Catherine Schairer1, Cecile A Laurent2, Lisa M Moy2, Gretchen L Gierach1, Neil E Caporaso1, Ruth M Pfeiffer3, Lawrence H Kushi2. 1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rm 7E142, Bethesda, MD, 20892, USA. 2. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. 3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rm 7E142, Bethesda, MD, 20892, USA. pfeiffer@mail.nih.gov.
Abstract
PURPOSE: Inflammatory breast cancer (IBC) is a rare, poorly understood and aggressive tumor. We extended prior findings linking high body mass index (BMI) to substantial increased IBC risk by examining BMI associations before and after adjustment for well-characterized comorbidities using medical record data for diabetes, insulin resistance, and disturbances of cholesterol metabolism in a general community healthcare setting. METHODS: We identified 247 incident IBC cases diagnosed at Kaiser Permanente Northern California between 2005 and 2017 and 2470 controls matched 10:1 on birth year and geographic area and with ≥ 13 months of continuous enrollment prior to diagnosis/index date. We assessed exposures from 6 years up to one year prior to the diagnosis/index date, using logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Before adjustment for comorbidities, ORs (95% CIs) for BMI of 25-< 30, 30-< 35, and ≥ 35 compared to < 25 kg/m2 were 1.5 (0.9-2.3), 2.0 (1.2-3.1), and 2.5 (1.4-4.4), respectively. After adjustment for pre-diabetes/diabetes, HDL-C and triglyceride levels, and dyslipidemia, corresponding ORs were 1.3 (0.8-2.1), 1.6 (0.9-2.9), and 1.9 (1.0-3.5). The OR for HDL-C levels < 50 mg/dL compared to ≥ 65 mg/dL was 2.0 (1.2-3.3) in the adjusted model. In a separate model the OR for a triglyceride/HDL-C ratio ≥ 2.50 compared to < 1.62 was 1.7 (1.1-2.8) after adjustment for BMI, pre-diabetes/diabetes, and dyslipidemia. Results did not differ significantly by estrogen receptor status. CONCLUSIONS: Obesity and measures of insulin resistance independently increased IBC risk as did obesity and low HDL-C levels. These findings, if confirmed, have implications for IBC prevention.
PURPOSE:Inflammatory breast cancer (IBC) is a rare, poorly understood and aggressive tumor. We extended prior findings linking high body mass index (BMI) to substantial increased IBC risk by examining BMI associations before and after adjustment for well-characterized comorbidities using medical record data for diabetes, insulin resistance, and disturbances of cholesterol metabolism in a general community healthcare setting. METHODS: We identified 247 incident IBC cases diagnosed at Kaiser Permanente Northern California between 2005 and 2017 and 2470 controls matched 10:1 on birth year and geographic area and with ≥ 13 months of continuous enrollment prior to diagnosis/index date. We assessed exposures from 6 years up to one year prior to the diagnosis/index date, using logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Before adjustment for comorbidities, ORs (95% CIs) for BMI of 25-< 30, 30-< 35, and ≥ 35 compared to < 25 kg/m2 were 1.5 (0.9-2.3), 2.0 (1.2-3.1), and 2.5 (1.4-4.4), respectively. After adjustment for pre-diabetes/diabetes, HDL-C and triglyceride levels, and dyslipidemia, corresponding ORs were 1.3 (0.8-2.1), 1.6 (0.9-2.9), and 1.9 (1.0-3.5). The OR for HDL-C levels < 50 mg/dL compared to ≥ 65 mg/dL was 2.0 (1.2-3.3) in the adjusted model. In a separate model the OR for a triglyceride/HDL-C ratio ≥ 2.50 compared to < 1.62 was 1.7 (1.1-2.8) after adjustment for BMI, pre-diabetes/diabetes, and dyslipidemia. Results did not differ significantly by estrogen receptor status. CONCLUSIONS:Obesity and measures of insulin resistance independently increased IBC risk as did obesity and low HDL-C levels. These findings, if confirmed, have implications for IBC prevention.
Authors: Catherine Schairer; Shahinaz M Gadalla; Ruth M Pfeiffer; Steven C Moore; Eric A Engels Journal: Cancer Epidemiol Biomarkers Prev Date: 2017-01-13 Impact factor: 4.254
Authors: Lorenzo Scappaticcio; Maria Ida Maiorino; Giuseppe Bellastella; Dario Giugliano; Katherine Esposito Journal: Endocrine Date: 2016-12-31 Impact factor: 3.633
Authors: Kenneth W Hance; William F Anderson; Susan S Devesa; Heather A Young; Paul H Levine Journal: J Natl Cancer Inst Date: 2005-07-06 Impact factor: 13.506
Authors: Rachel L Atkinson; Randa El-Zein; Vicente Valero; Anthony Lucci; Therese B Bevers; Tamer Fouad; Weiqin Liao; Naoto T Ueno; Wendy A Woodward; Abenaa M Brewster Journal: Cancer Causes Control Date: 2016-01-21 Impact factor: 2.506
Authors: Gregory A Nichols; Jay Desai; Jennifer Elston Lafata; Jean M Lawrence; Patrick J O'Connor; Ram D Pathak; Marsha A Raebel; Robert J Reid; Joseph V Selby; Barbara G Silverman; John F Steiner; W F Stewart; Suma Vupputuri; Beth Waitzfelder Journal: Prev Chronic Dis Date: 2012-06-07 Impact factor: 2.830
Authors: Grace Makari-Judson; Richard Viskochil; Deborah Katz; Ruth Barham; Wilson C Mertens Journal: Breast Cancer Res Treat Date: 2022-05-21 Impact factor: 4.872