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Pedersen DC, Aarestrup J, Blond K, Jensen BW, Andersen ZJ, Mellemkjær L, Tjønneland A, Baker JL. Trajectories of body mass index across the lifecourse and associations with post-menopausal breast cancer by estrogen receptor status. Cancer Epidemiol 2023; 87:102479. [PMID: 37897969 DOI: 10.1016/j.canep.2023.102479] [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: 06/14/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Associations between a high body mass index (BMI) at single timepoints during child- and adulthood and risks of post-menopausal breast cancer are well-established, but associations with BMI across the lifecourse remains largely unknown. Therefore, we examined whether lifecourse BMI trajectories were associated with risks of post-menopausal breast cancer overall and by estrogen receptor (ER) status. METHODS We included 6698 Danish women born 1930-1946. Information on BMI at ages 6-15 years came from the Copenhagen School Health Records Register, and information on BMI at ages 20, 30, 40, 50 and/or 50-64 years came from the Diet, Cancer and Health cohort. Breast cancer cases (n = 577) were identified in the Danish Breast Cancer Cooperative Group database. Six BMI trajectories were identified using latent class trajectory modelling. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression models. RESULTS Compared to women with a trajectory characterized by an average BMI gain across life, women with the two trajectories with steep increases in BMI during childhood and adolescence that thereafter largely stabilized, had lower risks of post-menopausal breast cancer and ER-positive tumors. The adjusted HRs for ER-positive tumors were 0.67 (95% CI: 0.47-0.95) and 0.68 (95% CI: 0.46-1.01), respectively. In contrast, women with a trajectory with a low gain in BMI during childhood and adolescence followed by a subsequent steep increase during adulthood, had higher risks of post-menopausal breast cancer and ER-positive tumors when compared to women with an average BMI gain. The adjusted HR for ER-positive tumors was 1.28 (95% CI: 0.98-1.67). CONCLUSIONS Our findings suggest that the timing of excess gain in BMI across the lifecourse impacts subsequent post-menopausal breast cancer risks. Thus, the BMI development across life is likely useful in the identification of women at increased risks of post-menopausal breast cancer.
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Affiliation(s)
- Dorthe C Pedersen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Julie Aarestrup
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Kim Blond
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Britt W Jensen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Denmark
| | | | - Anne Tjønneland
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Denmark; Danish Cancer Institute, Copenhagen, Denmark
| | - Jennifer L Baker
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
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2
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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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3
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Leyden GM, Greenwood MP, Gaborieau V, Han Y, Amos CI, Brennan P, Murphy D, Davey Smith G, Richardson TG. Disentangling the aetiological pathways between body mass index and site-specific cancer risk using tissue-partitioned Mendelian randomisation. Br J Cancer 2023; 128:618-625. [PMID: 36434155 PMCID: PMC9938133 DOI: 10.1038/s41416-022-02060-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Body mass index (BMI) is known to influence the risk of various site-specific cancers, however, dissecting which subcomponents of this heterogenous risk factor are predominantly responsible for driving disease effects has proven difficult to establish. We have leveraged tissue-specific gene expression to separate the effects of distinct phenotypes underlying BMI on the risk of seven site-specific cancers. METHODS SNP-exposure estimates were weighted in a multivariable Mendelian randomisation analysis by their evidence for colocalization with subcutaneous adipose- and brain-tissue-derived gene expression using a recently developed methodology. RESULTS Our results provide evidence that brain-tissue-derived BMI variants are predominantly responsible for driving the genetically predicted effect of BMI on lung cancer (OR: 1.17; 95% CI: 1.01-1.36; P = 0.03). Similar findings were identified when analysing cigarettes per day as an outcome (Beta = 0.44; 95% CI: 0.26-0.61; P = 1.62 × 10-6), highlighting a possible shared aetiology or mediator effect between brain-tissue BMI, smoking and lung cancer. Our results additionally suggest that adipose-tissue-derived BMI variants may predominantly drive the effect of BMI and increased risk for endometrial cancer (OR: 1.71; 95% CI: 1.07-2.74; P = 0.02), highlighting a putatively important role in the aetiology of endometrial cancer. CONCLUSIONS The study provides valuable insight into the divergent underlying pathways between BMI and the risk of site-specific cancers.
