Rowan T Chlebowski1, Juhua Luo2, Garnet L Anderson3, Wendy Barrington4, Kerryn Reding5, Michael S Simon6, JoAnn E Manson7, Thomas E Rohan8, Jean Wactawski-Wende9, Dorothy Lane10, Howard Strickler8, Yasmin Mosaver-Rahmani8, Jo L Freudenheim9, Nazmus Saquib11, Marcia L Stefanick12. 1. Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California. 2. Epidemiology and Biostatistics, Indiana University, Bloomington, Indiana. 3. Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. 4. Psychosocial and Community Health, University of Washington, Seattle, Washington. 5. Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, Washington. 6. Clinical Arrangements, Karmanos Cancer Institute, Detroit, Michigan. 7. Department of Epidemiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 8. Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York. 9. Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, New York. 10. Department of Epidemiology & Population Health, Stony Brook University School of Medicine, Stony Brook, New York. 11. Department of Research, Sulaimaon Al Rajhi College School of Medicine, Al Bukayri ah, Saudi Arabia. 12. Department of Medicine, Stanford University School of Medicine, Stanford, California.
Abstract
BACKGROUND: Although obesity is an established risk factor for postmenopausal breast cancer, the results of weight loss and breast cancer studies are inconsistent. Therefore, we evaluated associations between weight change and breast cancer risk in postmenopausal women in the Women's Health Initiative Observational Study. METHODS: Postmenopausal women (n = 61,335) who had no prior breast cancer and a normal mammogram had body weight and height measured and body mass index (BMI) calculated at baseline and year 3. Weight change at year 3 was categorized as stable (<5%), loss (≥5%), or gain (≥5%) with further assessment of weight loss intentionality by self-report. Multivariable Cox proportional hazard regression models were used to evaluate relationships between weight change and subsequent breast cancer incidence. RESULTS: During a mean follow-up of 11.4 years with 3061 incident breast cancers, women with weight loss (n = 8175) had a significantly lower risk of breast cancer compared with women whose weight remained stable (n = 41,139) (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.78-0.98; P = .02) with no interaction by BMI. Adjustment for mammography did not alter findings (HR, 0.88; 95% CI, 0.78-0.99) with no significant difference by weight loss intentionality. Weight gain (≥5%) (n = 12,021) was not associated with breast cancer risk (HR, 1.02; 95% CI, 0.93-1.11) but was associated with higher triple-negative breast cancer incidence (HR, 1.54; 95% CI, 1.16-2.05). CONCLUSIONS: Postmenopausal women who lose weight have lower breast cancer risk than those with stable weight. These findings suggest that postmenopausal women who lose weight may reduce their breast cancer risk.
BACKGROUND: Although obesity is an established risk factor for postmenopausal breast cancer, the results of weight loss and breast cancer studies are inconsistent. Therefore, we evaluated associations between weight change and breast cancer risk in postmenopausal women in the Women's Health Initiative Observational Study. METHODS: Postmenopausal women (n = 61,335) who had no prior breast cancer and a normal mammogram had body weight and height measured and body mass index (BMI) calculated at baseline and year 3. Weight change at year 3 was categorized as stable (<5%), loss (≥5%), or gain (≥5%) with further assessment of weight loss intentionality by self-report. Multivariable Cox proportional hazard regression models were used to evaluate relationships between weight change and subsequent breast cancer incidence. RESULTS: During a mean follow-up of 11.4 years with 3061 incident breast cancers, women with weight loss (n = 8175) had a significantly lower risk of breast cancer compared with women whose weight remained stable (n = 41,139) (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.78-0.98; P = .02) with no interaction by BMI. Adjustment for mammography did not alter findings (HR, 0.88; 95% CI, 0.78-0.99) with no significant difference by weight loss intentionality. Weight gain (≥5%) (n = 12,021) was not associated with breast cancer risk (HR, 1.02; 95% CI, 0.93-1.11) but was associated with higher triple-negative breast cancer incidence (HR, 1.54; 95% CI, 1.16-2.05). CONCLUSIONS: Postmenopausal women who lose weight have lower breast cancer risk than those with stable weight. These findings suggest that postmenopausal women who lose weight may reduce their breast cancer risk.
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