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000141707 0247_ $$2doi$$a10.1001/jamaoncol.2018.1771
000141707 0247_ $$2pmid$$apmid:29931120
000141707 0247_ $$2ISSN$$a2374-2437
000141707 0247_ $$2ISSN$$a2374-2445
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000141707 037__ $$aDKFZ-2018-01978
000141707 041__ $$aeng
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000141707 1001_ $$aGroup, Premenopausal Breast Cancer Collaborative$$b0$$eCollaboration Author
000141707 245__ $$aAssociation of Body Mass Index and Age With Subsequent Breast Cancer Risk in Premenopausal Women.
000141707 260__ $$aChicago, Ill.$$bAmerican Medical Association$$c2018
000141707 3367_ $$2DRIVER$$aarticle
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000141707 520__ $$aThe association between increasing body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and risk of breast cancer is unique in cancer epidemiology in that a crossover effect exists, with risk reduction before and risk increase after menopause. The inverse association with premenopausal breast cancer risk is poorly characterized but might be important in the understanding of breast cancer causation.To investigate the association of BMI with premenopausal breast cancer risk, in particular by age at BMI, attained age, risk factors for breast cancer, and tumor characteristics.This multicenter analysis used pooled individual-level data from 758 592 premenopausal women from 19 prospective cohorts to estimate hazard ratios (HRs) of premenopausal breast cancer in association with BMI from ages 18 through 54 years using Cox proportional hazards regression analysis. Median follow-up was 9.3 years (interquartile range, 4.9-13.5 years) per participant, with 13 082 incident cases of breast cancer. Participants were recruited from January 1, 1963, through December 31, 2013, and data were analyzed from September 1, 2013, through December 31, 2017.Body mass index at ages 18 to 24, 25 to 34, 35 to 44, and 45 to 54 years.Invasive or in situ premenopausal breast cancer.Among the 758 592 premenopausal women (median age, 40.6 years; interquartile range, 35.2-45.5 years) included in the analysis, inverse linear associations of BMI with breast cancer risk were found that were stronger for BMI at ages 18 to 24 years (HR per 5 kg/m2 [5.0-U] difference, 0.77; 95% CI, 0.73-0.80) than for BMI at ages 45 to 54 years (HR per 5.0-U difference, 0.88; 95% CI, 0.86-0.91). The inverse associations were observed even among nonoverweight women. There was a 4.2-fold risk gradient between the highest and lowest BMI categories (BMI≥35.0 vs <17.0) at ages 18 to 24 years (HR, 0.24; 95% CI, 0.14-0.40). Hazard ratios did not appreciably vary by attained age or between strata of other breast cancer risk factors. Associations were stronger for estrogen receptor-positive and/or progesterone receptor-positive than for hormone receptor-negative breast cancer for BMI at every age group (eg, for BMI at age 18 to 24 years: HR per 5.0-U difference for estrogen receptor-positive and progesterone receptor-positive tumors, 0.76 [95% CI, 0.70-0.81] vs hormone receptor-negative tumors, 0.85 [95% CI: 0.76-0.95]); BMI at ages 25 to 54 years was not consistently associated with triple-negative or hormone receptor-negative breast cancer overall.The results of this study suggest that increased adiposity is associated with a reduced risk of premenopausal breast cancer at a greater magnitude than previously shown and across the entire distribution of BMI. The strongest associations of risk were observed for BMI in early adulthood. Understanding the biological mechanisms underlying these associations could have important preventive potential.
000141707 536__ $$0G:(DE-HGF)POF3-313$$a313 - Cancer risk factors and prevention (POF3-313)$$cPOF3-313$$fPOF III$$x0
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000141707 7001_ $$aSchoemaker, Minouk J$$b1
000141707 7001_ $$aNichols, Hazel B$$b2
000141707 7001_ $$aWright, Lauren B$$b3
000141707 7001_ $$aBrook, Mark N$$b4
000141707 7001_ $$aJones, Michael E$$b5
000141707 7001_ $$aO'Brien, Katie M$$b6
000141707 7001_ $$aAdami, Hans-Olov$$b7
000141707 7001_ $$aBaglietto, Laura$$b8
000141707 7001_ $$aBernstein, Leslie$$b9
000141707 7001_ $$aBertrand, Kimberly A$$b10
000141707 7001_ $$aBoutron-Ruault, Marie-Christine$$b11
000141707 7001_ $$aBraaten, Tonje$$b12
000141707 7001_ $$aChen, Yu$$b13
000141707 7001_ $$aConnor, Avonne E$$b14
000141707 7001_ $$aDorronsoro, Miren$$b15
000141707 7001_ $$aDossus, Laure$$b16
000141707 7001_ $$aEliassen, A Heather$$b17
000141707 7001_ $$aGiles, Graham G$$b18
000141707 7001_ $$aHankinson, Susan E$$b19
000141707 7001_ $$0P:(DE-He78)4b2dc91c9d1ac33a1c0e0777d0c1697a$$aKaaks, Rudolf$$b20$$udkfz
000141707 7001_ $$aKey, Timothy J$$b21
000141707 7001_ $$aKirsh, Victoria A$$b22
000141707 7001_ $$aKitahara, Cari M$$b23
000141707 7001_ $$aKoh, Woon-Puay$$b24
000141707 7001_ $$aLarsson, Susanna C$$b25
000141707 7001_ $$aLinet, Martha S$$b26
000141707 7001_ $$aMa, Huiyan$$b27
000141707 7001_ $$aMasala, Giovanna$$b28
000141707 7001_ $$aMerritt, Melissa A$$b29
000141707 7001_ $$aMilne, Roger L$$b30
000141707 7001_ $$aOvervad, Kim$$b31
000141707 7001_ $$aOzasa, Kotaro$$b32
000141707 7001_ $$aPalmer, Julie R$$b33
000141707 7001_ $$aPeeters, Petra H$$b34
000141707 7001_ $$aRiboli, Elio$$b35
000141707 7001_ $$aRohan, Thomas E$$b36
000141707 7001_ $$aSadakane, Atsuko$$b37
000141707 7001_ $$aSund, Malin$$b38
000141707 7001_ $$aTamimi, Rulla M$$b39
000141707 7001_ $$aTrichopoulou, Antonia$$b40
000141707 7001_ $$aUrsin, Giske$$b41
000141707 7001_ $$aVatten, Lars$$b42
000141707 7001_ $$aVisvanathan, Kala$$b43
000141707 7001_ $$aWeiderpass, Elisabete$$b44
000141707 7001_ $$aWillett, Walter C$$b45
000141707 7001_ $$aWolk, Alicja$$b46
000141707 7001_ $$aYuan, Jian-Min$$b47
000141707 7001_ $$aZeleniuch-Jacquotte, Anne$$b48
000141707 7001_ $$aSandler, Dale P$$b49
000141707 7001_ $$aSwerdlow, Anthony J$$b50
000141707 773__ $$0PERI:(DE-600)2810928-4$$a10.1001/jamaoncol.2018.1771$$gVol. 4, no. 11, p. e181771 -$$n11$$pe181771$$tJAMA oncology$$v4$$x2374-2437$$y2018
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000141707 9141_ $$y2018
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