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Affiliation(s)
- Genevieve M Leyden
- MRC Integrative Epidemiology Unit, Bristol Population Health Science Institute, University of Bristol, Bristol, BS8 2BN, UK.
- Bristol Medical School: Translational Health Sciences, Dorothy Hodgkin Building, University of Bristol, Bristol, BS1 3NY, UK.
| | - Michael P Greenwood
- Bristol Medical School: Translational Health Sciences, Dorothy Hodgkin Building, University of Bristol, Bristol, BS1 3NY, UK
| | - Valérie Gaborieau
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Younghun Han
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Christopher I Amos
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Paul Brennan
- Bristol Medical School: Translational Health Sciences, Dorothy Hodgkin Building, University of Bristol, Bristol, BS1 3NY, UK
| | - David Murphy
- Bristol Medical School: Translational Health Sciences, Dorothy Hodgkin Building, University of Bristol, Bristol, BS1 3NY, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, Bristol Population Health Science Institute, University of Bristol, Bristol, BS8 2BN, UK
| | - Tom G Richardson
- MRC Integrative Epidemiology Unit, Bristol Population Health Science Institute, University of Bristol, Bristol, BS8 2BN, UK.
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4
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Dorgan JF, Baer HJ, Bertrand KA, LeBlanc ES, Jung S, Magder LS, Snetselaar LG, Stevens VJ, Zhang Y, Van Horn L. Childhood adiposity, serum metabolites and breast density in young women. Breast Cancer Res 2022; 24:91. [PMID: 36536390 PMCID: PMC9764542 DOI: 10.1186/s13058-022-01588-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Childhood adiposity is inversely associated with young adult percent dense breast volume (%DBV) and absolute dense breast volume (ADBV), which could contribute to its protective effect for breast cancer later in life. The objective of this study was to identify metabolites in childhood serum that may mediate the inverse association between childhood adiposity and young adult breast density. METHODS Longitudinal data from 182 female participants in the Dietary Intervention Study in Children (DISC) and the DISC 2006 (DISC06) Follow-Up Study were analyzed. Childhood adiposity was assessed by anthropometry at the DISC visit with serum available that occurred closest to menarche and expressed as a body mass index (BMI) z-score. Serum metabolites were measured by untargeted metabolomics using ultra-high-performance liquid chromatography-tandem mass spectrometry. %DBV and ADBV were measured by magnetic resonance imaging at the DISC06 visit when participants were 25-29 years old. Robust mixed effects linear regression was used to identify serum metabolites associated with childhood BMI z-scores and breast density, and the R package mediation was used to quantify mediation. RESULTS Of the 115 metabolites associated with BMI z-scores (FDR < 0.20), 4 were significantly associated with %DBV and 6 with ADBV before, though not after, adjustment for multiple comparisons. Mediation analysis identified 2 unnamed metabolites, X-16576 and X-24588, as potential mediators of the inverse association between childhood adiposity and dense breast volume. X-16576 mediated 14% (95% confidence interval (CI) = 0.002, 0.46; P = 0.04) of the association of childhood adiposity with %DBV and 11% (95% CI = 0.01, 0.26; P = 0.02) of its association with ADBV. X-24588 also mediated 7% (95% CI = 0.001, 0.18; P = 0.05) of the association of childhood adiposity with ADBV. None of the other metabolites examined contributed to mediation of the childhood adiposity-%DBV association, though there was some support for contributions of lysine, valine and 7-methylguanine to mediation of the inverse association of childhood adiposity with ADBV. CONCLUSIONS Additional large longitudinal studies are needed to identify metabolites and other biomarkers that mediate the inverse association of childhood adiposity with breast density and possibly breast cancer risk.
