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Sökning: WFRF:(Eliassen A Heather) > (2018)

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2.
  • Schoemaker, Minouk J., et al. (författare)
  • Association of body mass index and age With subsequent breast cancer risk in premenopausal women
  • 2018
  • Ingår i: JAMA Oncology. - American Medical Assocation. - 2374-2437 .- 2374-2445. ; 4:11
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>IMPORTANCE The association between increasing body mass index (BMI; calculated as wei ght in kilograms divided by height in meters squared) and risk of breast cancer is unique in cancer epidemiology in that a crossover effect exists, with risk reduction before and risk increase after menopause. The inverse association with premenopausal breast cancer risk is poorly characterized but might be important in the understanding of breast cancer causation.</p><p>OBJECTIVE To investigate the association of BMI with premenopausal breast cancer risk, in particular by age at BMI, attained age, risk factors for breast cancer, and tumor characteristics.</p><p>DESIGN, SETTING, AND PARTICIPANTS This multicenter analysis used pooled individual-level data from 758 592 premenopausal women from 19 prospective cohorts to estimate hazard ratios (HRs) of premenopausal breast cancer in association with BMI from ages 18 through 54 years using Cox proportional hazards regression analysis. Median follow-up was 9.3 years (interquartile range, 4.9-13.5 years) per participant, with 13 082 incident cases of breast cancer. Participants were recruited from January 1,1963, through December 31, 2013, and data were analyzed from September 1.2013, through December 31, 2017.</p><p>EXPOSURES Body mass index at ages 18 to 24, 25 to 34,35 to 44, and 45 to 54 years.</p><p>MAIN OUTCOMES AND MEASURES Invasive or in situ premenopausal breast cancer.</p><p>RESULTS Among the 758 592 premenopausal women (median age, 40.6 years; interquartile range, 35.2-45.5 years) included in the analysis, inverse linear associations of BMI with breast cancer risk were found that were stronger for BMI at ages 18 to 24 years (HR per 5 kg/m(2) [5.0-U] difference, 0.77; 95% CI, 0.73-0.80) than for BMI at ages 45 to 54 years (HR per 5.0-U difference, 0.88; 95% CI, 0.86-0.91). The inverse associations were observed even among nonoverweight women. There was a 4.2-fold risk gradient between the highest and lowest BMI categories (BMI &gt;= 35.0 vs &lt;17.0) at ages 18 to 24 years (HR, 0.24; 95% CI, 0.14-0.40). Hazard ratios did not appreciably vary by attained age or between strata of other breast cancer risk factors. Associations were stronger for estrogen receptor-positive and/or progesterone receptor-positive than for hormone receptor-negative breast cancer for BMI at every age group (eg, for BMI at age 18 to 24 years: HR per 5.0-U difference for estrogen receptor-positive and progesterone receptor-positive tumors, 0.76 [95% CI, 0.70-0.81] vs hormone receptor-negative tumors, 0.85 [95% CI: 0.76-0.95]); BMI at ages 25 to 54 years was not consistently associated with triple-negative or hormone receptor-negative breast cancer overall.</p><p>CONCLUSIONS AND RELEVANCE The results of this study suggest that increased adiposity is associated with a reduced risk of premenopausal breast cancer at a greater magnitude than previously shown and across the entire distribution of BMI. The strongest associations of risk were observed for BMI in early adulthood. Understanding the biological mechanisms underlying these associations could have important preventive potential.</p>
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3.
  • Schoemaker, Minouk J, et al. (författare)
  • Association of Body Mass Index and Age With Subsequent Breast Cancer Risk in Premenopausal Women.
