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  • Original Article
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Hip circumference is associated with the risk of premenopausal ER−/PR− breast cancer

Abstract

Objective:

We evaluated the relationship between hip and waist circumferences (HCs, WCs), waist-to-hip ratio, height, weight and body mass index (BMI) and breast cancer risk according to menopausal status of women and cancer hormone receptor status.

Design:

We used data from the French E3N longitudinal prospective cohort.

Subjects:

In the total population of 63 726 women who were analyzed, 1887 breast cancer cases were diagnosed during follow-up.

Results:

Among postmenopausal women, the risk of ER+/PR+ breast cancer increased with increasing weight, BMI, and both HCs and WCs, although these two associations disappeared after adjustment for BMI. No association was seen with ER−/PR− breast cancers. Among premenopausal women, among the different factors studied, HC only (no association was observed for any of the different factors studied except for HC) was associated with an increased risk of ER+/PR+ breast cancer after adjustment for BMI (hazard ratio (HR)=1.65; (1.04–2.62) when comparing the highest to lowest tertile; P-trend across tertiles=0.03) and of ER−/PR− breast cancer both before and after adjustment for BMI (HR=2.85 (1.33–6.13); P-trend <0.01, and HR=3.13 (1.19–8.27) P-trend =0.02, respectively). In the latter group, the association with HC was observed whatever the WC (HR=2.81 (1.18–6.70) and HR=2.79 (1.16–6.76) in women with high HC/low WC and high HC/high WC, respectively).

Conclusion:

The increase in risk of premenopausal breast cancer associated with large HC for both ER+/PR+ and ER−/PR− subtypes may provide insight into a specific risk factor for premenopausal breast cancer.

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References

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

    Article  CAS  Google Scholar 

  2. Aronne LJ . Classification of obesity and assessment of obesity-related health risks. Obes Res 2002; 10 (Suppl 2): 105S–115S.

    Article  Google Scholar 

  3. Chen WY, Colditz GA . Risk factors and hormone-receptor status: epidemiology, risk-prediction models and treatment implications for breast cancer. Nat Clin Pract Oncol 2007; 4: 415–423.

    Article  Google Scholar 

  4. Althuis MD, Fergenbaum JH, Garcia-Closas M, Brinton LA, Madigan MP, Sherman ME . Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomarkers Prev 2004; 13: 1558–1568.

    CAS  PubMed  Google Scholar 

  5. Suzuki R, Orsini N, Saji S, Key TJ, Wolk A . Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status--a meta-analysis. Int J Cancer 2009; 124: 698–712.

    Article  CAS  Google Scholar 

  6. Colditz GA, Rosner BA, Chen WY, Holmes MD, Hankinson SE . Risk factors for breast cancer according to estrogen and progesterone receptor status. J Natl Cancer Inst 2004; 96: 218–228.

    Article  CAS  Google Scholar 

  7. Yasui Y, Potter JD . The shape of age-incidence curves of female breast cancer by hormone-receptor status. Cancer Causes Control 1999; 10: 431–437.

    Article  CAS  Google Scholar 

  8. Bentzon N, During M, Rasmussen BB, Mouridsen H, Kroman N . Prognostic effect of estrogen receptor status across age in primary breast cancer. Int J Cancer 2008; 122: 1089–1094.

    Article  CAS  Google Scholar 

  9. Ahn J, Schatzkin A, Lacey Jr JV, Albanes D, Ballard-Barbash R, Adams KF et al. Adiposity, adult weight change, and postmenopausal breast cancer risk. Arch Intern Med 2007; 167: 2091–2102.

    Article  Google Scholar 

  10. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M . Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 2008; 371: 569–578.

    Article  Google Scholar 

  11. Wiseman M . The Second World Cancer Research Fund/American Institute for Cancer Research Expert Report. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. World Cancer Research Fund International, 2010; London, UK.

  12. Friedenreich CM . Review of anthropometric factors and breast cancer risk. Eur J Cancer Prev 2001; 10: 15–32.

    Article  CAS  Google Scholar 

  13. Harvie M, Hooper L, Howell AH . Central obesity and breast cancer risk: a systematic review. Obes Rev 2003; 4: 157–173.

    Article  CAS  Google Scholar 

  14. Huang Z, Willett WC, Colditz GA, Hunter DJ, Manson JE, Rosner B et al. Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses’ Health Study. Am J Epidemiol 1999; 150: 1316–1324.

    Article  CAS  Google Scholar 

  15. Tian YF, Chu CH, Wu MH, Chang CL, Yang T, Chou YC et al. Anthropometric measures, plasma adiponectin, and breast cancer risk. Endocr Relat Cancer 2007; 14: 669–677.