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Affiliation(s)
- Joanne F Dorgan
- Division of Cancer Epidemiology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood St., Howard Hall, Room 102E, Baltimore, MD, 21201, USA.
| | - Heather J Baer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Department of Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Kimberly A Bertrand
- Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Erin S LeBlanc
- Kaiser Permanente Center for Health Research, Portland, OR, 97227, USA
| | - Seungyoun Jung
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, South Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, South Korea
| | - Laurence S Magder
- Division of Cancer Epidemiology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood St., Howard Hall, Room 102E, Baltimore, MD, 21201, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, 21201, USA
| | - Linda G Snetselaar
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, 52242, USA
| | - Victor J Stevens
- Kaiser Permanente Center for Health Research, Portland, OR, 97227, USA
| | - Yuji Zhang
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, 21201, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
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5
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Pedersen DC, Jensen BW, Tjønneland A, Andersen ZJ, Mellemkjaer L, Bjerregaard LG, Aarestrup J, Baker JL. Birthweight, childhood body size, and timing of puberty and risks of breast cancer by menopausal status and tumor receptor subtypes. Breast Cancer Res 2022; 24:77. [DOI: 10.1186/s13058-022-01578-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 10/23/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Associations of birthweight, childhood body size and pubertal timing with breast cancer risks by menopausal status and tumor receptor subtypes are inconclusive. Thus, we investigated these associations in a population-based cohort of Danish women.
Methods
We studied 162,419 women born between 1930 and 1996 from the Copenhagen School Health Records Register. The register includes information on birthweight, measured childhood weights and heights at the age of 7–13 years, and computed ages at the onset of the growth spurt (OGS) and at peak height velocity (PHV). The Danish Breast Cancer Cooperative Group database provided information on breast cancer (n = 7510), including estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2) and menopausal status. Hormone replacement therapy use came from the Danish National Prescription Registry. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regression.
Results
We found that birthweight was not associated with any breast cancer subtypes. While childhood BMI was not statistically significantly associated with ER+ tumors nor consistently with ER− tumors among pre-menopausal women, consistent inverse associations were found among postmenopausal women. At the age of 7 years, the HRs for postmenopausal ER+ and ER− tumors were 0.90 (95% CI 0.87–0.93) and 0.84 (95% CI 0.79–0.91) per BMI z-score, respectively. Similarly, childhood BMI was inversely associated with pre- and postmenopausal HER2− tumors, but not with HER2+ tumors. Childhood height was positively associated with both pre- and postmenopausal ER+ tumors, but not with ER− tumors. At the age of 7 years, the HRs for postmenopausal ER+ and ER− tumors were 1.09 (95% CI 1.06–1.12) and 1.02 (95% CI 0.96–1.09) per height z-score, respectively. In general, childhood height was positively associated with HER2+ and HER2− tumors among pre- and postmenopausal women. Ages at OGS and PHV were not associated with any breast cancer subtypes.
Conclusions
We showed that a high BMI and short stature in childhood are associated with reduced risks of certain breast cancer subtypes. Thus, childhood body composition may play a role in the development of breast cancer.
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6
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Pubertal mammary gland development is a key determinant of adult mammographic density. Semin Cell Dev Biol 2020; 114:143-158. [PMID: 33309487 DOI: 10.1016/j.semcdb.2020.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/25/2020] [Accepted: 11/28/2020] [Indexed: 01/04/2023]
Abstract
Mammographic density refers to the radiological appearance of fibroglandular and adipose tissue on a mammogram of the breast. Women with relatively high mammographic density for their age and body mass index are at significantly higher risk for breast cancer. The association between mammographic density and breast cancer risk is well-established, however the molecular and cellular events that lead to the development of high mammographic density are yet to be elucidated. Puberty is a critical time for breast development, where endocrine and paracrine signalling drive development of the mammary gland epithelium, stroma, and adipose tissue. As the relative abundance of these cell types determines the radiological appearance of the adult breast, puberty should be considered as a key developmental stage in the establishment of mammographic density. Epidemiological studies have pointed to the significance of pubertal adipose tissue deposition, as well as timing of menarche and thelarche, on adult mammographic density and breast cancer risk. Activation of hypothalamic-pituitary axes during puberty combined with genetic and epigenetic molecular determinants, together with stromal fibroblasts, extracellular matrix, and immune signalling factors in the mammary gland, act in concert to drive breast development and the relative abundance of different cell types in the adult breast. Here, we discuss the key cellular and molecular mechanisms through which pubertal mammary gland development may affect adult mammographic density and cancer risk.
