENSA, San José, Costa Rica
| | - Maria Luisa Garmendia
- Instituto de Nutrición y de Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Magali Olivier
- Molecular Mechanisms and Biomarkers Group, Section of Mechanisms of Carcinogenesis, International Agency for Research on Cancer, Lyon, France
| | - Peggy L Porter
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - MingGang Lin
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Romieu
- Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
- Hubert Department of Global Health, Emory University, Atlanta, Georgia, United States of America
| | - Sabina Rinaldi
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France.
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10
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Agurs-Collins T, Ross SA, Dunn BK. The Many Faces of Obesity and Its Influence on Breast Cancer Risk. Front Oncol 2019; 9:765. [PMID: 31555578 PMCID: PMC6737012 DOI: 10.3389/fonc.2019.00765] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/29/2019] [Indexed: 12/12/2022] Open
Abstract
Obesity is associated with increased risk of breast and other cancers. However, the complexity of the underlying mechanisms, together with the interplay of diet and physical activity—contributing to energy balance—and the role of adipose tissue, pose challenges to our understanding of the basis of this increased risk. Epidemiologic studies have documented a higher obesity prevalence in US black women compared to white women. Elucidation of the contribution of potential biological differences among racially distinct groups to their differences in breast cancer (BC) risk and mortality have been topics of considerable interest in recent years. The racial and ethnic variation in body fat distribution may account for at least part of the differences in breast cancer rates in these populations. Yet, while black women exhibit higher rates of obesity compared to white women, this does not translate directly into higher rates of BC. In fact, overall, BC in black women occurs with a lower incidence than BC in white women. Obesity is a known risk factor for postmenopausal breast cancer, and growing evidence suggests that abdominal obesity, also known as central obesity, may increase risk for triple negative breast cancer, which is more common in premenopausal women. The positive association of postmenopausal BC risk and specifically estrogen receptor (ER)-positive BC, is presumably due largely to accumulation of estrogen in the adipose tissue of the breast and other tissues. Of the two main types of adipose tissue—subcutaneous and visceral—visceral adipocytes are more active metabolically. Such adipose tissue harbors multiple molecular entities that promote carcinogenesis: endocrine molecules/hormones, immunologic factors, inflammatory cytokines, metabolic alterations, and other components of the microenvironment. Expression of these culpable entities is largely regulated by epigenetic mechanisms. The interrelationship between these entities and drivers of epigenetic alteration are critical to the regulation of pathways connecting obesity and cancer risk. Initiatives to counteract the carcinogenic effects of obesity have primarily involved modulation of energy balance by diet. However, targeting of specific molecular abnormalities characterizing adiposity offers an alternative approach to preventing cancer. Our goal in this review is to first discuss the major mechanisms contributing to the obesity-breast cancer link. We will also consider race, specifically black/white differences, as they relate to the association of obesity with breast cancer risk. Then we will enumerate strategies targeting these mechanisms to reduce BC risk, in large part by way of dietary interventions with potential to mitigate the cancer-promoting components of adiposity.
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Affiliation(s)
- Tanya Agurs-Collins
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | - Sharon A Ross
- Division of Cancer Prevention, National Cancer Institute, Rockville, MD, United States
| | - Barbara K Dunn
- Division of Cancer Prevention, National Cancer Institute, Rockville, MD, United States
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11
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Ligibel JA, Basen-Engquist K, Bea JW. Weight Management and Physical Activity for Breast Cancer Prevention and Control. Am Soc Clin Oncol Educ Book 2019; 39:e22-e33. [PMID: 31099634 DOI: 10.1200/edbk_237423] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Observational evidence has consistently linked excess adiposity and inactivity to increased breast cancer risk and to poor outcomes in individuals diagnosed with early-stage, potentially curable breast cancer. There is less information from clinical trials testing the effect of weight management or physical activity interventions on breast cancer risk or outcomes, but a number of ongoing trials will test the impact of weight loss and other lifestyle changes after cancer diagnosis on the risk of breast cancer recurrence. Lifestyle changes have additional benefits beyond their potential to decrease primary or secondary breast cancer risk, including improvements in metabolic parameters, reduction in the risk of comorbidities such as diabetes and heart disease, improvement of physical functioning, and mitigation of side effects of cancer therapy. Despite these myriad benefits, implementation of lifestyle interventions in at-risk and survivor populations has been limited to date. This article reviews the evidence linking lifestyle factors to breast cancer risk and outcomes, discusses completed and ongoing randomized trials testing the impact of lifestyle change in primary and secondary breast cancer prevention, and reviews efforts to implement and disseminate lifestyle interventions in at-risk and breast cancer survivor populations.
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12
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Sangaramoorthy M, Hines LM, Torres-Mejía G, Phipps AI, Baumgartner KB, Wu AH, Koo J, Ingles SA, Slattery ML, John EM. A Pooled Analysis of Breastfeeding and Breast Cancer Risk by Hormone Receptor Status in Parous Hispanic Women. Epidemiology 2019; 30:449-457. [PMID: 30964816 PMCID: PMC6472273 DOI: 10.1097/ede.0000000000000981] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Data on breastfeeding and breast cancer risk are sparse and inconsistent for Hispanic women. METHODS Pooling data for nearly 6,000 parous Hispanic women from four population-based studies conducted between 1995 and 2007 in the United States and Mexico, we examined the association of breastfeeding with risk of breast cancer overall and subtypes defined by estrogen receptor (ER) and progesterone receptor (PR) status, and the joint effects of breastfeeding, parity, and age at first birth. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. RESULTS Among parous Hispanic women, older age at first birth was associated with increased breast cancer risk, whereas parity was associated with reduced risk. These associations were found for hormone receptor positive (HR+) breast cancer only and limited to premenopausal women. Age at first birth and parity were not associated with risk of ER- and PR- breast cancer. Increasing duration of breastfeeding was associated with decreasing breast cancer risk (≥25 vs. 0 months: OR = 0.73; 95% CI = 0.60, 0.89; Ptrend = 0.03), with no heterogeneity by menopausal status or subtype. At each parity level, breastfeeding further reduced HR+ breast cancer risk. Additionally, breastfeeding attenuated the increase in risk of HR+ breast cancer associated with older age at first birth. CONCLUSIONS Our findings suggest that breastfeeding is associated with reduced risk of both HR+ and ER- and PR- breast cancer among Hispanic women, as reported for other populations, and may attenuate the increased risk in women with a first pregnancy at older ages.
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Affiliation(s)
| | - Lisa M. Hines
- Department of Biology, University of Colorado at Colorado Springs, Colorado Springs, CO 80918
| | - Gabriela Torres-Mejía
- Instituto Nacional de Salud Puública, Population Health Research Center, Cuernavaca Morelos,
Mexico
| | - Amanda I. Phipps
- Department of Epidemiology, University of Washington, Seattle, WA 98195
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
98109
| | - Kathy B. Baumgartner
- Department of Epidemiology and Population Health, School of Public Health & Information Sciences, James
Graham Brown Cancer Center, University of Louisville, Louisville, KY 40202
| | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine of USC, Norris Comprehensive Cancer Center,
University of Southern California, Los Angeles, CA 90089
| | - Jocelyn Koo
- Cancer Prevention Institute of California, Fremont, CA 94538
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94304
| | - Sue A. Ingles
- Department of Preventive Medicine, Keck School of Medicine of USC, Norris Comprehensive Cancer Center,
University of Southern California, Los Angeles, CA 90089
| | | | - Esther M. John
- Cancer Prevention Institute of California, Fremont, CA 94538
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94304
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA
94304
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13
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Ortega-Olvera C, Ulloa-Aguirre A, Ángeles-Llerenas A, Mainero-Ratchelous FE, González-Acevedo CE, Hernández-Blanco MDL, Ziv E, Avilés-Santa L, Pérez-Rodríguez E, Torres-Mejía G. Thyroid hormones and breast cancer association according to menopausal status and body mass index. Breast Cancer Res 2018; 20:94. [PMID: 30092822 PMCID: PMC6085630 DOI: 10.1186/s13058-018-1017-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/10/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Thyroxine (T4) has been positively associated with tumor cell proliferation, while the effect of triiodothyronine (T3) on cell proliferation has not been well-established because it differs according to the type of cell line used. In Mexico, it has been reported that 14.5% of adult women have some type of thyroid dysfunction and abnormalities in thyroid function tests have been observed in a variety of non-thyroidal illnesses, including breast cancer (BC). These abnormalities might change with body mass index (BMI) because thyroid hormones are involved in the regulation of various metabolic pathways and probably by menopausal status because obesity has been negatively associated with BC in premenopausal women and has been positively associated with BC in postmenopausal women. METHODS To assess the association between serum thyroid hormone concentration (T4 and T3) and BC and the influence of obesity as an effect modifier of this relationship in premenopausal and postmenopausal women, we measured serum thyroid hormone and thyroid antibody levels in 682 patients with incident breast cancer (cases) and 731 controls, who participated in a population-based case-control study performed from 2004 to 2007 in three states of Mexico. We tested the association of total T4 (TT4) and total T3 (TT3) stratifying by menopausal status and body mass index (BMI), and adjusted for other health and demographic risk factors using logistic regressions models. RESULTS Higher serum total T4 (TT4) concentrations were associated with BC in both premenopausal (odds ratio (OR) per standard deviation = 5.98, 95% CI 3.01-11.90) and postmenopausal women (OR per standard deviation = 2.81, 95% CI 2.17-3.65). In premenopausal women, the effect of TT4 decreased as BMI increased while the opposite was observed in postmenopausal women. The significance of the effect modification was marginal (p = 0.059) in postmenopausal women and was not significant in premenopausal women (p = 0.22). Lower TT3 concentrations were associated with BC in both premenopausal and postmenopausal women and no effect modification was observed. CONCLUSIONS There is a strong association between BC and serum concentrations of TT3 and TT4; this needs to be further investigated to understand why it happens and how important it is to consider these alterations in treatment.
