Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Body mass index at the time of diagnosis and the risk of advanced stages and poorly differentiated cancers of the breast: findings from a case-series study

Abstract

Introduction:

Obesity is a risk factor for postmenopausal breast cancer and is independently associated with shorter disease-free and overall survival. Currently, in clinical settings, the combination of stage and grade of cancer at the initial presentation of the disease is the best prognostic indicator.

Objective:

To evaluate the association between body mass index (BMI) and risk of advanced stages and poorly differentiated grade of breast cancer.

Design:

A case-series study of women diagnosed with their first primary invasive breast cancer. Patients include a total of 831 women aged 40 years with a mean BMI of 29.6(±6.6) kg m−2. Pathological, clinical and demographic data were retrieved from electronic medical records. Multinomial logistic regression analysis was preformed to estimate the risk of more advanced stages and poorly differentiated grade of cancer, adjusting for covariates.

Results:

Obese compared with normal weight women had an 80% increased risk of cancer with more advanced stages (III/IV) and poorly differentiated grade (odds ratio=1.80, 95% confidence interval 1.13–2.86, P=0.014). No significant increase in risk was observed for overweight women.

Conclusion:

Obesity at the time of diagnosis of breast cancer is associated with more advanced stages and poorly differentiated grade of cancers.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. 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: 2091–2100.

    Article  Google Scholar 

  2. Majed B, Moreau T, Senouci K, Salmon RJ, Fourquet A, Asselain B . Is obesity an independent prognosis factor in women breast cancer? Breast Cancer Res Treat 2008; 111: 329–342.

    Article  Google Scholar 

  3. Cummings SR, Tice JA, Bauer S, Browner WS, Cuzick J, Ziv E et al. Prevention of breast cancer in postmenopausal women: approaches to estimating and reducing risk. J Natl Cancer Inst 2009; 101: 384–398.

    Article  Google Scholar 

  4. Eliassen AH, Colditz GA, Rosner B, Willet WC, Hankinson SE . Adult weight change and risk of postmenopausal breast cancer. JAMA 2006; 296: 193–201.

    Article  CAS  Google Scholar 

  5. Folson AR, Kaye SA, Prineas RJ, Potter JD, Gapstur SM, Wallace RB . Increased incidence of carcinoma of the breast is associated with abdominal adiposity in postmenopausal women. Am J Epidemiol 1990; 131: 794–803.

    Article  Google Scholar 

  6. Hankinson SE, Willet WC, Colditz G, Hunter DJ, Michaud DS, Deroo B et al. Circulating concentration of insulin-like growth factor-I and risk of breast cancer. Lancet 1998; 351: 1393–1395.

    Article  CAS  Google Scholar 

  7. Hankinson SE, Willet WC, Manson JE, Colditz GA, Huntr DJ, Spiegelman D et al. Plasma sex steroid hormone levels and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 1998; 90: 1292–1299.

    Article  CAS  Google Scholar 

  8. Haffner SM, Dunn JF, Katz MS . Relationship of sex hormone binding globulin to lipid, lipoprotein, glucose, and insulin concentrations in postmenopausal women. Metabolism 1992; 41: 278–284.

    Article  CAS  Google Scholar 

  9. Cleveland RJ, Eng SM, Abrahamson PE, Britton JA, Teitelbaum SL, Neugut AI et al. Weight gain prior to diagnosis and survival from breast cancer. Cancer Epidemio Biomarkers Prev 2007; 16: 1803–1811.

    Article  Google Scholar 

  10. Michaelson JS, Silverstein M, Wyatt J, Weber G, Moore R, Halpern E et al. Predicting the survival of patients with breast carcinoma using tumor size. Cancer 2002; 95: 713–723.

    Article  Google Scholar 

  11. Roberti NE . The role of histologic grading in the prognosis of patients with carcinoma of the breast. Is this a neglected opportunity? Cancer 1997; 80: 1708–1716.

    Article  CAS  Google Scholar 

  12. Stokes ME, Davis CS, Koch GG (eds). Categorical Data Analysis Using the SAS System 2nd edition SAS Institute Inc.: Cary, NC, 2000.

    Google Scholar 

  13. Cui Y, Whiteman MK, Flaws JA, Langenberg P, Tkaczuk KH, Buxh TL . Body mass and stage of breast cancer at diagnosis. Int J Cancer 2002; 98: 279–283.

    Article  CAS  Google Scholar 

  14. Kerlikowske K, Walker R, Miglioretti DL, Desai A, Ballard-Barbash R, Buist DSM . Obesity, mammography use and accuracy, and advanced breast cancer risk. J Natl Cancer Inst 2008; 100: 1724–1733.

    Article  Google Scholar 

  15. Porter GA, Inglis KM, Wood LA, Veugelers PJ . Effect of obesity on presentation of breast cancer. Ann Surg Oncol 2006; 13: 327–332.

    Article  Google Scholar 

  16. Majed B, Moreau T, Senouci K, Salmon RJ, Fourgquet A, Asselain B . Is obesity an independent prognosis factor in woman breast cancer? Breast Cancer Res Treat 2008; 111: 329–342.

    Article  Google Scholar 

  17. Griggs JJ, Sorbero ME, Stark A, Heininger SE, Dick AW . Racial/ethnic disparity in the dose and dose intensity of breast cancer adjuvant chemotherapy. Breast Cancer Res Treat 2003; 81: 21–31.

    Article  CAS  Google Scholar 

  18. Stoll BA . Obesity and breast cancer. Int J Obes Relat Metab Disord 1996; 20: 389–392.

    CAS  PubMed  Google Scholar 

  19. Madarnas Y, Sawka CA, Franssen E, Bjarnason GA . Are medical oncologists biased in their treatment for the large women with breast cancer? Breast Cancer Res Treat 2001; 66: 123–133.

    Article  CAS  Google Scholar 

  20. Sprague BL, Trentham-Dietz A, Egan KM, Titus-Ernstoff L, Hampton JM, Newcomb PA . Proportion of invasive breast cancer attributable to risk factors modifiable after menopause. Am J Epidemiol 2008; 168: 404–411.

    Article  Google Scholar 

  21. Centers for Disease Control Prevention.. US Obesity Trends 1985–2006. http://www.cdc.gov/obesity/data/trends.html.

  22. Stark A, Stahl M, Krum S, Prichard J, Evans J . Findings from a cohort of women diagnosed with their first primary invasive breast cancer in northeastern and central Pennsylvania. Unpublished data.

  23. National Cancer Institute. Surveillance Epidemiology and End Results; available at http://seer.cancer.gov/statfacts/html/breast.html.

Download references

Acknowledgements

This work was partially supported by a grant from the Geisinger Research Endowment Fund.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A Stark.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stark, A., Stahl, M., Kirchner, H. et al. Body mass index at the time of diagnosis and the risk of advanced stages and poorly differentiated cancers of the breast: findings from a case-series study. Int J Obes 34, 1381–1386 (2010). https://doi.org/10.1038/ijo.2010.69

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2010.69

Keywords

This article is cited by

Search

Quick links