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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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Khalis M, Dossus L, Rinaldi S, Biessy C, Moskal A, Charaka H, Fort E, His M, Mellas N, Nejjari C, Charbotel B, Soliman AS, Romieu I, Chajès V, Gunter MJ, Huybrechts I, El Rhazi K. Body size, silhouette trajectory and the risk of breast cancer in a Moroccan case-control study. Breast Cancer 2020; 27:748-758. [PMID: 32144737 DOI: 10.1007/s12282-020-01072-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/25/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is convincing evidence demonstrating that body size characteristics such as adiposity and height are associated with breast cancer in westernized countries. However, little is known about this relationship in North African countries currently undergoing nutritional transition and industrialization. The aim of this study was to explore associations between various body size characteristics, silhouette trajectories and the risk of breast cancer among Moroccan women. METHODS In this case-control study conducted in the Fez region (2016-2017), detailed measures of body size were collected for 300 cases of breast cancer and 300 matched controls. Unconditional logistic regression was used to assess the association between body size and breast cancer risk adjusting for confounding factors. RESULTS Higher waist circumference and hip circumference were positively associated with breast cancer risk in pre- (highest [T3] vs. lowest tertile [T1]: OR = 2.92, 95% confidence intervals [CI]: 1.33-6.42; OR = 3.00, 95% CI: 1.42-6.33, respectively) and post-menopausal women (T3 vs. T1: OR = 4.46, 95% CI: 1.86-10.66; OR = 4.08, 95% CI: 1.76-9.42, respectively). Body shape at younger ages (6-11 years) was inversely associated with the risk of breast cancer in premenopausal women (large vs. lean silhouette: OR = 0.31, 95% CI: 0.12-0.80). Women with the greatest increase in body shape trajectory had higher risk for both pre- and post-menopausal breast cancer (T3 vs. T1: OR = 2.74, 95% CI: 1.03-7.26; OR = 3.56, 95% CI: 1.34-9.44, respectively). CONCLUSION Our findings suggest that adiposity, body shape at younger ages, and silhouette trajectory may play a role in the development of pre- and post-menopausal breast cancer among Moroccan women. Larger-scale prospective studies are needed to confirm our findings and to explore these associations with breast cancer subtypes.
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Affiliation(s)
- Mohamed Khalis
- School of Public Health, Mohammed VI University of Health Sciences, Anfa City : Bld Mohammed Taïeb Naciri, Hay Hassani, 82 403, Casablanca, Morocco.
- UCBL, Ifsttar, UMRESTTE, University of Lyon, Lyon, France.