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Affiliation(s)
- Carolina Ortega-Olvera
- Universidad Autónoma de San Luis Potosí, Facultad de Enfermería y Nutrición, Niño Artillero #130, Zona Universitaria, C.P. 78240 San Luis Potosí, S.L.P. México
| | - Alfredo Ulloa-Aguirre
- Red de Apoyo a la Investigación, Universidad Nacional Autónoma de México-Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, calle Vasco de Quiroga No. 15, Col. Belisario Domínguez Sección XVI, Del. Tlalpan, C.P. 14080 Ciudad de México, México
| | - Angélica Ángeles-Llerenas
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad No. 655, Col. Santa María Ahuacatitlán, Cuernavaca, C.P. 62100 Morelos México
| | - Fernando Enrique Mainero-Ratchelous
- Hospital de Ginecología y Obstetricia No. 4 Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, Avenida Río Magdalena No. 289, Col. Tizapán, San Angel, Ciudad de México, C.P. 01090 México
| | - Claudia Elena González-Acevedo
- Universidad Autónoma de San Luis Potosí, Facultad de Enfermería y Nutrición, Niño Artillero #130, Zona Universitaria, C.P. 78240 San Luis Potosí, S.L.P. México
| | - Ma. de Lourdes Hernández-Blanco
- Universidad Autónoma de San Luis Potosí, Facultad de Enfermería y Nutrición, Niño Artillero #130, Zona Universitaria, C.P. 78240 San Luis Potosí, S.L.P. México
| | - Elad Ziv
- Department of Medicine, Division of General Internal Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 1450 3rd St, San Francisco, CA 94143 USA
- Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 1450 3rd St, San Francisco, CA 94143 USA
| | - Larissa Avilés-Santa
- National Heart, Lung, and Blood Institute at the National Institutes of Health, 6701 Rockledge, Room 10188, Bethesda, MD 20892 USA
| | - Edelmiro Pérez-Rodríguez
- Hospital Universitario “Dr José Eleuterio González”. Madero y Dr. Aguirre Pequeño, Col. Mitras, C.P. 64460 Monterrey, N.L. México
| | - Gabriela Torres-Mejía
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad No. 655, Col. Santa María Ahuacatitlán, Cuernavaca, C.P. 62100 Morelos México
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Avenida Universidad 655, Col. Santa María Ahuacatitlán, C.P. 62100 Cuernavaca, Morelos México
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14
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John EM, Hines LM, Phipps AI, Koo J, Longacre TA, Ingles SA, Baumgartner KB, Slattery ML, Wu AH. Reproductive history, breast-feeding and risk of triple negative breast cancer: The Breast Cancer Etiology in Minorities (BEM) study. Int J Cancer 2018; 142:2273-2285. [PMID: 29330856 PMCID: PMC5893409 DOI: 10.1002/ijc.31258] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/28/2017] [Accepted: 01/02/2018] [Indexed: 02/03/2023]
Abstract
Few risk factors have been identified for triple negative breast cancer (TNBC) which lacks expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). This more aggressive subtype disproportionately affects some racial/ethnic minorities and is associated with lower survival. We pooled data from three population-based studies (558 TNBC and 5,111 controls) and examined associations of TNBC risk with reproductive history and breast-feeding. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariable logistic regression. For younger women, aged <50 years, TNBC risk was increased two-fold for parous women who never breast-fed compared to nulliparous women (OR = 2.02, 95% CI = 1.12-3.63). For younger parous women, longer duration of lifetime breast-feeding was associated with a borderline reduced risk (≥24 vs. 0 months: OR = 0.52, 95% CI = 0.26-1.04, Ptrend = 0.06). Considering the joint effect of parity and breast-feeding, risk was increased two-fold for women with ≥3 full-term pregnancies (FTPs) and no or short-term (<12 months) breast-feeding compared to women with 1-2 FTPs and breast-feeding ≥12 months (OR = 2.56, 95% CI = 1.22-5.35). None of these associations were observed among older women (≥50 years). Differences in reproductive patterns possibly contribute to the ethnic differences in TNBC incidence. Among controls aged <50 years, the prevalence of no or short-term breast-feeding and ≥3 FTPs was highest for Hispanics (22%), followed by African Americans (18%), Asian Americans (15%) and non-Hispanic whites (6%). Breast-feeding is a modifiable behavioral factor that may lower TNBC risk and mitigate the effect of FTPs in women under age 50 years.
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Affiliation(s)
- Esther M. John
- Cancer Prevention Institute of California, Fremont, CA 94538
- Department of Health Research and Policy (Epidemiology) and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305
| | - Lisa M. Hines
- University of Colorado at Colorado Springs, Department of Biology, Colorado Springs, CO 80918
| | - Amanda I. Phipps
- Department of Epidemiology, University of Washington, Seattle, WA 98195
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109
| | - Jocelyn Koo
- Cancer Prevention Institute of California, Fremont, CA 94538
| | - Teri A. Longacre
- Department of Pathology and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305
| | - Sue A. Ingles
- Department of Preventive Medicine, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089
| | - Kathy B. Baumgartner
- Department of Epidemiology and Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY 40202
| | | | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089
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15
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Xia Z, Baumgartner KB, Baumgartner RN, Boone SD, Hines LM, John EM, Wolff R, Slattery ML, Connor AE. Associations between ALDH1A1 polymorphisms, alcohol consumption, and mortality among Hispanic and non-Hispanic white women diagnosed with breast cancer: the Breast Cancer Health Disparities Study. Breast Cancer Res Treat 2017; 168:443-455. [DOI: 10.1007/s10549-017-4600-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/24/2017] [Indexed: 02/07/2023]
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16
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Lambertz IU, Luo L, Berton TR, Schwartz SL, Hursting SD, Conti CJ, Fuchs-Young R. Early Exposure to a High Fat/High Sugar Diet Increases the Mammary Stem Cell Compartment and Mammary Tumor Risk in Female Mice. Cancer Prev Res (Phila) 2017; 10:553-562. [DOI: 10.1158/1940-6207.capr-17-0131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/21/2017] [Accepted: 08/30/2017] [Indexed: 11/16/2022]
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17
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Heitz AE, Baumgartner RN, Baumgartner KB, Boone SD. Healthy lifestyle impact on breast cancer-specific and all-cause mortality. Breast Cancer Res Treat 2017; 167:171-181. [PMID: 28861753 DOI: 10.1007/s10549-017-4467-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/14/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE While several studies have evaluated the association of combined lifestyle factors on breast cancer-specific mortality, few have included Hispanic women. We constructed a "healthy behavior index" (HBI) and evaluated its associations with mortality in non-Hispanic White (NHW) and Hispanic women diagnosed with breast cancer from the southwestern U.S. METHODS Diet and lifestyle questionnaires were analyzed for 837 women diagnosed with invasive breast cancer (1999-2004) in New Mexico as part of the 4-Corners Women's Health Study. An HBI score ranging from 0 to 12 was based on dietary pattern, physical activity, smoking, alcohol consumption, and body size and shape, with increasing scores representing less healthy characteristics. Hazard ratios for mortality over 14 years of follow-up were estimated for HBI quartiles using Cox proportional hazards models adjusting for education and stratified by ethnicity and stage at diagnosis. RESULTS A significant increasing trend was observed across HBI quartiles among all women, NHW women, and those diagnosed with localized or regional/distant stage of disease for all-cause (AC) mortality (p-trend = 0.006, 0.002, 0.03, respectively). AC mortality was increased >2-fold for all women and NHW women in HBI Q4 versus Q1 (HR = 2.18, 2.65, respectively). The association was stronger in women with regional/distant than localized stage of disease (HR = 2.62, 1.94, respectively). Associations for Hispanics or breast cancer-specific mortality were not significant. CONCLUSIONS These findings indicate the associations between the HBI and AC mortality, which appear to differ by ethnicity and stage at diagnosis. Interventions for breast cancer survivors should address the combination of lifestyle factors on prognosis.
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Affiliation(s)
- Adaline E Heitz
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, 485 E. Gray St., Louisville, KY, 40202, USA
| | - Richard N Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, 485 E. Gray St., Louisville, KY, 40202, USA
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, 485 E. Gray St., Louisville, KY, 40202, USA
| | - Stephanie D Boone
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, 485 E. Gray St., Louisville, KY, 40202, USA.
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18
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Maskarinec G, Jacobs S, Park SY, Haiman CA, Setiawan VW, Wilkens LR, Le Marchand L. Type II Diabetes, Obesity, and Breast Cancer Risk: The Multiethnic Cohort. Cancer Epidemiol Biomarkers Prev 2017; 26:854-861. [PMID: 28087607 PMCID: PMC5457323 DOI: 10.1158/1055-9965.epi-16-0789] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/06/2016] [Accepted: 12/13/2016] [Indexed: 12/16/2022] Open
Abstract
Background: Obesity has been more consistently associated with breast cancer than type II diabetes. This analysis examined the combination of the two factors in the Multiethnic Cohort (MEC).Methods: Women ages 45-75 years entered the MEC in 1993-1996 by completing a questionnaire. Type II diabetes status was self-reported at baseline, two follow-up questionnaires, and confirmed by administrative data. Cancers were identified from tumor registries and deaths through vital records until 2010. Cox regression was applied to estimate HRs and 95% confidence intervals (CI) for BMI and type II diabetes status alone and in combination.Results: Among 103,721 (25,146 white, 20,255 African American, 7,681 Native Hawaiian, 28,012 Japanese American, 22,627 Latina) women with 14,558 type II diabetes cases, 6,692 women developed breast cancer during 14.8 ± 4.1 years of follow-up. Type II diabetes was significantly associated with breast cancer risk (HR, 1.15; 95% CI, 1.07-1.23), but including body mass index (BMI) lowered the HR to 1.08 (95% CI, 1.00-1.16). Ethnic-specific BMI-adjusted models showed elevated risks for type II diabetes in Latinas only (HR, 1.30; 95% CI, 1.11-1.52). In contrast, obesity predicted statistically significant 21%-46% higher risks, after type II diabetes adjustment, in all ethnic groups except Latinas (HR, 1.17; 95% CI, 0.99-1.38).Conclusions: As reported previously, inclusion of BMI weakened the association of type II diabetes with breast cancer. Type II diabetes status, but not BMI, was primarily associated with higher breast cancer risk in Latinas.Impact: The role of obesity and type II diabetes in breast cancer etiology may differ by ethnicity suggesting metabolic differences related to obesity. Cancer Epidemiol Biomarkers Prev; 26(6); 854-61. ©2017 AACR.
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Affiliation(s)
| | - Simone Jacobs
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Song-Yi Park
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Veronica W Setiawan
- Department of Preventive Medicine, Keck School of Medicine, and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
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19
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Lynce F, Graves KD, Jandorf L, Ricker C, Castro E, Moreno L, Augusto B, Fejerman L, Vadaparampil ST. Genomic Disparities in Breast Cancer Among Latinas. Cancer Control 2017; 23:359-372. [PMID: 27842325 DOI: 10.1177/107327481602300407] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer diagnosed among Latinas in the United States and the leading cause of cancer-related death among this population. Latinas tend to be diagnosed at a later stage and have worse prognostic features than their non-Hispanic white counterparts. Genetic and genomic factors may contribute to observed breast cancer health disparities in Latinas. METHODS We provide a landscape of our current understanding and the existing gaps that need to be filled across the cancer prevention and control continuum. RESULTS We summarize available data on mutations in high and moderate penetrance genes for inherited risk of breast cancer and the associated literature on disparities in awareness of and uptake of genetic counseling and testing in Latina populations. We also discuss common genetic polymorphisms and risk of breast cancer in Latinas. In the treatment setting, we examine tumor genomics and pharmacogenomics in Latina patients with breast cancer. CONCLUSIONS As the US population continues to diversify, extending genetic and genomic research into this underserved and understudied population is critical. By understanding the risk of breast cancer among ethnically diverse populations, we will be better positioned to make treatment advancements for earlier stages of cancer, identify more effective and ideally less toxic treatment regimens, and increase rates of survival.
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Affiliation(s)
- Filipa Lynce
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.
