title: Overweight in relation to tumour size and axillary lymph node involvement in postmenopausal breast cancer patients-differences between women invited to vs. not invited to mammography in a randomized screening trial.
abstract: OBJECTIVE
  Overweight is associated with advanced stage at diagnosis in breast cancer patients. This could be explained by specific tumour characteristics or tumour promoting factors in the obese, but a diagnostic delay could also be of importance. Mammographic screening has caused a change towards diagnosis of less advanced tumours. This study investigates invitation to mammographic screening and the association between overweight and tumour size/axillary lymph node involvement at breast cancer diagnosis in postmenopausal women.
  
  
  METHODS
  In 1976 a randomized mammographic screening trial, inviting 50% of all women aged 45-69 was set up in Malmö, Sweden. The present analysis examined overweight (body mass index >or=25) as a determinant for large tumours (>20mm) and axillary lymph node involvement in postmenopausal women. These associations were studied separately in patients diagnosed prior to the mammographic screening trial, in invited women and in non-invited subjects (controls). In all, 2478 postmenopausal women were diagnosed with invasive breast cancer in these groups between 1961 and 1991. Logistic regression analysis allowed adjustment for other potential determinants of tumours size and axillary lymph node involvement.
  
  
  RESULTS
  In women diagnosed before the onset of the screening trial and in women not invited to mammography in the trial (controls), overweight was positively associated with large tumour size and axillary node involvement. There was no statistically significant association between overweight and these factors in women invited to mammographic screening.
  
  
  CONCLUSIONS
  Invitation to mammographic screening may be particularly important for overweight postmenopausal women in order to detect breast tumours early.
authors.affiliation: Dept. of Surgery, Malmö University Hospital, Malmö, Sweden. Asa.Olsson@skane.se
authors.forename: Asa
authors.initials: A
authors.lastname: Olsson
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Garne
authors.forename: Ingrid
authors.initials: I
authors.lastname: Tengrup
authors.forename: Sophia
authors.initials: S
authors.lastname: Zackrisson
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001365:Axilla; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology*; D016504:Breast Self-Examination; D016009:Chi-Square Distribution; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D050177:Overweight / Q000150:complications*; D017698:Postmenopause; D016032:Randomized Controlled Trials as Topic