Environment and Breast Cancer: Science Review
About
Interaction of waist/hip ratio and family history on the risk of hormone receptor-defined breast cancer in a prospective study of postmenopausal women
Sellers, T. A., Davis, J., Cerhan, J. R., Vierkant, R. A., Olson, J. E., Pankratz, V. S., Potter, J. D., Folsom, A. R. American Journal of Epidemiology. 2002. 155:3, 225-33.
Topic area
Body size
Body size
Study design
Prospective Cohort
Prospective Cohort
Funding agency
NCI
NCI
Study Participants
Number of Cases
1,874 (invasive and in situ)
1,874 (invasive and in situ)
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Number in Cohort
Cohort: 37,105
Cohort: 37,105
Cohort participation rate
Retention/participation exceeded 70% for exposed a
Retention/participation exceeded 70% for exposed a
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: age 55-69 at baseline; resided in Iowa; Iowa driver's license holder; participants of the Iowa Women's Health Study
Ex: women who were not postmenopausal at baseline; women who had a mastectomy or a partial breast removal; previous cancer other than skin cancer at baseline
Comment about participation selection
Strengths: Large cohort study; lengthy follow-up of 13 years and 415,000 person years; obtained information on tumor size and grade, estrogen receptor and progesterone receptor status and extent of disease (cases); effect modification with family history and body size; analyzed breast cancer by anthropometric risk factors and hormone receptor status; Limitations: Anthropometric data self-reported;
Strengths: Large cohort study; lengthy follow-up of 13 years and 415,000 person years; obtained information on tumor size and grade, estrogen receptor and progesterone receptor status and extent of disease (cases); effect modification with family history and body size; analyzed breast cancer by anthropometric risk factors and hormone receptor status; Limitations: Anthropometric data self-reported;
Exposure Investigated
Exposures investigated
Height, weight, BMI, W/H ratio, BMI at 18 years, and waist circumference
Height, weight, BMI, W/H ratio, BMI at 18 years, and waist circumference
How exposure was measured
Questionnaire, self-administered
Questionnaire, self-administered
Exposure assessment comment
Anthropometric data self-reported
Anthropometric data self-reported
Breast cancer outcome investigated
Primary breast cancer
Primary breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
No
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Adequately controlled, Confounders: education, age at menarche, age at menopause, oral contraceptive use, HRT use, parity, age at first birth, alcohol consumption, smoking habits, physical activity, family history of breast cancer, height, w/h ratio, BMI
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
No
Description of major analysis
ER+, ER-, PR+, PR- Effect modification: family history of breast cancer and hormone receptor status Follow up: 13 years
ER+, ER-, PR+, PR- Effect modification: family history of breast cancer and hormone receptor status Follow up: 13 years
Strength of associations reported
Association between postmenopausal breast cancer risk and weight in women with no family history of breast cancer, >174 lbs vs. <128 lbs, RR=1.83(1.49-2.24) trend p<0.001
Association between postmenopausal breast cancer risk and weight in women with a family history of breast cancer, >174 lbs vs. <128 lbs, RR=1.74(1.15-2.65) trend p=0.02
Association between postmenopausal breast cancer risk and BMI in women with no family history of breast cancer, >30.70 vs. <22.89, RR=1.93(1.57-2.36) trend p<0.001
Association between postmenopausal breast cancer risk and BMI in women with a family history of breast cancer, >30.70 vs. <22.89, RR=1.47(0.99-2.17) trend p=0.05
Association between postmenopausal breast cancer risk and WHR in women with a family history of breast cancer, >0.90 vs. <0.76, RR=1.55(1.04-2.32) trend p=0.06
Association between PR+ postmenopausal breast cancer risk and weight, >174 lbs vs. <128 lbs, RR=2.31(1.76-3.05) trend p=0.05
Association between ER+ postmenopausal breast cancer risk and weight, >174 lbs vs. <128 lbs, RR=2.03(1.59-2.59) trend p=0.05
Association between ER + postmenopausal breast cancer risk and BMI, >30.70 vs. <22.89, RR=2.00(1.58-2.53) trend p=0.01
Association between PR + postmenopausal breast cancer risk and BMI, >30.70 vs. <22.89, RR=2.24(1.72-2.91) trend p=0.01
Association between postmenopausal breast cancer risk and weight in women with no family history of breast cancer, >174 lbs vs. <128 lbs, RR=1.83(1.49-2.24) trend p<0.001
Association between postmenopausal breast cancer risk and weight in women with a family history of breast cancer, >174 lbs vs. <128 lbs, RR=1.74(1.15-2.65) trend p=0.02
Association between postmenopausal breast cancer risk and BMI in women with no family history of breast cancer, >30.70 vs. <22.89, RR=1.93(1.57-2.36) trend p<0.001
Association between postmenopausal breast cancer risk and BMI in women with a family history of breast cancer, >30.70 vs. <22.89, RR=1.47(0.99-2.17) trend p=0.05
Association between postmenopausal breast cancer risk and WHR in women with a family history of breast cancer, >0.90 vs. <0.76, RR=1.55(1.04-2.32) trend p=0.06
Association between PR+ postmenopausal breast cancer risk and weight, >174 lbs vs. <128 lbs, RR=2.31(1.76-3.05) trend p=0.05
Association between ER+ postmenopausal breast cancer risk and weight, >174 lbs vs. <128 lbs, RR=2.03(1.59-2.59) trend p=0.05
Association between ER + postmenopausal breast cancer risk and BMI, >30.70 vs. <22.89, RR=2.00(1.58-2.53) trend p=0.01
Association between PR + postmenopausal breast cancer risk and BMI, >30.70 vs. <22.89, RR=2.24(1.72-2.91) trend p=0.01
Author address
Department of Health Sciences Research, Mayo Clinic and Mayo Clinic Cancer Center, Rochester, MN 55905, USA. sellers@mayo.edu
Department of Health Sciences Research, Mayo Clinic and Mayo Clinic Cancer Center, Rochester, MN 55905, USA. sellers@mayo.edu