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20
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Connor AE, Baumgartner KB, Pinkston CM, Boone SD, Baumgartner RN, Hines LM, Stern MC, Torres-Mejía G, John EM, Slattery ML. Response to Conner et al. Re: "Cigarette Smoking and Breast Cancer Risk in Hispanic and Non-Hispanic White Women: The Breast Cancer Health Disparities Study". J Womens Health (Larchmt) 2017; 26:92-93. [PMID: 28051904 DOI: 10.1089/jwh.2016.6292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Avonne E Connor
- 1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland
| | | | | | | | | | - Lisa M Hines
- 3 University of Colorado at Colorado Springs , Colorado Springs, Colorado
| | - Mariana C Stern
- 4 University of Southern California , Los Angeles, California
| | - Gabriela Torres-Mejía
- 5 Instituto Nacional de Salud Pública , Centro de Investigación en Salud Poblacional, Cuernavaca, Mexico
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21
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Banegas MP, John EM, Slattery ML, Gomez SL, Yu M, LaCroix AZ, Pee D, Chlebowski RT, Hines LM, Thompson CA, Gail MH. Projecting Individualized Absolute Invasive Breast Cancer Risk in US Hispanic Women. J Natl Cancer Inst 2016; 109:2572048. [PMID: 28003316 DOI: 10.1093/jnci/djw215] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/19/2016] [Accepted: 08/26/2016] [Indexed: 01/21/2023] Open
Abstract
Background There is no model to estimate absolute invasive breast cancer risk for Hispanic women. Methods The San Francisco Bay Area Breast Cancer Study (SFBCS) provided data on Hispanic breast cancer case patients (533 US-born, 553 foreign-born) and control participants (464 US-born, 947 foreign-born). These data yielded estimates of relative risk (RR) and attributable risk (AR) separately for US-born and foreign-born women. Nativity-specific absolute risks were estimated by combining RR and AR information with nativity-specific invasive breast cancer incidence and competing mortality rates from the California Cancer Registry and Surveillance, Epidemiology, and End Results program to develop the Hispanic risk model (HRM). In independent data, we assessed model calibration through observed/expected (O/E) ratios, and we estimated discriminatory accuracy with the area under the receiver operating characteristic curve (AUC) statistic. Results The US-born HRM included age at first full-term pregnancy, biopsy for benign breast disease, and family history of breast cancer; the foreign-born HRM also included age at menarche. The HRM estimated lower risks than the National Cancer Institute's Breast Cancer Risk Assessment Tool (BCRAT) for US-born Hispanic women, but higher risks in foreign-born women. In independent data from the Women's Health Initiative, the HRM was well calibrated for US-born women (observed/expected [O/E] ratio = 1.07, 95% confidence interval [CI] = 0.81 to 1.40), but seemed to overestimate risk in foreign-born women (O/E ratio = 0.66, 95% CI = 0.41 to 1.07). The AUC was 0.564 (95% CI = 0.485 to 0.644) for US-born and 0.625 (95% CI = 0.487 to 0.764) for foreign-born women. Conclusions The HRM is the first absolute risk model that is based entirely on data specific to Hispanic women by nativity. Further studies in Hispanic women are warranted to evaluate its validity.
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Affiliation(s)
- Matthew P Banegas
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA, USA
| | | | | | - Mandi Yu
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Andrea Z LaCroix
- Division of Epidemiology, Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
| | - David Pee
- Information Management Services, Rockville, MD, USA
| | - Rowan T Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Lisa M Hines
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Cynthia A Thompson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Mitchell H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
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22
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Hines LM, Sedjo RL, Byers T, John EM, Fejerman L, Stern MC, Baumgartner KB, Giuliano AR, Torres-Mejia G, Wolff RK, Harrall KK, Slattery ML. The Interaction between Genetic Ancestry and Breast Cancer Risk Factors among Hispanic Women: The Breast Cancer Health Disparities Study. Cancer Epidemiol Biomarkers Prev 2016; 26:692-701. [PMID: 27932594 DOI: 10.1158/1055-9965.epi-16-0721] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/04/2016] [Accepted: 11/28/2016] [Indexed: 11/16/2022] Open
Abstract
Background: Hispanic women have lower breast cancer incidence rates than non-Hispanic white (NHW) women. To what extent genetic versus nongenetic factors account for this difference is unknown.Methods: Using logistic regression, we evaluated the interactive influences of established risk factors and ethnicity (self-identified and identified by ancestral informative markers) on breast cancer risk among 2,326 Hispanic and 1,854 NHW postmenopausal women from the United States and Mexico in the Breast Cancer Health Disparities Study.Results: The inverse association between the percentage of Native American (NA) ancestry and breast cancer risk was only slightly attenuated after adjusting for known risk factors [lowest versus highest quartile: odds ratio (OR) =1.39, 95% confidence interval (CI) = 1.00-1.92 among U.S. Hispanics; OR = 1.92 (95% CI, 1.29-2.86) among Mexican women]. The prevalence of several risk factors, as well as the associations with certain factors and breast cancer risk, differed according to genetic admixture. For example, higher body mass index (BMI) was associated with reduced risk among women with lower NA ancestry only [BMI <25 versus >30: OR = 0.65 (95% CI, 0.44-0.98) among U.S. Hispanics; OR = 0.53 (95% CI, 0.29-0.97) among Mexicans]. The average number of risk factors among cases was inversely related to the percentage of NA ancestry.Conclusions: The lower NA ancestry groups were more likely to have the established risk factors, with the exception of BMI. Although the majority of factors were associated with risk in the expected directions among all women, BMI had an inverse association among Hispanics with lower NA ancestry.Impact: These data suggest that the established risk factors are less relevant for breast cancer development among women with more NA ancestry. Cancer Epidemiol Biomarkers Prev; 26(5); 692-701. ©2016 AACR.
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Affiliation(s)
- Lisa M Hines
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, Colorado.
| | - Rebecca L Sedjo
- University of Colorado Cancer Center and Colorado School of Public Health, Aurora, Colorado
| | - Tim Byers
- University of Colorado Cancer Center and Colorado School of Public Health, Aurora, Colorado
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, California.,Department of Health Research and Policy (Epidemiology) and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Laura Fejerman
- Department of Medicine, Division of General Internal Medicine, Institute for Human Genetics and Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, California
| | - Mariana C Stern
- Department of Preventive Medicine, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Anna R Giuliano
- Moffitt Cancer Center, Cancer Prevention and Control, Tampa, Florida
| | - Gabriela Torres-Mejia
- Instituto Nacional de Salud Publica, Centro de Investigacion en Salud Poblacional Av. Universidad No. 655, Col. Sta. Ma. Ahuacatitlan Cuernavaca, Morelos CP 62100, Mexico
| | - Roger K Wolff
- Department of Medicine, University of Utah, Salt Lake City, Utah
| | - Kylie K Harrall
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado
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23
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Connor AE, Visvanathan K, Baumgartner KB, Baumgartner RN, Boone SD, Hines LM, Wolff RK, John EM, Slattery ML. Pre-diagnostic breastfeeding, adiposity, and mortality among parous Hispanic and non-Hispanic white women with invasive breast cancer: the Breast Cancer Health Disparities Study. Breast Cancer Res Treat 2016; 161:321-331. [PMID: 27837379 DOI: 10.1007/s10549-016-4048-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/05/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND U.S. Hispanic women have high rates of parity, breastfeeding, and obesity. It is unclear whether these reproductive factors are associated with breast cancer (BC) mortality. We examined the associations between breastfeeding, parity, adiposity and BC-specific and overall mortality in Hispanic and non-Hispanic white (NHW) BC cases. METHODS The study population included 2921 parous women (1477 Hispanics, 1444 NHWs) from the Breast Cancer Health Disparities Study with invasive BC diagnosed between 1995 and 2004. Information on reproductive history and lifestyle factors was collected by in-person interview. Overall and stratified Cox proportional hazard regression models by ethnicity, parity, and body mass index (BMI) at age 30 years were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS After a median follow-up time of 11.2 years, a total of 679 deaths occurred. Pre-diagnostic breastfeeding was associated with a 16% reduction in mortality (HR 0.84; 95% 0.72-0.99) irrespective of ethnicity. Parity significantly modified the association between breastfeeding duration and mortality (p interaction = 0.05), with longer breastfeeding duration associated with lower risk among women who had ≤2 births (p trend = 0.02). Breastfeeding duration was associated with reduced risk of both BC-specific and overall mortality among women with BMI <25 kg/m2, while positive associations were observed among women with BMI ≥25 kg/m2 (p interactions <0.01). CONCLUSION Pre-diagnostic breastfeeding was inversely associated with risk of mortality after BC, particularly in women of low parity or normal BMI. These results provide another reason to encourage breastfeeding and weight management among young women.
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Affiliation(s)
- Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Office E-6137, Baltimore, MD, 21205, USA. .,Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA.
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Office E-6137, Baltimore, MD, 21205, USA.,Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health; James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Richard N Baumgartner
- Department of Epidemiology and Population Health; James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Stephanie D Boone
- Department of Epidemiology and Population Health; James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Lisa M Hines
- Department of Biology, University of Colorado, Colorado Springs, Colorado Springs, CO, USA
| | - Roger K Wolff
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA, USA.,Department of Health Research and Policy (Epidemiology), and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Martha L Slattery
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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24
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Monroy-Cisneros K, Esparza-Romero J, Valencia ME, Guevara-Torres AG, Méndez-Estrada RO, Anduro-Corona I, Astiazarán-García H. Antineoplastic treatment effect on bone mineral density in Mexican breast cancer patients. BMC Cancer 2016; 16:860. [PMID: 27821086 PMCID: PMC5100258 DOI: 10.1186/s12885-016-2905-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 10/28/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Breast cancer is the most deadly malignancy in Mexican women. Although treatment has improved, it may significantly affect bone mineral status in those who receive it. The aim of this study was to assess the impact of cancer treatment on bone mineral density (BMD) and bone mineral content (BMC), in patients with breast cancer and explore the interaction of menopausal status and clinical stage with cancer treatment on such changes. METHODS A quasi-experimental design was applied with measurements before and after a chemotherapy treatment in 40 patients with primary diagnosis of invasive breast cancer. BMD and body composition measurements were taken by dual X-ray absorptiometry (DXA) and changes in these variables due to therapy were analyzed using mixed regression for repeated measurements. RESULTS Significant loss was found in femoral neck and L2-L4 BMD (p < 0.001). Patients diagnosed with osteopenia or osteoporosis received calcium + vitamin D supplementation (600 mg/200 IU day). It showed a protective effect in the decrease of femoral neck BMD and total BMC. BMD loss in both femoral neck and L2-L4 BMD was higher in premenopausal women: 0.023 g/cm2 in femoral neck and 0.063 g/cm2 in L2-L4 (p < 0.001), while in postmenopausal women BMD loss was 0.015 g/cm2 in femoral neck and 0.035 g/cm2 in L2-L4 (p = 0.021 and p = 0.001 respectively). Change in lumbar spine BMD was prominent in premenopausal women with advanced clinical stage (IIB, IIIA, IIIB): 0.066 g/cm2 (p = 0.003). CONCLUSION The antineoplastic breast cancer treatment with chemotherapy had a negative impact on BMD, in premenopausal women overall, although a differential effect was found according to clinical stage and calcium supplementation status.
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Affiliation(s)
- Karina Monroy-Cisneros
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico
| | - Julián Esparza-Romero
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico
| | - Mauro E Valencia
- Departamento de Ciencias Químico-Biológicas, Coordinación de Ciencias Nutricionales, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo, Sonora, Mexico
| | - Alfonso G Guevara-Torres
- Centro Estatal de Oncología (CEO), Reforma final y Paseo Río San Miguel, C.P. 83280, Hermosillo, Sonora, Mexico
| | - Rosa O Méndez-Estrada
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico
| | - Iván Anduro-Corona
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico
| | - Humberto Astiazarán-García
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Coordinación de Nutrición, Carretera a La Victoria km 0.6, C.P. 83304, Hermosillo, Sonora, Mexico.