  • 2018
  • Ingår i: JAMA Oncology. - 2374-2437 .- 2374-2445. ; 4:11
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Importance:</strong> The association between increasing body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and risk of breast cancer is unique in cancer epidemiology in that a crossover effect exists, with risk reduction before and risk increase after menopause. The inverse association with premenopausal breast cancer risk is poorly characterized but might be important in the understanding of breast cancer causation.</p><p><strong>Objective:</strong> To investigate the association of BMI with premenopausal breast cancer risk, in particular by age at BMI, attained age, risk factors for breast cancer, and tumor characteristics.</p><p><strong>Design, Setting, and Participants:</strong> This multicenter analysis used pooled individual-level data from 758 592 premenopausal women from 19 prospective cohorts to estimate hazard ratios (HRs) of premenopausal breast cancer in association with BMI from ages 18 through 54 years using Cox proportional hazards regression analysis. Median follow-up was 9.3 years (interquartile range, 4.9-13.5 years) per participant, with 13 082 incident cases of breast cancer. Participants were recruited from January 1, 1963, through December 31, 2013, and data were analyzed from September 1, 2013, through December 31, 2017.</p><p><strong>Exposures:</strong> Body mass index at ages 18 to 24, 25 to 34, 35 to 44, and 45 to 54 years.</p><p><strong>Main Outcomes and Measures:</strong> Invasive or in situ premenopausal breast cancer.</p><p><strong>Results:</strong> Among the 758 592 premenopausal women (median age, 40.6 years; interquartile range, 35.2-45.5 years) included in the analysis, inverse linear associations of BMI with breast cancer risk were found that were stronger for BMI at ages 18 to 24 years (HR per 5 kg/m2 [5.0-U] difference, 0.77; 95% CI, 0.73-0.80) than for BMI at ages 45 to 54 years (HR per 5.0-U difference, 0.88; 95% CI, 0.86-0.91). The inverse associations were observed even among nonoverweight women. There was a 4.2-fold risk gradient between the highest and lowest BMI categories (BMI≥35.0 vs &lt;17.0) at ages 18 to 24 years (HR, 0.24; 95% CI, 0.14-0.40). Hazard ratios did not appreciably vary by attained age or between strata of other breast cancer risk factors. Associations were stronger for estrogen receptor-positive and/or progesterone receptor-positive than for hormone receptor-negative breast cancer for BMI at every age group (eg, for BMI at age 18 to 24 years: HR per 5.0-U difference for estrogen receptor-positive and progesterone receptor-positive tumors, 0.76 [95% CI, 0.70-0.81] vs hormone receptor-negative tumors, 0.85 [95% CI: 0.76-0.95]); BMI at ages 25 to 54 years was not consistently associated with triple-negative or hormone receptor-negative breast cancer overall.</p><p><strong>Conclusions and Relevance:</strong> The results of this study suggest that increased adiposity is associated with a reduced risk of premenopausal breast cancer at a greater magnitude than previously shown and across the entire distribution of BMI. The strongest associations of risk were observed for BMI in early adulthood. Understanding the biological mechanisms underlying these associations could have important preventive potential.</p>
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4.
  • Gaudet, Mia M, et al. (författare)
  • Pooled Analysis of Nine Cohorts Reveals Breast Cancer Risk Factors by Tumor Molecular Subtype.
  • 2018
  • Ingår i: Cancer Research. - 0008-5472 .- 1538-7445. ; 78:20, s. 6011-6021
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Various subtypes of breast cancer defined by estrogen receptor (ER), progesterone receptor (PR), and HER2 exhibit etiologic differences in reproductive factors, but associations with other risk factors are inconsistent. To clarify etiologic heterogeneity, we pooled data from nine cohort studies. Multivariable, joint Cox proportional hazards regression models were used to estimate HRs and 95% confidence intervals (CI) for molecular subtypes. Of 606,025 women, 11,741 invasive breast cancers with complete tissue markers developed during follow-up: 8,700 luminal A–like (ER<sup>+</sup> or PR<sup>+</sup>/HER2<sup>−</sup>), 1,368 luminal B–like (ER<sup>+</sup> or PR<sup>+</sup>/HER2<sup>+</sup>), 521 HER2-enriched (ER<sup>−</sup>/PR<sup>−</sup>/HER2<sup>+</sup>), and 1,152 triple-negative (ER<sup>−</sup>/PR<sup>−</sup>/HER2<sup>−</sup>) disease. Ever parous compared with never was associated with lower risk of luminal A–like (HR, 0.78; 95% CI, 0.73–0.83) and luminal B–like (HR, 0.74; 95% CI, 0.64–0.87) as well as a higher risk of triple-negative disease (HR, 1.23; 95% CI, 1.02–1.50; <em>P</em> value for overall tumor heterogeneity &lt; 0.001). Direct associations with luminal-like, but not HER2-enriched or triple-negative, tumors were found for age at first birth, years between menarche and first birth, and age at menopause (<em>P</em> value for overall tumor heterogeneity &lt; 0.001). Age-specific associations with baseline body mass index differed for risk of luminal A–like and triple-negative breast cancer (<em>P</em> value for tumor heterogeneity = 0.02). These results provide the strongest evidence for etiologic heterogeneity of breast cancer to date from prospective studies.</p><p><strong>Significance:</strong> These findings comprise the largest study of prospective data to date and contribute to the accumulating evidence that etiological heterogeneity exists in breast carcinogenesis. <em>Cancer Res; 78(20); 6011–21. ©2018 AACR</em>.</p><p>.</p>
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5.
