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@ARTICLE{Group:141707,
      author       = {M. J. Schoemaker and H. B. Nichols and L. B. Wright and M.
                      N. Brook and M. E. Jones and K. M. O'Brien and H.-O. Adami
                      and L. Baglietto and L. Bernstein and K. A. Bertrand and
                      M.-C. Boutron-Ruault and T. Braaten and Y. Chen and A. E.
                      Connor and M. Dorronsoro and L. Dossus and A. H. Eliassen
                      and G. G. Giles and S. E. Hankinson and R. Kaaks$^*$ and T.
                      J. Key and V. A. Kirsh and C. M. Kitahara and W.-P. Koh and
                      S. C. Larsson and M. S. Linet and H. Ma and G. Masala and M.
                      A. Merritt and R. L. Milne and K. Overvad and K. Ozasa and
                      J. R. Palmer and P. H. Peeters and E. Riboli and T. E. Rohan
                      and A. Sadakane and M. Sund and R. M. Tamimi and A.
                      Trichopoulou and G. Ursin and L. Vatten and K. Visvanathan
                      and E. Weiderpass and W. C. Willett and A. Wolk and J.-M.
                      Yuan and A. Zeleniuch-Jacquotte and D. P. Sandler and A. J.
                      Swerdlow},
      collaboration = {P. B. C. C. Group},
      title        = {{A}ssociation of {B}ody {M}ass {I}ndex and {A}ge {W}ith
                      {S}ubsequent {B}reast {C}ancer {R}isk in {P}remenopausal
                      {W}omen.},
      journal      = {JAMA oncology},
      volume       = {4},
      number       = {11},
      issn         = {2374-2437},
      address      = {Chicago, Ill.},
      publisher    = {American Medical Association},
      reportid     = {DKFZ-2018-01978},
      pages        = {e181771},
      year         = {2018},
      abstract     = {The 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.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29931120},
      doi          = {10.1001/jamaoncol.2018.1771},
      url          = {https://inrepo02.dkfz.de/record/141707},
}