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25
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Bertrand KA, Bethea TN, Adams-Campbell LL, Rosenberg L, Palmer JR. Differential Patterns of Risk Factors for Early-Onset Breast Cancer by ER Status in African American Women. Cancer Epidemiol Biomarkers Prev 2016; 26:270-277. [PMID: 27756774 DOI: 10.1158/1055-9965.epi-16-0692] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/04/2016] [Accepted: 10/11/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Given the disproportionately high incidence of early-onset breast cancer and aggressive subtypes, such as estrogen receptor (ER)-negative tumors, in African American (AA) women, elucidation of risk factors for early onset of specific subtypes of breast cancer is needed. METHODS We evaluated associations of reproductive, anthropometric, and other factors with incidence of invasive breast cancer by age at onset (<45, ≥45) in 57,708 AA women in the prospective Black Women's Health Study. From 1995 to 2013, we identified 529 invasive breast cancers among women <45 years of age (151 ER-, 219 ER+) and 1,534 among women ≥45 years (385 ER-, 804 ER+). We used multivariable Cox proportional hazards regression to estimate hazard ratios (HRs) for associations by age and ER status. RESULTS Higher parity, older age at first birth, never having breastfed, and abdominal adiposity were associated with increased risk of early-onset ER- breast cancer: HRs were 1.71 for ≥3 births versus one birth; 2.29 for first birth after age 25 versus <20 years; 0.61 for ever having breastfed versus never; and 1.64 for highest versus lowest tertile of waist-to-hip ratio. These factors were not associated with ER- cancer in older women or with ER+ cancer regardless of age. CONCLUSIONS Differences in risk factors by ER subtype were observed for breast cancer diagnosed before the age of 45 years. IMPACT Etiological heterogeneity by tumor subtype in early-onset breast cancer, in combination with a higher prevalence of the risk factors in AA women, may explain, in part, racial disparities in breast cancer incidence. Cancer Epidemiol Biomarkers Prev; 26(2); 270-7. ©2016 AACR.
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Affiliation(s)
| | - Traci N Bethea
- Slone Epidemiology Center at Boston University, Boston, Massachusetts
| | | | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston, Massachusetts
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston, Massachusetts
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26
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Brooks JD, John EM, Mellemkjaer L, Lynch CF, Knight JA, Malone KE, Reiner AS, Bernstein L, Liang X, Shore RE, Stovall M, Bernstein JL. Body mass index, weight change, and risk of second primary breast cancer in the WECARE study: influence of estrogen receptor status of the first breast cancer. Cancer Med 2016; 5:3282-3291. [PMID: 27700016 PMCID: PMC5119984 DOI: 10.1002/cam4.890] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/12/2016] [Accepted: 08/10/2016] [Indexed: 12/03/2022] Open
Abstract
Studies examining the relationship between body mass index (BMI) and risk of contralateral breast cancer (CBC) have reported mixed findings. We previously showed that obese postmenopausal women with estrogen receptor (ER)‐negative breast cancer have a fivefold higher risk of CBC compared with normal weight women. In the current analysis, we reexamined this relationship in the expanded Women's Environmental Cancer and Radiation Epidemiology (WECARE) Study, focusing on the impact of menopausal status and ER status of the first breast cancer. The WECARE Study is a population‐based case–control study of young women with CBC (cases, N = 1386) and with unilateral breast cancer (controls, N = 2045). Rate ratios (RR) and 95% confidence intervals (CI) were calculated to assess the relationship between BMI and risk of CBC stratified by menopausal and ER status. Positive associations with obesity and weight gain were limited to women who became postmenopausal following their first primary breast cancer. Among those with an ER‐negative first breast cancer, obesity (vs. normal weight) at first diagnosis was associated with an increased risk of CBC (RR = 1.9, 95% CI: 1.02, 3.4). Also, weight gain of ≥10 kg after first diagnosis was associated with an almost twofold increased risk of CBC (RR = 1.9, 95% CI: 0.99, 3.8). These results suggest that women with an ER‐negative first primary cancer who are obese at first primary diagnosis or who experience a large weight gain afterward may benefit from heightened surveillance. Future studies are needed to address the impact of weight loss interventions on risk of CBC.
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Affiliation(s)
- Jennifer D Brooks
- University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, Canada
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, California.,Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, California
| | | | | | - Julia A Knight
- University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | | | - Anne S Reiner
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Leslie Bernstein
- Beckman Research Institute, City of Hope National Medical Center, Duarte, California
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Roy E Shore
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Marilyn Stovall
- The University of Texas MD Anderson Cancer Center, Houston, Texas
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27
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Energy homeostasis genes and survival after breast cancer diagnosis: the Breast Cancer Health Disparities Study. Cancer Causes Control 2016; 27:47-57. [PMID: 26472474 DOI: 10.1007/s10552-015-0681-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 10/03/2015] [Indexed: 12/15/2022]
Abstract
PURPOSE The leptin-signaling pathway and other genes involved in energy homeostasis (EH) have been examined in relation to breast cancer risk as well as to obesity. We test the hypothesis that genetic variation in EH genes influences survival after diagnosis with breast cancer and that body mass index (BMI) will modify that risk. METHODS We evaluated associations between 10 EH genes and survival among 1,186 non-Hispanic white and 1,155 Hispanic/Native American women diagnosed with breast cancer. Percent Native American (NA) ancestry was determined from 104 ancestry-informative markers. Adaptive rank truncation product (ARTP) was used to determine gene and pathway significance. RESULTS The overall EH pathway was marginally significant for all-cause mortality among women with low NA ancestry (P(ARTP) = 0.057). Within the pathway, ghrelin(GHRL) and leptin receptor (LEPR) were significantly associated with all-cause mortality (P(ARTP) = 0.035 and 0.007, respectively). The EH pathway was significantly associated with breast cancer-specific mortality among women with low NA ancestry (P(ARTP) = 0.038). Three genes cholecystokinin (CCK), GHRL, and LEPR were significantly associated with breast cancer-specific mortality among women with low NA ancestry (P(ARTP) = 0.046,0.015, and 0.046, respectively), while neuropeptide Y (NPY) was significantly associated with breast cancer-specific mortality among women with higher NA ancestry(P(ARTP) = 0.038). BMI did not modify these associations. CONCLUSIONS Our data support our hypothesis that certain EH genes influence survival after diagnosis with breast cancer; associations appear to be most important among women with low NA ancestry.
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Frugé AD, Cases MG, Schildkraut JM, Demark-Wahnefried W. Associations between Obesity, Body Fat Distribution, Weight Loss and Weight Cycling on Serum Pesticide Concentrations. ACTA ACUST UNITED AC 2016; 5. [PMID: 27478857 DOI: 10.4172/2324-9323.1000198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Preliminary studies suggest pesticides may be linked to increased cancer risk. Since most pesticides are lipophilic and stored within adipose tissue, serum levels of organochlorines are affected not only by environmental exposures, but also by factors related to lipid turnover and storage. Our objective was to investigate whether serum organochlorines are influenced by weight loss, body fat distribution, and weight cycling. METHODS Ten overweight women were recruited upon entry into a weight loss program and surveyed regarding weight history, childbearing/lactation, and exposure to environmental contaminants. Anthropometric measures and phlebotomy were conducted at baseline and at four weeks (mean weight loss=5.1 kg). Serum was analyzed for 19 common polychlorinated pesticides and metabolites and 10 PCB congeners. RESULTS Organochlorine levels were not significantly affected by weight loss nor associated with body mass index (BMI). Strong positive correlations were noted between levels of DDE/DDT and age (DDE β=0.6986/p=0.0246/DDT β=0.6536/p=0.0404) and between DDE/DDT and waist-to-hip ratio (WHR) (DDE β=0.4356/p=0.0447/DDT β=0.8108/p=0.0044). Trends were noted for decreased levels of DDT in women who reported more episodes of weight cycling. CONCLUSION Serum organochlorine levels may be affected not only by age, but also factors related to lipid turnover (i.e., episodes of weight cycling and WHR), and warrants further study.
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Affiliation(s)
- Andrew Dandridge Frugé
- Department of Nutrition Sciences, University of Alabama at Birmingham, 1675 University Blvd., Birmingham, Alabama 35294, USA
| | - Mallory Gamel Cases
- Department of Health Behavior, University of Alabama at Birmingham, 1675 University Blvd., Birmingham, Alabama 35294, USA
| | - Joellen Martha Schildkraut
- Program of Cancer Prevention, Detection and Control Research, Duke University Medical Center, Box 2715 Med Center, Durham, North Carolina 27705, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, 1675 University Blvd., Birmingham, Alabama 35294, USA
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29
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Yanez B, McGinty HL, Buitrago D, Ramirez AG, Penedo FJ. Cancer Outcomes in Hispanics/Latinos in the United States: An Integrative Review and Conceptual Model of Determinants of Health. ACTA ACUST UNITED AC 2016; 4:114-129. [PMID: 27429867 DOI: 10.1037/lat0000055] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cancer is the leading cause of death among Hispanics. Compared to non-Hispanic Whites, Hispanics are more likely to be diagnosed with advanced stages of disease and experience poor quality of life following a cancer diagnosis. Cancer outcomes are influenced by a confluence of social, cultural, behavioral and biological factors. Yet, much of the behavioral and psychosocial research in oncology has focused on non-Hispanic Whites, thus limiting our understanding of the potential web of factors that can influence cancer-related outcomes among Hispanics. Furthermore, features of Hispanic ethnicity and culture may influence and interact with, social, psychosocial, health care, disease-specific, and medical factors known to influence cancer-related outcomes, yet very few studies have integrated Hispanic cultural processes when addressing cancer-related outcomes for this ethnic group. Guided by the extant literature in oncology, Hispanic culture and health, and previously established models of determinants of minority health, we present a conceptual model that highlights the interplay of social, cultural, psychosocial, disease-specific, health care, and medical factors as determinants of cancer outcomes (morbidity, mortality, quality of life) and review key evidence of how features of Hispanic culture may influence cancer outcomes and contribute to the disparate outcomes observed in Hispanic cancer samples relative to non-Hispanic Whites. Finally, we conclude with a discussion of future research opportunities and existing challenges to researching oncology outcomes among Hispanics.