| | - Laure Dossus
- Nutrition and Metabolism Section, International Agency for Research On Cancer, Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Section, International Agency for Research On Cancer, Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Section, International Agency for Research On Cancer, Lyon, France
| | - Aurélie Moskal
- Nutrition and Metabolism Section, International Agency for Research On Cancer, Lyon, France
| | - Hafida Charaka
- Department of Research and Development, Hassan II University Hospital of Fez, Fez, Morocco
| | - Emmanuel Fort
- UCBL, Ifsttar, UMRESTTE, University of Lyon, Lyon, France
| | - Mathilde His
- Nutrition and Metabolism Section, International Agency for Research On Cancer, Lyon, France
| | - Nawfel Mellas
- Department of Oncology, Hassan II University Hospital of Fez, Fez, Morocco
| | - Chakib Nejjari
- School of Public Health, Mohammed VI University of Health Sciences, Anfa City : Bld Mohammed Taïeb Naciri, Hay Hassani, 82 403, Casablanca, Morocco
| | | | - Amr S Soliman
- Department of Community Health and Social Medicine, School of Medicine, City University of New York, New York, USA
| | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research On Cancer, Lyon, France
| | - Véronique Chajès
- Nutrition and Metabolism Section, International Agency for Research On Cancer, Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Section, International Agency for Research On Cancer, Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research On Cancer, Lyon, France
| | - Karima El Rhazi
- Department of Epidemiology, Faculty of Medicine and Pharmacy, Fez, Morocco
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9
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Nodler JL, Harris HR, Chavarro JE, Frazier AL, Missmer SA. Dairy consumption during adolescence and endometriosis risk. Am J Obstet Gynecol 2020; 222:257.e1-257.e16. [PMID: 31526789 DOI: 10.1016/j.ajog.2019.09.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/09/2019] [Accepted: 09/09/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Modifiable risk factors such as diet may be important in both the etiology and progression of endometriosis as well as the prevalence of pain symptoms and infertility associated with this condition. In adults, higher intake of dairy has been associated with a lower risk of endometriosis diagnosis. There is currently no literature on whether dairy intake during adolescence, a potentially critical window of exposure, influences endometriosis risk. OBJECTIVE The objectige of the study was to evaluate the association between consumption of dairy foods in adolescence and the risk of laparoscopically confirmed endometriosis. STUDY DESIGN This was a prospective cohort study, the Nurses' Health Study II, which has prospectively collected data since 1989. In 1998, when participants were aged 34-51 years, they completed a 124 item food frequency questionnaire about their high school diet. Cases were defined as those who self-reported laparoscopically confirmed endometriosis. Cox proportional hazard models were used to calculate hazard ratios and 95% confidence intervals for the association between dairy foods and laparoscopically confirmed endometriosis. RESULTS Among women who completed the questionnaire about their high school diet in 1998, 581 cases of laparoscopically confirmed endometriosis were diagnosed among 32,868 premenopausal women from 1998 to 2013. Women who consumed more than 4 servings per day of dairy foods during adolescence had a 32% lower risk of laparoscopically confirmed endometriosis during adulthood (95% confidence interval, 0.47-0.96; Ptrend = .04) compared with women consuming 1 or fewer servings per day. The association was similar for low-fat and high-fat dairy foods. Yogurt and ice cream consumption, specifically, were associated with a lower risk of endometriosis. Those who consumed 2 or more servings of yogurt per week as an adolescent had a 29% lower risk of endometriosis diagnosis (95% confidence interval, 0.52-0.97; Ptrend = .02) compared with those consuming less than 1 serving per week. In addition, women who consumed 1 or more servings per day of ice cream per day during adolescence had a 38% lower risk of endometriosis diagnosis (95% confidence interval, 0.40-0.94; Ptrend = .20) compared with those consuming less than 1 serving per week. CONCLUSION Our findings suggest that dairy consumption, specifically yogurt and ice cream intake, in adolescence may reduce the risk of subsequent endometriosis diagnosis. Future studies in adolescent populations are needed to confirm these results.
