Environment and Breast Cancer: Science Review

Evidence From Humans
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Adiposity and sex hormones in postmenopausal breast cancer survivors
McTiernan, A., Rajan, K. B., Tworoger, S. S., Irwin, M., Bernstein, L., Baumgartner, R., Gilliland, F., Stanczyk, F. Z., Yasui, Y., Ballard-Barbash, R. Journal of Clinical Oncology. 2003. 21:10, 1961-6.
Topic area
Body size
Study design
Prospective cohort
Funding agency
NCI, and NIH
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Post menopausal
Number in Cohort
Cohort: 503
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: women with newly diagnosed stage 0 to IIIA breast cancer between 1996 and 1999; residents of King, Pierce or Snohomish counties in Washington or in Bernalillo, Santa Fe, Sandoval, Valencia or Taos counties in New Mexico; had blood drawn and anthropometric measurements taken by trained staff Ex: women who did not have their blood drawn
Comment about participation selection
Strengths: anthropometric data measured by trained staff; characterized stage of disease; noted estrogen receptor status; first study to report on the association between adiposity and sex hormones in a relatively large cohort of breast cancer survivors limited to postmenopausal women; found significant trends towards increasing serum hormones (not DHEAS) with increasing BMI; found significant trends towards decreasing SHBG with increasing adiposity; adjusted results by clinical sites Limitations: only 41% of age and stage eligible incident patients were enrolled onto the cohort; African-American and Asian-American races were underrepresented in analyses; did not ask women if they were undergoing chemotherapy or radiation treatment at the time of their blood draw
How exposure was measured
Questionnaire, self-administered in Western Washington Questionnaire, in person in New Mexico
Breast cancer outcome investigated
Mortality from breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
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: clinical site
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Results Comments
Women with a BMI of 30 or more had a 35% (P=.005) higher concentration of estrone and a 130% (P=.002) higher concentration of estradiol compared with women who had a BMI under 22. Similar associations were observed for body fat mass, % body fat and waist circumference. Testosterone concentrations also increased with increasing levels of adiposity (P=.0001).
Author address
Cancer Prevention Research Program, MP-900, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA. amctiern@fhcrc.org