title: An estrogen model: the relationship between body mass index, menopausal status, estrogen replacement therapy, and breast cancer risk.
abstract: We present a mathematical model that lends support to the hypothesis that estrogen levels mediate the complex relationship between body mass index (BMI), menopausal status, estrogen-only hormone replacement therapy (HRT), and breast cancer risk. The model predicts a decrease in the relative risk of breast cancer of 3% per unit increase in BMI (kg/m(2)) for premenopausal women and an increase in the relative risk of 4% per unit increase in BMI for postmenopausal women who are not HRT users. When comparing postmenopausal women who use estrogen-only HRT to postmenopausal women who do not use HRT, the model predicts an increased risk of breast cancer associated with use of estrogen that diminishes with increasing BMI, with a relative risk of 1.6 for women with BMI of 18, 1.2 for women with BMI of 25, and 1.0 for women with BMI ≥ 30. Model predictions agree with data from five major epidemiological studies.
authors.affiliation: Dominican University of California, San Rafael, CA 94901, USA. linda.green@dominican.edu
authors.forename: Linda E
authors.initials: LE
authors.lastname: Green
authors.forename: Tuan A
authors.initials: TA
authors.lastname: Dinh
authors.forename: Robert A
authors.initials: RA
authors.lastname: Smith
mesh_terms: D015992:Body Mass Index; D001943:Breast Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004967:Estrogens / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D005260:Female; D006801:Humans; D008593:Menopause / Q000097:blood*; D015201:Meta-Analysis as Topic; D008954:Models, Biological; D012306:Risk
chemical_list: D004967:Estrogens