title: Body mass index and breast cancer risk according to postmenopausal estrogen-progestin use and hormone receptor status.
abstract: To assess the joint relationships among body mass index, menopausal status, and breast cancer according to breast cancer subtype and estrogen-progestin medication use, we conducted a meta-analysis of 89 epidemiologic reports published in English during 1980-2012 identified through a systematic search of bibliographic databases. Pooled analysis yielded a summary risk ratio of 0.78 (95% confidence interval (CI): 0.67, 0.92) for hormone receptor-positive premenopausal breast cancer associated with obesity (body mass index (weight (kg)/height (m)(2)) ≥30 compared with <25). Obesity was associated with a summary risk ratio of 1.39 (95% CI: 1.14, 1.70) for receptor-positive postmenopausal breast cancer. For receptor-negative breast cancer, the summary risk ratios of 1.06 (95% CI: 0.70, 1.60) and 0.98 (95% CI: 0.78, 1.22) associated with obesity were null for both premenopausal and postmenopausal women, respectively. Elevated postmenopausal breast cancer risk ratios associated with obesity were limited to women who never took estrogen-progestin therapy, with risk ratios of 1.42 (95% CI: 1.30, 1.55) among never users and 1.18 (95% CI: 0.98, 1.42) among users; too few studies were available to examine this relationship according to receptor subtype. Future research is needed to confirm whether obesity is unrelated to receptor-negative breast cancer in populations of postmenopausal women with low prevalence of hormone medication use.
authors.affiliation: Abbreviations: CI, confidence interval; ER, estrogen receptor; MeSH, Medical Subject Headings; PR, progesterone receptor; RR, risk ratio.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Munsell
authors.forename: Brian L
authors.initials: BL
authors.lastname: Sprague
authors.forename: Donald A
authors.initials: DA
authors.lastname: Berry
authors.forename: Gary
authors.initials: G
authors.lastname: Chisholm
authors.forename: Amy
authors.initials: A
authors.lastname: Trentham-Dietz
mesh_terms: D044383:Black People / Q000706:statistics & numerical data; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000378:metabolism*; D015984:Causality; D015897:Comorbidity; D016001:Confidence Intervals; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D004967:Estrogens / Q000008:administration & dosage*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism; D017698:Postmenopause / Q000187:drug effects* / Q000502:physiology; D011372:Progestins / Q000008:administration & dosage*; D011960:Receptors, Estrogen / Q000378:metabolism; D012307:Risk Factors
chemical_list: D004967:Estrogens; D011372:Progestins; D011960:Receptors, Estrogen
keywords: body mass index; breast neoplasms; estrogen receptors; meta-analysis as topic; postmenopausal hormone replacement therapy; progesterone receptors