Trajectories of body mass index across the lifecourse and associations with post-menopausal breast cancer by estrogen receptor status

Dorthe C. Pedersen, Julie Aarestrup, Kim Blond, Britt W. Jensen, Zorana J. Andersen, Lene Mellemkjær, Anne Tjønneland, Jennifer L. Baker*

*Corresponding author af dette arbejde

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Abstract

Background
Associations between a high body mass index (BMI) at single timepoints during child- and adulthood and risks of post-menopausal breast cancer are well-established, but associations with BMI across the lifecourse remains largely unknown. Therefore, we examined whether lifecourse BMI trajectories were associated with risks of post-menopausal breast cancer overall and by estrogen receptor (ER) status.

Methods
We included 6698 Danish women born 1930–1946. Information on BMI at ages 6–15 years came from the Copenhagen School Health Records Register, and information on BMI at ages 20, 30, 40, 50 and/or 50–64 years came from the Diet, Cancer and Health cohort. Breast cancer cases (n = 577) were identified in the Danish Breast Cancer Cooperative Group database. Six BMI trajectories were identified using latent class trajectory modelling. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression models.

Results
Compared to women with a trajectory characterized by an average BMI gain across life, women with the two trajectories with steep increases in BMI during childhood and adolescence that thereafter largely stabilized, had lower risks of post-menopausal breast cancer and ER-positive tumors. The adjusted HRs for ER-positive tumors were 0.67 (95% CI: 0.47–0.95) and 0.68 (95% CI: 0.46–1.01), respectively. In contrast, women with a trajectory with a low gain in BMI during childhood and adolescence followed by a subsequent steep increase during adulthood, had higher risks of post-menopausal breast cancer and ER-positive tumors when compared to women with an average BMI gain. The adjusted HR for ER-positive tumors was 1.28 (95% CI: 0.98–1.67).

Conclusions
Our findings suggest that the timing of excess gain in BMI across the lifecourse impacts subsequent post-menopausal breast cancer risks. Thus, the BMI development across life is likely useful in the identification of women at increased risks of post-menopausal breast cancer.
OriginalsprogEngelsk
Artikelnummer102479
TidsskriftCancer Epidemiology
Vol/bind87
Antal sider6
ISSN1877-7821
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Funding for grant 2018/1760 was obtained from World Cancer Research Fund (WCRF UK), as part of the World Cancer Research Fund International grant programme. The funders had no role in the study design, data collection, data analyses, interpretation of results, preparation of the manuscript or the publication process.

Funding Information:
Funding for grant 2018/1760 was obtained from World Cancer Research Fund (WCRF UK), as part of the World Cancer Research Fund International grant programme. The funders had no role in the study design, data collection, data analyses, interpretation of results, preparation of the manuscript or the publication process.The CSHRR was initiated and planned by Dr. Thorkild I.A. Sørensen and built by the Institute of Preventive Medicine, The Capital Region of Denmark. The Diet, Cancer and Health cohort is supported by the Danish Cancer Society, Denmark. The Danish Clinical Quality Program - National Clinical Registries (RKKP) and the Danish Breast Cancer Cooperative Group (DBCG) provided data on breast cancer for this project.

Funding Information:
The CSHRR was initiated and planned by Dr. Thorkild I.A. Sørensen and built by the Institute of Preventive Medicine, The Capital Region of Denmark. The Diet, Cancer and Health cohort is supported by the Danish Cancer Society , Denmark. The Danish Clinical Quality Program - National Clinical Registries ( RKKP ) and the Danish Breast Cancer Cooperative Group (DBCG) provided data on breast cancer for this project.

Publisher Copyright:
© 2023 The Authors

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