    Article  CAS  Google Scholar 

  16. Tehard B, Clavel-Chapelon F . Several anthropometric measurements and breast cancer risk: results of the E3N cohort study. Int J Obes (Lond) 2006; 30: 156–163.

    Article  CAS  Google Scholar 

  17. Potischman N, Swanson CA, Siiteri P, Hoover RN . Reversal of relation between body mass and endogenous estrogen concentrations with menopausal status. J Natl Cancer Inst 1996; 88: 756–758.

    Article  CAS  Google Scholar 

  18. Thomas HV, Key TJ, Allen DS, Moore JW, Dowsett M, Fentiman IS et al. Re: Reversal of relation between body mass and endogenous estrogen concentrations with menopausal status. J Natl Cancer Inst 1997; 89: 396–398.

    Article  CAS  Google Scholar 

  19. Agnoli C, Berrino F, Abagnato CA, Muti P, Panico S, Crosignani P et al. Metabolic syndrome and postmenopausal breast cancer in the ORDET cohort: a nested case-control study. Nutr Metab Cardiovasc Dis 2010; 20: 41–48.

    Article  CAS  Google Scholar 

  20. Vona-Davis L, Howard-McNatt M, Rose DP . Adiposity, type 2 diabetes and the metabolic syndrome in breast cancer. Obes Rev 2007; 8: 395–408.

    Article  CAS  Google Scholar 

  21. Wang J, Thornton JC, Bari S, Williamson B, Gallagher D, Heymsfield SB et al. Comparisons of waist circumferences measured at 4 sites. Am J Clin Nutr 2003; 77: 379–384.

    Article  Google Scholar 

  22. Snijder MB, Zimmet PZ, Visser M, Dekker JM, Seidell JC, Shaw JE . Independent and opposite associations of waist and hip circumferences with diabetes, hypertension and dyslipidemia: the AusDiab Study. Int J Obes Relat Metab Disord 2004; 28: 402–409.

    Article  CAS  Google Scholar 

  23. Iwasaki M, Otani T, Inoue M, Sasazuki S, Tsugane S . Body size and risk for breast cancer in relation to estrogen and progesterone receptor status in Japan. Ann Epidemiol 2007; 17: 304–312.

    Article  Google Scholar 

  24. Batty GD, Barzi F, Woodward M, Jamrozik K, Woo J, Kim HC et al. Adult height and cancer mortality in Asia: the Asia Pacific Cohort Studies Collaboration. Ann Oncol 2010; 21: 646–654.

    Article  CAS  Google Scholar 

  25. Kawai M, Minami Y, Kuriyama S, Kakizaki M, Kakugawa Y, Nishino Y et al. Adiposity, adult weight change and breast cancer risk in postmenopausal Japanese women: the Miyagi Cohort Study. Br J Cancer 2010; 103: 1443–1447.

    Article  CAS  Google Scholar 

  26. Parr CL, Batty GD, Lam TH, Barzi F, Fang X, Ho SC et al. Body-mass index and cancer mortality in the Asia-Pacific Cohort Studies Collaboration: pooled analyses of 424,519 participants. Lancet Oncol 2010; 11: 741–752.

    Article  Google Scholar 

  27. Singh AK, Pandey A, Tewari M, Pratyush DD, Singh HK, Pandey HP et al. Obesity augmented breast cancer risk: A potential risk factor for Indian women. J Surg Oncol 2011; 103: 217–222.

    Article  Google Scholar 

  28. Huang WY, Newman B, Millikan RC, Schell MJ, Hulka BS, Moorman PG . Hormone-related factors and risk of breast cancer in relation to estrogen receptor and progesterone receptor status. Am J Epidemiol 2000; 151: 703–714.

    Article  CAS  Google Scholar 

  29. Key TJ, Appleby PN, Reeves GK, Roddam A, Dorgan JF, Longcope C et al. Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. J Natl Cancer Inst 2003; 95: 1218–1226.

    Article  CAS  Google Scholar 

  30. Sonnenschein E, Toniolo P, Terry MB, Bruning PF, Kato I, Koenig KL et al. Body fat distribution and obesity in pre- and postmenopausal breast cancer. Int J Epidemiol 1999; 28: 1026–1031.

    Article  CAS  Google Scholar 

  31. Lahmann PH, Hoffmann K, Allen N, van Gils CH, Khaw KT, Tehard B et al. Body size and breast cancer risk: findings from the European prospective investigation into cancer and nutrition (EPIC). Int J Cancer 2004; 111: 762–771.

    Article  CAS  Google Scholar 

  32. Mellemkjaer L, Bigaard J, Tjonneland A, Christensen J, Thomsen B, Johansen C et al. Body composition and breast cancer in postmenopausal women: a Danish prospective cohort study. Obesity (Silver Spring) 2006; 14: 1854–1862.