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Affiliation(s)
- James L Nodler
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Houston IVF, Houston, TX
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA.
| | - Jorge E Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - A Lindsay Frazier
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Dana-Farber Children's Cancer Care, Boston, MA
| | - Stacey A Missmer
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA; Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA; Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI
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High maternal milk intake in the postnatal life reduces the incidence of breast cancer during adulthood in rats. J Dev Orig Health Dis 2019; 10:479-487. [DOI: 10.1017/s2040174418001071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractEnvironmental factors during perinatal life can lead to changes in the mammary gland, making it susceptible to cancer in adulthood. Breastfeeding has a special importance since it takes place at a critical period of growth and development of the newborn. We aimed to analyze if an appropriate lactation protects the offspring against mammary carcinogenesis during adult life and explore the mechanisms involved in the protective effect. One-day-old Sprague-Dawley female rats were randomly distributed in litters of three (L3), eight (L8) or 12 (L12) pups per dam, to induce a differential consumption of breast milk. At 55 days of age, the animals were treated with a single dose of dimethylbenzanthracene to study tumor latency, incidence and progression. Histological, immunohistochemical and Western blot studies were performed. We observed lower incidence and higher latency in L3 compared to the other groups. The mitotic index and expression of proliferating cell nuclear antigen (PCNA) was significantly augmented in tumors of L12 rats compared to L3 and L8, while the apoptotic index was augmented in tumors of L3 v. L12. Cleaved caspase 8 was significantly higher in tumors from L3 compared to L12. Tumors developed in L3 have a greater number of apoptotic bodies and a greater expression of caspase 8. These results demonstrate that the animals that maintained a higher intake of maternal milk (L3) presented lower incidence and greater tumor latency. Lower consumption of breast milk (L12) would increase tumor mitosis and the expression of PCNA, explaining the higher tumor incidence observed in this group.
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Hopper JL, Dite GS, MacInnis RJ, Liao Y, Zeinomar N, Knight JA, Southey MC, Milne RL, Chung WK, Giles GG, Genkinger JM, McLachlan SA, Friedlander ML, Antoniou AC, Weideman PC, Glendon G, Nesci S, Andrulis IL, Buys SS, Daly MB, John EM, Phillips KA, Terry MB. Age-specific breast cancer risk by body mass index and familial risk: prospective family study cohort (ProF-SC). Breast Cancer Res 2018; 20:132. [PMID: 30390716 PMCID: PMC6215632 DOI: 10.1186/s13058-018-1056-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 10/02/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The association between body mass index (BMI) and risk of breast cancer depends on time of life, but it is unknown whether this association depends on a woman's familial risk. METHODS We conducted a prospective study of a cohort enriched for familial risk consisting of 16,035 women from 6701 families in the Breast Cancer Family Registry and the Kathleen Cunningham Foundation Consortium for Research into Familial Breast Cancer followed for up to 20 years (mean 10.5 years). There were 896 incident breast cancers (mean age at diagnosis 55.7 years). We used Cox regression to model BMI risk associations as a function of menopausal status, age, and underlying familial risk based on pedigree data using the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA), all measured at baseline. RESULTS The strength and direction of the BMI risk association depended on baseline menopausal status (P < 0.001); after adjusting for menopausal status, the association did not depend on age at baseline (P = 0.6). In terms of absolute risk, the negative association with BMI for premenopausal women has a much smaller influence than the positive association with BMI for postmenopausal women. Women at higher familial risk have a much larger difference in absolute risk depending on their BMI than women at lower familial risk. CONCLUSIONS The greater a woman's familial risk, the greater the influence of BMI on her absolute postmenopausal breast cancer risk. Given that age-adjusted BMI is correlated across adulthood, maintaining a healthy weight throughout adult life is particularly important for women with a family history of breast cancer.