  • Ge, Wenzhen, et al. (författare)
  • Circulating anti-Müllerian hormone and breast cancer risk : a study in ten prospective cohorts
  • 2018
  • Ingår i: International Journal of Cancer. - Hoboken : John Wiley & Sons. - 0020-7136 .- 1097-0215. ; 142:11, s. 2215-2226
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>A strong positive association has been observed between circulating anti‐Müllerian hormone (AMH), a biomarker of ovarian reserve, and breast cancer risk in three prospective studies. Confirming this association is important because of the paucity of biomarkers of breast cancer risk in premenopausal women. We conducted a consortium study including ten prospective cohorts that had collected blood from premenopausal women. A nested case–control design was implemented within each cohort. A total of 2,835 invasive (80%) and <em>in situ</em> (20%) breast cancer cases were individually matched to controls (<em>n</em> = 3,122) on age at blood donation. AMH was measured using a high sensitivity enzyme‐linked immunoabsorbent assay. Conditional logistic regression was applied to the aggregated dataset. There was a statistically significant trend of increasing breast cancer risk with increasing AMH concentration (<em>p</em><sub>trend</sub> across quartiles &lt;0.0001) after adjusting for breast cancer risk factors. The odds ratio (OR) for breast cancer in the top <em>vs</em>. bottom quartile of AMH was 1.60 (95% CI = 1.31–1.94). Though the test for interaction was not statistically significant (<em>p</em><sub>interaction</sub> = 0.15), the trend was statistically significant only for tumors positive for both estrogen receptor (ER) and progesterone receptor (PR): ER+/PR+: OR<sub>Q4–Q1</sub> = 1.96, 95% CI = 1.46–2.64, <em>p</em><sub>trend</sub> &lt;0.0001; ER+/PR−: OR<sub>Q4–Q1</sub> = 0.82, 95% CI = 0.40–1.68, <em>p</em><sub>trend</sub> = 0.51; ER−/PR+: OR<sub>Q4–Q1</sub> = 3.23, 95% CI = 0.48–21.9, <em>p</em><sub>trend</sub> = 0.26; ER−/PR−: OR<sub>Q4–Q1</sub> = 1.15, 95% CI = 0.63–2.09, <em>p</em><sub>trend</sub> = 0.60. The association was observed for both pre‐ (OR<sub>Q4–Q1</sub>= 1.35, 95% CI = 1.05–1.73) and post‐menopausal (OR<sub>Q4–Q1</sub> = 1.61, 95% CI = 1.03–2.53) breast cancer (<em>p</em><sub>interaction</sub> = 0.34). In this large consortium study, we confirmed that AMH is associated with breast cancer risk, with a 60% increase in risk for women in the top <em>vs</em>. bottom quartile of AMH.</p><p>What's new? To make informed decisions about screening and prevention, women need tools to accurately assess their breast cancer risk. Young women have few predictive biomarkers to look to; estrogen and progesterone are only weakly predictive before menopause. Anti-Müllerian hormone (AMH), which strongly correlates with age at menopause, may also correlate with breast cancer risk, according to some previous data. Here, the authors test this correlation by conducting nested case-control studies within ten different cohorts. They found that breast cancer risk increased along with increasing AMH concentration, confirming this hormone as a possible biomarker for breast cancer.</p>
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