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Affiliation(s)
- Betina Yanez
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Heather L McGinty
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Diana Buitrago
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Amelie G Ramirez
- Institute for Health Promotion, University of Texas Health Science Center
| | - Frank J Penedo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
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30
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Ethnic differences in the relationships between diabetes, early age adiposity and mortality among breast cancer survivors: the Breast Cancer Health Disparities Study. Breast Cancer Res Treat 2016; 157:167-78. [DOI: 10.1007/s10549-016-3810-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 04/19/2016] [Indexed: 02/07/2023]
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31
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Red meat, poultry, and fish intake and breast cancer risk among Hispanic and Non-Hispanic white women: The Breast Cancer Health Disparities Study. Cancer Causes Control 2016; 27:527-43. [PMID: 26898200 DOI: 10.1007/s10552-016-0727-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 02/08/2016] [Indexed: 02/07/2023]
Abstract
PURPOSE There is suggestive but limited evidence for a relationship between meat intake and breast cancer (BC) risk. Few studies included Hispanic women. We investigated the association between meats and fish intake and BC risk among Hispanic and NHW women. METHODS The study included NHW (1,982 cases and 2,218 controls) and the US Hispanics (1,777 cases and 2,218 controls) from two population-based case-control studies. Analyses considered menopausal status and percent Native American ancestry. We estimated pooled ORs combining harmonized data from both studies, and study- and race-/ethnicity-specific ORs that were combined using fixed or random effects models, depending on heterogeneity levels. RESULTS When comparing highest versus lowest tertile of intake, among NHW we observed an association between tuna intake and BC risk (pooled OR 1.25; 95 % CI 1.05-1.50; trend p = 0.006). Among Hispanics, we observed an association between BC risk and processed meat intake (pooled OR 1.42; 95% CI 1.18-1.71; trend p < 0.001), and between white meat (OR 0.80; 95% CI 0.67-0.95; trend p = 0.01) and BC risk, driven by poultry. All these findings were supported by meta-analysis using fixed or random effect models and were restricted to estrogen receptor-positive tumors. Processed meats and poultry were not associated with BC risk among NHW women; red meat and fish were not associated with BC risk in either race/ethnic groups. CONCLUSIONS Our results suggest the presence of ethnic differences in associations between meat and BC risk that may contribute to BC disparities.
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Schairer C, Fuhrman BJ, Boyd-Morin J, Genkinger JM, Gail MH, Hoover RN, Ziegler RG. Quantifying the Role of Circulating Unconjugated Estradiol in Mediating the Body Mass Index-Breast Cancer Association. Cancer Epidemiol Biomarkers Prev 2016; 25:105-13. [PMID: 26637268 PMCID: PMC5555590 DOI: 10.1158/1055-9965.epi-15-0687] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 10/23/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Higher body mass index (BMI) and circulating estrogen levels each increase postmenopausal breast cancer risk, particularly estrogen receptor-positive (ER(+)) tumors. Higher BMI also increases estrogen production. METHODS We estimated the proportion of the BMI-ER(+) breast cancer association mediated through estrogen in a case-control study nested within the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Participants included 143 women with invasive ER(+) breast cancer and 268 matched controls, all postmenopausal and never having used hormone therapy at baseline. We used liquid chromatography-tandem mass spectrometry to measure 15 estrogens and estrogen metabolites in baseline serum. We calculated BMI from self-reported height and weight at baseline. We estimated the mediating effect of unconjugated estradiol on the BMI-ER(+) breast cancer association using Aalen additive hazards and Cox regression models. RESULTS All estrogens and estrogen metabolites were statistically significantly correlated with BMI, with unconjugated estradiol most strongly correlated [Pearson correlation (r) = 0.45]. Approximately 7% to 10% of the effect of overweight, 12% to 15% of the effect of obesity, and 19% to 20% of the effect of a 5 kg/m(2) BMI increase on ER(+) breast cancer risk was mediated through unconjugated estradiol. The BMI-breast cancer association, once adjusted for unconjugated estradiol, was not modified by further adjustment for two metabolic ratios statistically significantly associated with both breast cancer and BMI. CONCLUSION Circulating unconjugated estradiol levels partially mediate the BMI-breast cancer association, but other potentially important estrogen mediators (e.g., bioavailable estradiol) were not evaluated. IMPACT Further research is required to identify mechanisms underlying the BMI-breast cancer association.
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Affiliation(s)
- Catherine Schairer
- Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland.
| | - Barbara J Fuhrman
- Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Jeanine M Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York. Herbert Irving Comprehensive Cancer Center, Columbia University, New York, New York
| | - Mitchell H Gail
- Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland
| | - Robert N Hoover
- Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland
| | - Regina G Ziegler
- Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland
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Connor AE, Baumgartner KB, Baumgartner RN, Pinkston CM, Boone SD, John EM, Torres-Mejía G, Hines LM, Giuliano AR, Wolff RK, Slattery ML. Cigarette Smoking and Breast Cancer Risk in Hispanic and Non-Hispanic White Women: The Breast Cancer Health Disparities Study. J Womens Health (Larchmt) 2015; 25:299-310. [PMID: 26682495 DOI: 10.1089/jwh.2015.5502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Few epidemiological studies have included Hispanics with the evaluation of the effects of cigarette smoking and breast cancer. We examined the relationship between cigarette smoking, ethnicity, and breast cancer risk using data from the Breast Cancer Health Disparities Study (BCHDS). MATERIALS AND METHODS The BCHDS is a consortium of three population-based case-control studies, including U.S. non-Hispanic whites (NHWs) (1,525 cases; 1,593 controls), U.S. Hispanics/Native Americans (1,265 cases; 1,495 controls), and Mexican women (990 cases; 1,049 controls). Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Breast cancer risk was elevated among Mexican former smokers (OR 1.43, 95% CI 1.04-1.96) and among those who smoked ≥ 31 years (OR 1.95, 95% CI 1.13-3.35), compared to never smokers. In addition, Mexican former smokers with a history of alcohol consumption had increased breast cancer risk (OR 2.30, 95% CI 1.01-5.21). Among NHW premenopausal women, breast cancer risk was increased for smoking ≥ 20 cigarettes per day (OR 1.61, 95% CI 1.07-2.41). CONCLUSION Our findings suggest the possibility of ethnic differences with the associations between cigarette smoking and breast cancer risk.
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Affiliation(s)
- Avonne E Connor
- 1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.,2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Kathy B Baumgartner
- 2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Richard N Baumgartner
- 2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Christina M Pinkston
- 2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Stephanie D Boone
- 2 Department of Epidemiology and Population Health, James Graham Brown Cancer Center, School of Public Health & Information Sciences, University of Louisville , Louisville, Kentucky
| | - Esther M John
- 3 Cancer Prevention Institute of California , Fremont, California.,4 Division of Epidemiology, Department of Health Research and Policy, Stanford Cancer Institute, Stanford University School of Medicine , Stanford, California
| | - Gabriela Torres-Mejía
- 5 Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional , Cuernavaca, Morelos, México
| | - Lisa M Hines
- 6 Department of Biology, University of Colorado at Colorado Springs , Colorado Springs, Colorado
| | - Anna R Giuliano
- 7 H. Lee Moffit Cancer Center & Research Institute , Tampa, Florida
| | - Roger K Wolff
- 8 Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Martha L Slattery
- 8 Department of Internal Medicine, University of Utah , Salt Lake City, Utah
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Bandera EV, Maskarinec G, Romieu I, John EM. Racial and ethnic disparities in the impact of obesity on breast cancer risk and survival: a global perspective. Adv Nutr 2015; 6:803-19. [PMID: 26567202 PMCID: PMC4642425 DOI: 10.3945/an.115.009647] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Obesity is a global concern, affecting both developed and developing countries. Although there are large variations in obesity and breast cancer rates worldwide and across racial/ethnic groups, most studies evaluating the impact of obesity on breast cancer risk and survival have been conducted in non-Hispanic white women in the United States or Europe. Given the known racial/ethnic differences in tumor hormone receptor subtype distribution, obesity prevalence, and risk factor profiles, we reviewed published data for women of African, Hispanic, and Asian ancestry in the United States and their countries of origin. Although the data are limited, current evidence suggests a stronger adverse effect of obesity on breast cancer risk and survival in women of Asian ancestry. For African Americans and Hispanics, the strength of the associations appears to be more comparable to that of non-Hispanic whites, particularly when accounting for subtype and menopausal status. Central obesity seems to have a stronger impact in African-American women than general adiposity as measured by body mass index. International data from countries undergoing economic transition offer a unique opportunity to evaluate the impact of rapid weight gain on breast cancer. Such studies should take into account genetic ancestry, which may help elucidate differences in associations between ethnically admixed populations. Overall, additional large studies that use a variety of adiposity measures are needed, because the current evidence is based on few studies, most with limited statistical power. Future investigations of obesity biomarkers will be useful to understand possible racial/ethnic biological differences underlying the complex association between obesity and breast cancer development and progression.
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Affiliation(s)
- Elisa V Bandera
- Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ
| | | | | | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA; and Department of Health Research and Policy (Epidemiology) and Stanford Cancer Institute, Stanford School of Medicine, Stanford, CA
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Energy homeostasis genes and breast cancer risk: The influence of ancestry, body size, and menopausal status, the breast cancer health disparities study. Cancer Epidemiol 2015; 39:1113-22. [PMID: 26395295 DOI: 10.1016/j.canep.2015.08.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/20/2015] [Accepted: 08/22/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Obesity and breast cancer risk is multifaceted and genes associated with energy homeostasis may modify this relationship. METHODS We evaluated 10 genes that have been associated with obesity and energy homeostasis to determine their association with breast cancer risk in Hispanic/Native American (2111 cases, 2597 controls) and non-Hispanic white (1481 cases, 1585 controls) women. RESULTS Cholecystokinin (CCK) rs747455 and proopiomelanocortin (POMC) rs6713532 and rs7565877 (for low Indigenous American (IA) ancestry); CCK rs8192472 and neuropeptide Y (NYP) rs16141 and rs14129 (intermediate IA ancestry); and leptin receptor (LEPR) rs11585329 (high IA ancestry) were strongly associated with multiple indicators of body size. There were no significant associations with breast cancer risk between genes and SNPs overall. However, LEPR was significantly associated with breast cancer risk among women with low IA ancestry (PARTP=0.024); POMC was significantly associated with breast cancer risk among women with intermediate (PARTP=0.015) and high (PARTP=0.012) IA ancestry. The overall pathway was statistically significant for pre-menopausal women with low IA ancestry (PARTP=0.05), as was cocaine and amphetamine regulated transcript protein (CARTPT) (PARTP=0.014) and ghrelin (GHRL) (PARTP=0.007). POMC was significantly associated with breast cancer risk among post-menopausal women with higher IA ancestry (PARTP=0.005). Three SNPs in LEPR (rs6704167, rs17412175, and rs7626141), and adiponectin (ADIPOQ); rs822391) showed significant 4-way interactions (GxExMenopausexAncestry) for multiple indicators of body size among pre-menopausal women. CONCLUSIONS Energy homeostasis genes were associated with breast cancer risk; menopausal status, body size, and genetic ancestry influenced this relationship.
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Fejerman L, Stern MC, John EM, Torres-Mejía G, Hines LM, Wolff RK, Baumgartner KB, Giuliano AR, Ziv E, Pérez-Stable EJ, Slattery ML. Interaction between common breast cancer susceptibility variants, genetic ancestry, and nongenetic risk factors in Hispanic women. Cancer Epidemiol Biomarkers Prev 2015; 24:1731-8. [PMID: 26364163 DOI: 10.1158/1055-9965.epi-15-0392] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 08/14/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Most genetic variants associated with breast cancer risk have been discovered in women of European ancestry, and only a few genome-wide association studies (GWAS) have been conducted in minority groups. This research disparity persists in post-GWAS gene-environment interaction analyses. We tested the interaction between hormonal and lifestyle risk factors for breast cancer, and ten GWAS-identified SNPs among 2,107 Hispanic women with breast cancer and 2,587 unaffected controls, to gain insight into a previously reported gene by ancestry interaction in this population. METHODS We estimated genetic ancestry with a set of 104 ancestry-informative markers selected to discriminate between Indigenous American and European ancestry. We used logistic regression models to evaluate main effects and interactions. RESULTS We found that the rs13387042-2q35(G/A) SNP was associated with breast cancer risk only among postmenopausal women who never used hormone therapy [per A allele OR: 0.94 (95% confidence intervals, 0.74-1.20), 1.20 (0.94-1.53), and 1.49 (1.28-1.75) for current, former, and never hormone therapy users, respectively, Pinteraction 0.002] and premenopausal women who breastfed >12 months [OR: 1.01 (0.72-1.42), 1.19 (0.98-1.45), and 1.69 (1.26-2.26) for never, <12 months, and >12 months breastfeeding, respectively, Pinteraction 0.014]. CONCLUSIONS The correlation between genetic ancestry, hormone replacement therapy use, and breastfeeding behavior partially explained a previously reported interaction between a breast cancer risk variant and genetic ancestry in Hispanic women. IMPACT These results highlight the importance of understanding the interplay between genetic ancestry, genetics, and nongenetic risk factors and their contribution to breast cancer risk.
