Lauren R Teras1, Alpa V Patel1, Molin Wang2,3,4, Shiaw-Shyuan Yaun3, Kristin Anderson5, Roderick Brathwaite6, Bette J Caan7, Yu Chen8, Avonne E Connor9, A Heather Eliassen2,4, Susan M Gapstur1, Mia M Gaudet1, Jeanine M Genkinger10,11, Graham G Giles12,13, I-Min Lee2,14, Roger L Milne12,13, Kim Robien15, Norie Sawada16, Howard D Sesso2,14, Meir J Stampfer2,6,4, Rulla M Tamimi2,4, Cynthia A Thomson8, Shoichiro Tsugane16, Kala Visvanathan9, Walter C Willett2,6,4, Anne Zeleniuch-Jacquotte17, Stephanie A Smith-Warner2,6. 1. Epidemiology Research Program, American Cancer Society, Atlanta, GA. 2. Department of Epidemiology. 3. Department of Biostatistics. 4. Harvard T. H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA. 5. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN. 6. Department of Nutrition. 7. Division of Research, Kaiser Permanente of Northern California, Oakland, CA. 8. Department of Population Health and Environmental Medicine. 9. New York University School of Medicine, New York, NY; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 10. Department of Epidemiology, Columbia University Medical School of Public Health, New York, NY. 11. Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY. 12. Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia. 13. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. 14. Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 15. Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC. 16. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan. 17. New York University Cancer Institute.
Abstract
BACKGROUND: Excess body weight is an established cause of postmenopausal breast cancer, but it is unknown if weight loss reduces risk. METHODS: Associations between weight change and risk of breast cancer were examined among women aged 50 years and older in the Pooling Project of Prospective Studies of Diet and Cancer. In 10 cohorts, weight assessed on three surveys was used to examine weight change patterns over approximately 10 years (interval 1 median = 5.2 years; interval 2 median = 4.0 years). Sustained weight loss was defined as no less than 2 kg lost in interval 1 that was not regained in interval 2. Among 180 885 women, 6930 invasive breast cancers were identified during follow-up. RESULTS: Compared with women with stable weight (±2 kg), women with sustained weight loss had a lower risk of breast cancer. This risk reduction was linear and specific to women not using postmenopausal hormones (>2-4.5 kg lost: hazard ratio [HR] = 0.82, 95% confidence interval [CI] = 0.70 to 0.96; >4.5-<9 kg lost: HR = 0.75, 95% CI = 0.63 to 0.90; ≥9 kg lost: HR = 0.68, 95% CI = 0.50 to 0.93). Women who lost at least 9 kg and gained back some (but not all) of it were also at a lower risk of breast cancer. Other patterns of weight loss and gain over the two intervals had a similar risk of breast cancer to women with stable weight. CONCLUSIONS: These results suggest that sustained weight loss, even modest amounts, is associated with lower breast cancer risk for women aged 50 years and older. Breast cancer prevention may be a strong weight-loss motivator for the two-thirds of American women who are overweight or obese.
BACKGROUND: Excess body weight is an established cause of postmenopausal breast cancer, but it is unknown if weight loss reduces risk. METHODS: Associations between weight change and risk of breast cancer were examined among women aged 50 years and older in the Pooling Project of Prospective Studies of Diet and Cancer. In 10 cohorts, weight assessed on three surveys was used to examine weight change patterns over approximately 10 years (interval 1 median = 5.2 years; interval 2 median = 4.0 years). Sustained weight loss was defined as no less than 2 kg lost in interval 1 that was not regained in interval 2. Among 180 885 women, 6930 invasive breast cancers were identified during follow-up. RESULTS: Compared with women with stable weight (±2 kg), women with sustained weight loss had a lower risk of breast cancer. This risk reduction was linear and specific to women not using postmenopausal hormones (>2-4.5 kg lost: hazard ratio [HR] = 0.82, 95% confidence interval [CI] = 0.70 to 0.96; >4.5-<9 kg lost: HR = 0.75, 95% CI = 0.63 to 0.90; ≥9 kg lost: HR = 0.68, 95% CI = 0.50 to 0.93). Women who lost at least 9 kg and gained back some (but not all) of it were also at a lower risk of breast cancer. Other patterns of weight loss and gain over the two intervals had a similar risk of breast cancer to women with stable weight. CONCLUSIONS: These results suggest that sustained weight loss, even modest amounts, is associated with lower breast cancer risk for women aged 50 years and older. Breast cancer prevention may be a strong weight-loss motivator for the two-thirds of American women who are overweight or obese.
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