    Article  Google Scholar 

  33. Pinheiro RL, Sarian LO, Pinto-Neto AM, Morais S, Costa-Paiva L . Relationship between body mass index, waist circumference and waist to hip ratio and the steroid hormone receptor status in breast carcinoma of pre- and postmenopausal women. Breast 2009; 18: 8–12.

    Article  Google Scholar 

  34. Harris HR, Willett WC, Terry KL, Michels KB . Body fat distribution and risk of premenopausal breast cancer in the Nurses’ Health Study II. J Natl Cancer Inst 2011; 103: 273–278.

    Article  Google Scholar 

  35. Wu MH, Chou YC, Yu JC, Yu CP, Wu CC, Chu CM et al. Hormonal and body-size factors in relation to breast cancer risk: a prospective study of 11,889 women in a low-incidence area. Ann Epidemiol 2006; 16: 223–229.

    Article  Google Scholar 

  36. Heitmann BL, Frederiksen P, Lissner L . Hip circumference and cardiovascular morbidity and mortality in men and women. Obes Res 2004; 12: 482–487.

    Article  Google Scholar 

  37. Lissner L, Bjorkelund C, Heitmann BL, Seidell JC, Bengtsson C . Larger hip circumference independently predicts health and longevity in a Swedish female cohort. Obes Res 2001; 9: 644–646.

    Article  CAS  Google Scholar 

  38. Parker ED, Pereira MA, Stevens J, Folsom AR . Association of hip circumference with incident diabetes and coronary heart disease: the Atherosclerosis Risk in Communities study. Am J Epidemiol 2009; 169: 837–847.

    Article  Google Scholar 

  39. Seidell JC, Perusse L, Despres JP, Bouchard C . Waist and hip circumferences have independent and opposite effects on cardiovascular disease risk factors: the Quebec Family Study. Am J Clin Nutr 2001; 74: 315–321.

    Article  CAS  Google Scholar 

  40. Rosenbaum M, Leibel RL . Clinical review 107: Role of gonadal steroids in the sexual dimorphisms in body composition and circulating concentrations of leptin. J Clin Endocrinol Metab 1999; 84: 1784–1789.

    CAS  PubMed  Google Scholar 

  41. Peltz G, Sanderson M, Perez A, Sexton K, Ochoa CD, Fadden MK . Serum leptin concentration, adiposity, and body fat distribution in Mexican-Americans. Arch Med Res 2007; 38: 563–570.

    Article  CAS  Google Scholar 

  42. Pichard C, Plu-Bureau G, Neves-E Castro Gompel A . Insulin resistance, obesity and breast cancer risk. Maturitas 2008; 60: 19–30.

    Article  CAS  Google Scholar 

  43. Rene GR, Watters A, Xu Y, Singh UP, Mann DR, Rueda BR et al. Leptin-signaling inhibition results in efficient anti-tumor activity in estrogen receptor positive or negative breast cancer. Breast Cancer Res 2009; 11: R36.

    Article  Google Scholar 

  44. Isidori AM, Strollo F, More M, Caprio M, Aversa A, Moretti C et al. Leptin and aging: correlation with endocrine changes in male and female healthy adult populations of different body weights. J Clin Endocrinol Metab 2000; 85: 1954–1962.

    Article  CAS  Google Scholar 

  45. Tehard B, van Liere MJ, Com NC, Clavel-Chapelon F . Anthropometric measurements and body silhouette of women: validity and perception. J Am Diet Assoc 2002; 102: 1779–1784.

    Article  CAS  Google Scholar 

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Acknowledgements

We are indebted to all participants for providing data and to practitioners for providing pathology reports. The authors are grateful to Jerri Bram for her assistance with the English and to the E3N group. This work was supported by the Institut National du Cancer, the Mutuelle Générale de l’Education Nationale, the Institut de Cancérologie Gustave Roussy and the Institut National de la Santé et de la Recherche Médicale. Guy Fagherazzi was funded by the French Ministry of Research. Alban Fabre was funded by the Cancéropôle – Région Ile de France. The study sponsors had no role in the design of the study, analysis or interpretation of data, writing of the manuscript or the decision to submit the manuscript for publication.

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Correspondence to F Clavel-Chapelon.

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Supplementary Information accompanies the paper on International Journal of Obesity website

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Fagherazzi, G., Chabbert-Buffet, N., Fabre, A. et al. Hip circumference is associated with the risk of premenopausal ER−/PR− breast cancer. Int J Obes 36, 431–439 (2012). https://doi.org/10.1038/ijo.2011.66

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