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Affiliation(s)
- Laura Fejerman
- Division of General Internal Medicine, Department of Medicine, Institute for Human Genetics and Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, California.
| | - Mariana C Stern
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine of USC, Los Angeles, California
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, California and Department of Health Research and Policy (Epidemiology), and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Gabriela Torres-Mejía
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, Morelos, Mexico
| | - Lisa M Hines
- Department of Biology, University of Colorado at Colorado Springs, Colorado Springs, Colorado
| | - Roger K Wolff
- Department of Medicine, University of Utah, Salt Lake City, Utah
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | | | - Elad Ziv
- Division of General Internal Medicine, Department of Medicine, Institute for Human Genetics and Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, California
| | - Eliseo J Pérez-Stable
- Division of General Internal Medicine, Department of Medicine, Institute for Human Genetics and Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, California
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Adult BMI change and risk of Breast Cancer: National Health and Nutrition Examination Survey (NHANES) 2005-2010. Breast Cancer 2015; 22:648-56. [PMID: 26350490 DOI: 10.1007/s12282-015-0638-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 08/28/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Breast cancer is the second leading cause of cancer mortality among women in the developed world. This study assessed the association between occurrence of breast cancer and body mass index (BMI) change from age 25 to age closest to breast cancer diagnosis while exploring the modifying effects of demographic variables. METHODS The National Health and Nutrition Examination Survey data were used. Women included were ≥50 years, not pregnant and without a diagnosis of any cancer but breast. The total sample included 2895 women (172 with breast cancer and 2723 controls with no breast cancer diagnosis). Multivariate logistic regression was used to estimate the OR and 95 % CIs and interaction evaluated by including an interaction term in the model. RESULTS Women whose BMI increased from normal or overweight to obese compared to those who remained at a normal BMI were found to have a 2 times higher odds (OR = 2.1; 95 % CI 1.11-3.79) of developing breast cancer. No significant association was observed for women who increased to overweight. However, a more pronounced association was observed in non-Hispanic black women (OR = 6.6; 95 % CI 1.68-25.86) and a significant association observed when they increased from normal to overweight (OR = 4.2; 95 % CI 1.02-17.75). CONCLUSIONS Becoming obese after age 25 is associated with increased risk of breast cancer in women over 50 years old, with non-Hispanic black women being at greatest risk.
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Active and passive cigarette smoking and mortality among Hispanic and non-Hispanic white women diagnosed with invasive breast cancer. Ann Epidemiol 2015; 25:824-31. [PMID: 26387598 DOI: 10.1016/j.annepidem.2015.08.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 08/06/2015] [Accepted: 08/17/2015] [Indexed: 01/17/2023]
Abstract
PURPOSE Women who smoke at breast cancer diagnosis have higher risk of breast cancer-specific and all-cause mortality than nonsmokers; however, differences by ethnicity or prognostic factors and risk for noncancer mortality have not been evaluated. METHODS We examined associations of active and passive smoke exposure with mortality among Hispanic (n = 1020) and non-Hispanic white (n = 1198) women with invasive breast cancer in the Breast Cancer Health Disparities Study (median follow-up of 10.6 years). RESULTS Risk of breast cancer-specific (HR = 1.55, 95% CI = 1.11-2.16) and all-cause (HR = 1.68, 95% CI = 1.30-2.17) mortality was increased for current smokers, with similar results stratified by ethnicity. Ever smokers had an increased risk of noncancer mortality (HR = 1.68, 95% CI = 1.12-2.51). Associations were strongest for current smokers who smoked for 20 years or more were postmenopausal, overweight and/or obese, or reported moderate and/or high alcohol consumption; however, interactions were not significant. Breast cancer-specific mortality was increased two fold for moderate and/or high recent passive smoke exposure among never smokers (HR = 2.12, 95% CI = 1.24-3.63). CONCLUSIONS Findings support associations of active-smoking and passive-smoking diagnosis with risk of breast cancer-specific and all-cause mortality and ever smoking with noncancer mortality, regardless of ethnicity, and other factors. Smoking is a modifiable lifestyle factor and effective smoking cessation, and maintenance programs should be routinely recommended for women with breast cancer.
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Surveillance and beliefs about follow-up care among long-term breast cancer survivors: a comparison of primary care and oncology providers. J Cancer Surviv 2015; 10:96-102. [PMID: 26070279 DOI: 10.1007/s11764-015-0454-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 04/23/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE Delivery of follow-up care to breast cancer survivors is an important public health issue due to their increasing number and the anticipated shortage of oncology providers. This study evaluated adherence to American Society of Clinical Oncology (ASCO)-recommended surveillance tests in a bi-ethnic cohort of long-term breast cancer survivors. METHODS Women (n = 298) in Arizona and Colorado who had previously participated in a population-based study of breast cancer were enrolled into a follow-up survey approximately 6 years post-diagnosis. ASCO-recommended surveillance (mammogram, clinical breast, and physical exam), other non-recommended tests (e.g. tumor markers, imaging scans), and patients' beliefs were compared by provider type using multivariate logistic regression. RESULTS No significant differences in patient self-report of physical exam or mammography prevalence by provider type was observed after adjustment for covariates. Receipt of surveillance tests not recommended by ASCO was higher among survivors who saw an oncologist (tumor marker tests: OR = 3.0, 95 % CI 1.5-5.8; and other blood tests: OR = 2.0, 95 % CI 1.1-3.5) as compared to those who routinely see a primary care physician. These observed differences persisted after adjustment for age, stage, lapse in insurance, education, or ethnicity. CONCLUSIONS Although overutilization of non-recommended tests was observed among women who saw an oncologist, the majority of breast cancer survivors received ASCO-recommended surveillance regardless of provider type. IMPLICATIONS FOR CANCER SURVIVORS Most breast cancer survivors receive recommended surveillance tests, whether their care is managed by a primary care physician or an oncologist, but some women receive unnecessary testing. Women should talk with their providers about tests recommended based on their past breast cancer diagnosis.
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Rosner B, Eliassen AH, Toriola AT, Hankinson SE, Willett WC, Natarajan L, Colditz GA. Short-term weight gain and breast cancer risk by hormone receptor classification among pre- and postmenopausal women. Breast Cancer Res Treat 2015; 150:643-53. [PMID: 25796612 PMCID: PMC4383816 DOI: 10.1007/s10549-015-3344-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 03/11/2015] [Indexed: 01/02/2023]
Abstract
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.
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Affiliation(s)
- Bernard Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA,
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Yao-Borengasser A, Monzavi-Karbassi B, Hedges RA, Rogers LJ, Kadlubar SA, Kieber-Emmons T. Adipocyte hypoxia promotes epithelial-mesenchymal transition-related gene expression and estrogen receptor-negative phenotype in breast cancer cells. Oncol Rep 2015; 33:2689-94. [PMID: 25823469 PMCID: PMC4431437 DOI: 10.3892/or.2015.3880] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/11/2015] [Indexed: 01/22/2023] Open
Abstract
The development of breast cancer is linked to the loss of estrogen receptor (ER) during the course of tumor progression, resulting in loss of responsiveness to hormonal treatment. The mechanisms underlying dynamic ERα gene expression change in breast cancer remain unclear. A range of physiological and biological changes, including increased adipose tissue hypoxia, accompanies obesity. Hypoxia in adipocytes can establish a pro-malignancy environment in breast tissues. Epidemiological studies have linked obesity with basal-like breast cancer risk and poor disease outcome, suggesting that obesity may affect the tumor phenotype by skewing the microenvironment toward support of more aggressive tumor phenotypes. In the present study, human SGBS adipocytes were co-cultured with ER-positive MCF7 cells for 24 h. After co-culture, HIF1α, TGF-β, and lectin-type oxidized LDL receptor 1 (LOX1) mRNA levels in the SGBS cells were increased. Expression levels of the epithelial-mesenchymal transition (EMT)-inducing transcription factors FOXC2 and TWIST1 were increased in the co-cultured MCF7 cells. In addition, the E-cadherin mRNA level was decreased, while the N-cadherin mRNA level was increased in the co-cultured MCF7 cells. ERα mRNA levels were significantly repressed in the co-cultured MCF7 cells. ERα gene expression in the MCF7 cells was decreased due to increased HIF1α in the SGBS cells. These results suggest that adipocytes can modify breast cancer cell ER gene expression through hypoxia and also can promote EMT processes in breast cancer cells, supporting an important role of obesity in aggressive breast cancer development.
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Affiliation(s)
- Aiwei Yao-Borengasser
- Division of Medical Genetics, College of Medicine, and Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Behjatolah Monzavi-Karbassi
- Department of Pathology, College of Medicine, and Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Rebecca A Hedges
- Division of Medical Genetics, College of Medicine, and Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Lora J Rogers
- Division of Medical Genetics, College of Medicine, and Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Susan A Kadlubar
- Division of Medical Genetics, College of Medicine, and Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Thomas Kieber-Emmons
- Department of Pathology, College of Medicine, and Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
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Slattery ML, Lundgreen A, John EM, Torres-Mejia G, Hines L, Giuliano AR, Baumgartner KB, Stern MC, Wolff RK. MAPK genes interact with diet and lifestyle factors to alter risk of breast cancer: the Breast Cancer Health Disparities Study. Nutr Cancer 2015; 67:292-304. [PMID: 25629224 DOI: 10.1080/01635581.2015.990568] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Mitogen-activated protein kinases (MAPK) are integration points for multiple biochemical signals. We evaluated 13 MAPK genes with breast cancer risk and determined if diet and lifestyle factors mediated risk. Data from 3 population-based case-control studies conducted in Southwestern United States, California, and Mexico included 4183 controls and 3592 cases. Percent Indigenous American (IA) ancestry was determined from 104 ancestry informative markers. The adaptive rank truncated product (ARTP) was used to determine the significance of each gene and the pathway with breast cancer risk, by menopausal status, genetic ancestry level, and estrogen receptor (ER)/progesterone receptor (PR) strata. MAP3K9 was associated with breast cancer overall (P(ARTP) = 0.02) with strongest association among women with the highest IA ancestry (P(ARTP) = 0.04). Several SNPs in MAP3K9 were associated with ER+/PR+ tumors and interacted with dietary oxidative balance score (DOBS), dietary folate, body mass index (BMI), alcohol consumption, cigarette smoking, and a history of diabetes. DUSP4 and MAPK8 interacted with calories to alter breast cancer risk; MAPK1 interacted with DOBS, dietary fiber, folate, and BMI; MAP3K2 interacted with dietary fat; and MAPK14 interacted with dietary folate and BMI. The patterns of association across diet and lifestyle factors with similar biological properties for the same SNPs within genes provide support for associations.