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Affiliation(s)
- John L. Hopper
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
| | - Gillian S. Dite
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
| | - Robert J. MacInnis
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC Australia
| | - Yuyan Liao
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 7th Floor, New York, NY USA
| | - Nur Zeinomar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 7th Floor, New York, NY USA
| | - Julia A. Knight
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Melissa C. Southey
- Department of Pathology, Genetic Epidemiology Laboratory, The University of Melbourne, Parkville, VIC Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, CA VIC 3168 USA
| | - Roger L. Milne
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC Australia
| | - Wendy K. Chung
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY USA
- Departments of Pediatrics and Medicine, Columbia University, New York, NY USA
| | - Graham G. Giles
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC Australia
| | - Jeanine M. Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 7th Floor, New York, NY USA
| | - Sue-Anne McLachlan
- Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Parkville, VIC Australia
- Department of Medical Oncology, St Vincent’s Hospital, Fitzroy, VIC Australia
| | - Michael L. Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW Australia
- Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW Australia
| | - Antonis C. Antoniou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Prue C. Weideman
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
| | - Gord Glendon
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON Canada
| | - Stephanie Nesci
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - kConFab Investigators
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
- The Research Department, The Peter MacCallum Cancer Centre, Melbourne, VIC Australia
| | - Irene L. Andrulis
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON Canada
- Departments of Molecular Genetics and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Saundra S. Buys
- Department of Medicine and Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, UT USA
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA USA
| | - Esther M. John
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
| | - Kelly Anne Phillips
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Parkville, VIC Australia
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC Australia
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 7th Floor, New York, NY USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY USA
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Childhood body size and midlife mammographic breast density in foreign-born and U.S.-born women in New York City. Ann Epidemiol 2018; 28:710-716. [PMID: 30172558 DOI: 10.1016/j.annepidem.2018.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/26/2018] [Accepted: 08/02/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE We investigated whether childhood body size is associated with midlife mammographic density, a strong risk factor for breast cancer. METHODS We collected interview data, including body size at age 10 years using a pictogram, and measured height and weight from 518 women, recruited at the time of screening mammography in New York City (ages 40-64 years, 71% Hispanic, 68% foreign-born). We used linear regression models to examine childhood body size in relation to percent density and areas of dense and nondense tissue, measured using a computer-assisted method from digital mammograms. RESULTS In models that adjusted for race/ethnicity, and age and body mass index at mammogram, the heaviest relative to leanest childhood body size was associated with 5.94% lower percent density (95% confidence interval [CI]: -9.20, -2.29), 7.69 cm2 smaller dense area (95% CI: -13.94, -0.63), and 26.17 cm2 larger nondense area (95% CI: 9.42, 43.58). In stratified analysis by menopausal status and nativity, the observed associations were stronger for postmenopausal and U.S.-born women although these differences did not reach statistical significance. CONCLUSIONS Heavy childhood body size is associated with lower mammographic density, consistent with its associations with breast cancer risk. Suggestive findings by nativity require confirmation in larger samples.
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Associations between childhood body size and seventeen adverse outcomes: analysis of 65,057 European women. Sci Rep 2017; 7:16917. [PMID: 29208999 PMCID: PMC5717076 DOI: 10.1038/s41598-017-17258-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 11/20/2017] [Indexed: 01/24/2023] Open
Abstract
Large childhood body size has been consistently shown to be associated with decreased breast cancer risk. However, it is important to consider the effects of a large childhood body size on other adult diseases. It is not clear if the associations between childhood body size and adult diseases will persist if they later attain healthy weight. The associations between body size at age 7 and 17 adverse outcomes in adulthood were examined using Cox models in a Swedish study of 65,057 women. Large body size at age 7, when compared to small body size, was associated with decreased risk for breast cancer (HR [95% CI]: 0.81 [0.70–0.93]) and increased risks for anorexia (2.13 [1.63–2.77]) and bulimia (1.91 [1.35–2.70]). Neither adjusting for adult BMI nor restricting the dataset to lean adults (BMI < 25 kg/m2) attenuated the associations. While large body size at age 7 by itself was positively associated with increased risks of diabetes (1.34 [1.16–1.55]), PCOS (1.69 [1.13–2.51]) and hypertension (before age 60), the associations were no longer significant after controlling for adult BMI. No clear associations were found with the remaining adverse outcomes (cervical, uterine, melanoma, colon cancer, depression, ovarian cyst, stroke, hyperlipidemia, heart failure, myocardial infarction, and angina pectoris).
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Affiliation(s)
- Mary Beth Terry
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 1611, New York, NY, 10032, USA. .,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
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