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Affiliation(s)
- Martha L Slattery
- a Department of Medicine , University of Utah , Salt Lake City , Utah , USA
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John EM, Sangaramoorthy M, Hines LM, Stern MC, Baumgartner KB, Giuliano AR, Wolff RK, Slattery ML. Body size throughout adult life influences postmenopausal breast cancer risk among hispanic women: the breast cancer health disparities study. Cancer Epidemiol Biomarkers Prev 2015; 24:128-37. [PMID: 25352523 PMCID: PMC4295775 DOI: 10.1158/1055-9965.epi-14-0560] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Few studies have assessed the association of body size with postmenopausal breast cancer risk in Hispanic women. Findings are inconsistent and appear to contradict those reported for non-Hispanic white (NHW) women. METHODS We pooled interview and anthropometric data for 2,023 Hispanic and 2,384 NHW women from two U.S. population-based case-control studies. Using logistic regression analysis, we examined associations of overall and abdominal adiposity with risk of postmenopausal breast cancer defined by estrogen receptor (ER) and progesterone receptor (PR) status. RESULTS Weight gain was associated with increased risk of ER(+)PR(+) breast cancer in Hispanics not currently using menopausal hormone therapy (HT), but only among those with a low young-adult body mass index (BMI). In the subset of Hispanics with data on genetic ancestry, the association with weight gain was limited to women with lower Indigenous American ancestry. Young-adult BMI was inversely associated with both ER(+)PR(+) and ER(-)PR(-) breast cancers for both ethnicities combined, with similar, although nonsignificant, inverse trends in Hispanics and NHWs. Among all Hispanics, regardless of HT use, height was associated with risk of ER(-)PR(-) breast cancer and hip circumference with risk of breast cancer overall. CONCLUSIONS Body size throughout adult life is associated with breast cancer risk among postmenopausal Hispanic women, as has been reported for NHW women. Associations were specific for breast cancer subtypes defined by hormone receptor status. IMPACT Avoiding weight gain and maintaining a healthy weight are important strategies to reduce the risk of postmenopausal ER(+)PR(+) breast cancer, the most common breast cancer subtype.
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Affiliation(s)
- Esther M John
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California.
| | | | - Lisa M Hines
- Department of Biology, University of Colorado at Colorado Springs, Colorado Springs, Colorado
| | - Mariana C Stern
- Department of Preventive Medicine, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Anna R Giuliano
- Moffitt Cancer Center, Cancer Prevention and Control, Tampa, Florida
| | - Roger K Wolff
- Department of Medicine, University of Utah, Salt Lake City, Utah
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John EM, Sangaramoorthy M, Hines LM, Stern MC, Baumgartner KB, Giuliano AR, Wolff RK, Slattery ML. Overall and abdominal adiposity and premenopausal breast cancer risk among hispanic women: the breast cancer health disparities study. Cancer Epidemiol Biomarkers Prev 2015; 24:138-47. [PMID: 25352526 PMCID: PMC4294975 DOI: 10.1158/1055-9965.epi-13-1007-t] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Few studies in Hispanic women have examined the relation between adult body size and risk of premenopausal breast cancer defined by hormone receptor status. METHODS The Breast Cancer Health Disparities Study pooled interview and anthropometric data from two large U.S. population-based case-control studies. We examined associations of overall and abdominal adiposity with risk of estrogen receptor- and progesterone receptor-positive (ER(+)PR(+)) and -negative (ER(-)PR(-)) breast cancer in Hispanic and non-Hispanic White (NHW) women, calculating ORs and 95% confidence intervals. RESULTS Among Hispanics, risk of ER(+)PR(+) breast cancer was inversely associated with measures of overall adiposity, including young-adult and current body mass index (BMI). Risk was substantially reduced among those with high (above the median) young-adult BMI and current overweight or obesity. The findings for overall adiposity were similar for Hispanics and NHWs. In the subset of Hispanics with data on genetic ancestry, inverse associations of current BMI, and weight gain with ER(+)PR(+) breast cancer were limited to those with lower Indigenous American ancestry. For ER(-)PR(-) breast cancer, height was associated with increased risk, and young-adult BMI was associated with reduced risk. For all breast cancers combined, positive associations were seen for waist circumference, waist-to-hip ratio, and waist-to-height ratio in Hispanic women only. CONCLUSIONS Our findings of body size associations with specific breast cancer subtypes among premenopausal Hispanic women were similar to those reported for NHW women. IMPACT Adiposity throughout the premenopausal years has a major influence on breast cancer risk in Hispanic women.
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Affiliation(s)
- Esther M John
- Cancer Prevention Institute of California, Fremont, California. Division of Epidemiology, Department of Health Research and Policy and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California.
| | | | - Lisa M Hines
- Department of Biology, University of Colorado at Colorado Springs, Colorado Springs, Colorado
| | - Mariana C Stern
- Department of Preventive Medicine, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Anna R Giuliano
- Moffitt Cancer Center, Cancer Prevention and Control, Tampa, Florida
| | - Roger K Wolff
- Department of Medicine, University of Utah, Salt Lake City, Utah
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Slattery ML, Lundgreen A, Torres-Mejia G, Wolff RK, Hines L, Baumgartner K, John EM. Diet and lifestyle factors modify immune/inflammation response genes to alter breast cancer risk and prognosis: the Breast Cancer Health Disparities Study. Mutat Res 2014; 770:19-28. [PMID: 25332681 PMCID: PMC4201121 DOI: 10.1016/j.mrfmmm.2014.08.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Tumor necrosis factor-α (TNF) and toll-like receptors (TLR) are important mediators of inflammation. We examined 10 of these genes with respect to breast cancer risk and mortality in a genetically admixed population of Hispanic/Native American (NA) (2111 cases, 2597 controls) and non-Hispanic white (NHW) (1481 cases, 1585 controls) women. Additionally, we explored if diet and lifestyle factors modified associations with these genes. Overall, these genes (collectively) were associated with breast cancer risk among women with >70% NA ancestry (P(ARTP) = 0.0008), with TLR1 rs7696175 being the primary risk contributor (OR 1.77, 95% CI 1.25, 2.51). Overall, TLR1 rs7696175 (HR 1.40, 95% CI 1.03, 1.91; P(adj) = 0.032), TLR4 rs5030728 (HR 1.96, 95% CI 1.30, 2.95; P(adj) = 0.014), and TNFRSF1A rs4149578 (HR 2.71, 95% CI 1.28, 5.76; P(adj) = 0.029) were associated with increased breast cancer mortality. We observed several statistically significant interactions after adjustment for multiple comparisons, including interactions between our dietary oxidative balance score and CD40LG and TNFSF1A; between cigarette smoking and TLR1, TLR4, and TNF; between body mass index (BMI) among pre-menopausal women and TRAF2; and between regular use of aspirin/non-steroidal anti-inflammatory drugs and TLR3 and TRA2. In conclusion, our findings support a contributing role of certain TNF-α and TLR genes in both breast cancer risk and survival, particularly among women with higher NA ancestry. Diet and lifestyle factors appear to be important mediators of the breast cancer risk associated with these genes.
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Affiliation(s)
- Martha L. Slattery
- University of Utah, Department of Medicine, 383 Colorow, Salt Lake City, UT 84108. 801-585-6955
| | - Abbie Lundgreen
- University of Utah, Department of Medicine, 383 Colorow, Salt Lake City, UT 84108. 801-585-6955
| | - Gabriela Torres-Mejia
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Av. Universidad No. 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca Morelos CP 62100, México
| | - Roger K. Wolff
- University of Utah, Department of Medicine, 383 Colorow, Salt Lake City, UT 84108. 801-585-6955
| | - Lisa Hines
- University of Colorado at Colorado Springs, Department of Biology, Colorado Springs, CO 80918
| | - Kathy Baumgartner
- Department of Epidemiology and Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY 40292
| | - Esther M. John
- Cancer Prevention Institute of California, Fremont, CA 94538, and Division of Epidemiology, Department of Health Research and Policy and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305
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Connor AE, Baumgartner RN, Baumgartner KB, Pinkston CM, Boone SD, John EM, Torres-Mejía G, Hines LM, Giuliano AR, Wolff RK, Slattery ML. Associations between ALOX, COX, and CRP polymorphisms and breast cancer among Hispanic and non-Hispanic white women: The breast cancer health disparities study. Mol Carcinog 2014; 54:1541-53. [PMID: 25339205 DOI: 10.1002/mc.22228] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/08/2014] [Accepted: 08/14/2014] [Indexed: 12/21/2022]
Abstract
Chronic inflammation is suggested to be associated with specific cancer sites, including breast cancer. Recent research has focused on the roles of genes involved in the leukotriene/lipoxygenase and prostaglandin/cyclooxygenase pathways in breast cancer etiology. We hypothesized that genes in ALOX/COX pathways and CRP polymorphisms would be associated with breast cancer risk and mortality in our sample of Hispanic/Native American (NA) (1430 cases, 1599 controls) and non-Hispanic white (NHW) (2093 cases, 2610 controls) women. A total of 104 Ancestral Informative Markers was used to distinguish European and NA ancestry. The adaptive rank truncated product (ARTP) method was used to determine the significance of associations for each gene and the inflammation pathway with breast cancer risk and by NA ancestry. Overall, the pathway was associated with breast cancer risk (PARTP = 0.01). Two-way interactions with NA ancestry (P(adj) < 0.05) were observed for ALOX12 (rs2292350, rs2271316) and PTGS1 (rs10306194). We observed increases in breast cancer risk in stratified analyses by tertiles of polyunsaturated fat intake for ALOX12 polymorphisms; the largest increase in risk was among women in the highest tertile with ALOX12 rs9904779CC (Odds Ratio (OR), 1.49; 95% Confidence Interval (CI) 1.14-1.94, P(adj) = 0.01). In a sub-analysis stratified by NSAIDs use, two-way interactions with NSAIDs use were found for ALOX12 rs9904779 (P(adj) = 0.02), rs434473 (P(adj ) = 0.02), and rs1126667 (P(adj) = 0.01); ORs for ALOX12 polymorphisms ranged from 1.55 to 1.64 among regular users. Associations were not observed with breast cancer mortality. These findings could support advances in the discovery of new pathways related to inflammation for breast cancer treatment.
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Affiliation(s)
- Avonne E Connor
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Richard N Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Christina M Pinkston
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Stephanie D Boone
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, California.,Division of Epidemiology, Department of Health Research and Policy, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Gabriela Torres-Mejía
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, Morelos, Mexico
| | - Lisa M Hines
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, Colorado
| | - Anna R Giuliano
- H. Lee Moffit Cancer Center & Research Institute, Tampa, Florida
| | - Roger K Wolff
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Martha L Slattery
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
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Slattery ML, Hines LH, Lundgreen A, Baumgartner KB, Wolff RK, Stern MC, John EM. Diet and lifestyle factors interact with MAPK genes to influence survival: the Breast Cancer Health Disparities Study. Cancer Causes Control 2014; 25:1211-25. [PMID: 24993294 PMCID: PMC4156917 DOI: 10.1007/s10552-014-0426-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/23/2014] [Indexed: 01/09/2023]
Abstract
INTRODUCTION MAPK genes are activated by a variety of factors related to growth factors, hormones, and environmental stress. METHODS We evaluated associations between 13 MAPK genes and survival among 1,187 nonHispanic White and 1,155 Hispanic/Native American (NA) women diagnosed with breast cancer. We assessed the influence of diet, lifestyle, and genetic ancestry on these associations. Percent NA ancestry was determined from 104 Ancestry Informative Markers. Adaptive rank truncation product (ARTP) was used to determine gene and pathway significance. RESULTS Associations were predominantly observed among women with lower NA ancestry. Specifically, the mitogen-activated protein kinases (MAPK) pathway was associated with all-cause mortality (P ARTP = 0.02), but not with breast cancer-specific mortality (P ARTP = 0.10). However, MAP2K1 and MAP3K9 were associated with both breast cancer-specific and all-cause mortality. MAPK12 (P ARTP = 0.05) was only associated with breast cancer-specific mortality, and MAP3K1 (P ARTP = 0.02) and MAPK1 (P ARTP = 0.05) were only associated with all-cause mortality. Among women with higher NA ancestry, MAP3K2 was significantly associated with all-cause mortality (P ARTP = 0.04). Several diet and lifestyle factors, including alcohol consumption, caloric intake, dietary folate, and cigarette smoking, significantly modified the associations with MAPK genes and all-cause mortality. CONCLUSIONS Our study supports an association between MAPK genes and survival after diagnosis with breast cancer, especially among women with low NA ancestry. The interaction between genetic variation in the MAPK pathway with diet and lifestyle factors for all women supports the important role of these factors for breast cancer survivorship.
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Affiliation(s)
- Martha L Slattery
- Department of Medicine, University of Utah, 383 Colorow, Salt Lake City, UT, 84108, USA,
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Associations between CYP19A1 polymorphisms, Native American ancestry, and breast cancer risk and mortality: the Breast Cancer Health Disparities Study. Cancer Causes Control 2014; 25:1461-71. [PMID: 25088806 DOI: 10.1007/s10552-014-0448-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 07/21/2014] [Indexed: 10/24/2022]
Abstract
The cytochrome p450 family 19 gene (CYP19A1) encodes for aromatase, which catalyzes the final step in estrogen biosynthesis and conversion of androgens to estrogens. Genetic variation in CYP19A1 is linked to higher circulating estrogen levels and increased aromatase expression. Using data from the Breast Cancer Health Disparities Study, a consortium of three population-based case-control studies in the United States (n = 3,030 non-Hispanic Whites; n = 2,893 Hispanic/Native Americans (H/NA) and Mexico (n = 1,810), we examined influence of 25 CYP19A1 tagging single-nucleotide polymorphisms (SNPs) on breast cancer risk and mortality, considering NA ancestry. Odds ratios (ORs) and 95 % confidence intervals (CIs) and hazard ratios estimated breast cancer risk and mortality. After multiple comparison adjustment, none of the SNPs were significantly associated with breast cancer risk or mortality. Two SNPs remained significantly associated with increased breast cancer risk in women of moderate to high NA ancestry (≥29 %): rs700518, ORGG 1.36, 95 % CI 1.11-1.67 and rs11856927, ORGG 1.35, 95 % CI 1.05-1.72. A significant interaction was observed for rs2470144 and menopausal status (p adj = 0.03); risk was increased in postmenopausal (ORAA 1.22, 95 % CI 1.05-1.14), but not premenopausal (ORAA 0.78, 95 % CI 0.64-0.95) women. The absence of an overall association with CYP19A1 and breast cancer risk is similar to previous literature. However, this analysis provides support that variation in CYP19A1 may influence breast cancer risk differently in women with moderate to high NA ancestry. Additional research is warranted to investigate the how variation in an estrogen-regulating gene contributes to racial/ethnic disparities in breast cancer.
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Slattery ML, Lundgreen A, Hines LM, Torres-Mejia G, Wolff RK, Stern MC, John EM. Genetic variation in the JAK/STAT/SOCS signaling pathway influences breast cancer-specific mortality through interaction with cigarette smoking and use of aspirin/NSAIDs: the Breast Cancer Health Disparities Study. Breast Cancer Res Treat 2014; 147:145-58. [PMID: 25104439 PMCID: PMC4167366 DOI: 10.1007/s10549-014-3071-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 07/19/2014] [Indexed: 11/26/2022]
Abstract
The Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signaling pathway is involved in immune function and cell growth; genetic variation in this pathway could influence breast cancer risk. We examined 12 genes in the JAK/STAT/SOCS signaling pathway with breast cancer risk and mortality in an admixed population of Hispanic (2,111 cases, 2,597 controls) and non-Hispanic white (1,481 cases, 1,585 controls) women. Associations were assessed by Indigenous American (IA) ancestry. After adjustment for multiple comparisons, JAK1 (three of ten SNPs) and JAK2 (4 of 11 SNPs) interacted with body mass index (BMI) among pre-menopausal women, while STAT3 (four of five SNPs) interacted significantly with BMI among post-menopausal women to alter breast cancer risk. STAT6 rs3024979 and TYK2 rs280519 altered breast cancer-specific mortality among all women. Associations with breast cancer-specific mortality differed by IA ancestry; SOCS1 rs193779, STAT3 rs1026916, and STAT4 rs11685878 associations were limited to women with low IA ancestry, and associations with JAK1 rs2780890, rs2254002, and rs310245 and STAT1 rs11887698 were observed among women with high IA ancestry. JAK2 (5 of 11 SNPs), SOCS2 (one of three SNPs), and STAT4 (2 of 20 SNPs) interacted with cigarette smoking status to alter breast cancer-specific mortality. SOCS2 (one of three SNPs) and all STAT3, STAT5A, and STAT5B SNPs significantly interacted with use of aspirin/NSAIDs to alter breast cancer-specific mortality. Genetic variation in the JAK/STAT/SOCS pathway was associated with breast cancer-specific mortality. The proportion of SNPs within a gene that significantly interacted with lifestyle factors lends support for the observed associations.
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Affiliation(s)
- Martha L. Slattery
- University of Utah, Department of Medicine, 383 Colorow, Salt Lake City, UT 84108
| | - Abbie Lundgreen
- University of Utah, Department of Medicine, 383 Colorow, Salt Lake City, UT 84108
| | - Lisa M. Hines
- University of Colorado at Colorado Springs, Department of Biology, Colorado Springs, CO 80918
| | - Gabriela Torres-Mejia
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Av. Universidad No. 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca Morelos CP 62100
| | - Roger K. Wolff
- University of Utah, Department of Medicine, 383 Colorow, Salt Lake City, UT 84108
| | - Mariana C. Stern
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90089
| | - Esther M. John
- Cancer Prevention Institute of California, Fremont, CA 94538, and Division of Epidemiology, Department of Health Research and Policy and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305
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Slattery ML, Herrick JS, Torres-Mejia G, John EM, Giuliano AR, Hines LM, Stern MC, Baumgartner KB, Presson AP, Wolff RK. Genetic variants in interleukin genes are associated with breast cancer risk and survival in a genetically admixed population: the Breast Cancer Health Disparities Study. Carcinogenesis 2014; 35:1750-9. [PMID: 24670917 DOI: 10.1093/carcin/bgu078] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Interleukins (ILs) are key regulators of immune response. Genetic variation in IL genes may influence breast cancer risk and mortality given their role in cell growth, angiogenesis and regulation of inflammatory process. We examined 16 IL genes with breast cancer risk and mortality in an admixed population of Hispanic/Native American (NA) (2111 cases and 2597 controls) and non-Hispanic white (NHW) (1481 cases and 1585 controls) women. Adaptive Rank Truncated Product (ARTP) analysis was conducted to determine gene significance and lasso (least absolute shrinkage and selection operator) was used to identify potential gene by gene and gene by lifestyle interactions. The pathway was statistically significant for breast cancer risk overall (P ARTP = 0.0006), for women with low NA ancestry (P(ARTP) = 0.01), for premenopausal women (P(ARTP) = 0.02), for estrogen receptor (ER)+/progesterone receptor (PR)+ tumors (P(ARTP) = 0.03) and ER-/PR- tumors (P(ARTP) = 0.02). Eight of the 16 genes evaluated were associated with breast cancer risk (IL1A, IL1B, IL1RN, IL2, IL2RA, IL4, IL6 and IL10); four genes were associated with breast cancer risk among women with low NA ancestry (IL1B, IL6, IL6R and IL10), two were associated with breast cancer risk among women with high NA ancestry (IL2 and IL2RA) and four genes were associated with premenopausal breast cancer risk (IL1A, IL1B, IL2 and IL3). IL4, IL6R, IL8 and IL17A were associated with breast cancer-specific mortality. We confirmed associations with several functional polymorphisms previously associated with breast cancer risk and provide support that their combined effect influences the carcinogenic process.
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Affiliation(s)
- Martha L Slattery
- Department of Medicine, University of Utah, 383 Colorow, Salt Lake City, UT 84108, USA, Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Av. Universidad No. 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca Morelos CP 62100, México, Cancer Prevention Institute of California, Fremont, CA 84108, USA, Division of Epidemiology, Department of Health Research and Policy and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 62508, USA, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA, Department of Biology, University of Colorado at Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, USA, Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90089, USA and Department of Epidemiology and Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY 90089-9031, USA
| | - Jennifer S Herrick
- Department of Medicine, University of Utah, 383 Colorow, Salt Lake City, UT 84108, USA, Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Av. Universidad No. 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca Morelos CP 62100, México, Cancer Prevention Institute of California, Fremont, CA 84108, USA, Division of Epidemiology, Department of Health Research and Policy and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 62508, USA, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA, Department of Biology, University of Colorado at Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, USA, Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90089, USA and Department of Epidemiology and Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY 90089-9031, USA
| | - Gabriella Torres-Mejia
- Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Av. Universidad No. 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca Morelos CP 62100, México
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA 84108, USA, Division of Epidemiology, Department of Health Research and Policy and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 62508, USA
| | - Anna R Giuliano
- Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Lisa M Hines
- Department of Biology, University of Colorado at Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, USA
| | - Mariana C Stern
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90089, USA and
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY 90089-9031, USA
| | - Angela P Presson
- Department of Medicine, University of Utah, 383 Colorow, Salt Lake City, UT 84108, USA, Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Av. Universidad No. 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca Morelos CP 62100, México, Cancer Prevention Institute of California, Fremont, CA 84108, USA, Division of Epidemiology, Department of Health Research and Policy and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 62508, USA, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA, Department of Biology, University of Colorado at Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, USA, Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90089, USA and Department of Epidemiology and Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY 90089-9031, USA
| | - Roger K Wolff
- Department of Medicine, University of Utah, 383 Colorow, Salt Lake City, UT 84108, USA, Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Av. Universidad No. 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca Morelos CP 62100, México, Cancer Prevention Institute of California, Fremont, CA 84108, USA, Division of Epidemiology, Department of Health Research and Policy and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 62508, USA, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA, Department of Biology, University of Colorado at Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, USA, Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90089, USA and Department of Epidemiology and Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY 90089-9031, USA
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