title: Body weight and risk of molecular breast cancer subtypes among postmenopausal Mediterranean women.
abstract: Breast cancer (BC) is the most common malignant tumor in women, obesity is associated with increased BC incidence and mortality and high levels of circulating insulin may negatively impact on cancer incidence. In the present study, we investigated whether the strength of several anthropometric and metabolic parameters varies between BC molecular subtypes. Eligible cases were 991 non-metastatic BC patients recruited between January 2009 and December 2013. Anthropometric, clinical and immunohistochemical features were measured. Multivariate logistic regression models were built to assess HER2 positive BC risk, comparing (a) triple positive (TP) with luminal A, luminal B and triple negative (TN) and (b) HER2-enriched group with luminal A, luminal B and TN. We stratified patients in pre- and post-menopause: significant differences emerged for luminal A in relation to age: they were more likely to be older compared to other groups. Among postmenopausal patients, the adjusted multivariate analysis showed that high BMI and high waist circumference were inversely correlated to TP subtype when compared to luminal B (OR=0.48 and OR=0.49, respectively). Conversely, HOMA-IR was a risk factor for TP when compared to luminal A and TN (OR=2.47 and OR=3.15, respectively). Our findings suggest a potential role of higher abdominal fat in the development of specific BC molecular subtypes in postmenopausal women. Moreover, they support a potential role of insulin resistance in the development of HER2 positive BC, although this role appears to be stronger when hormone receptors are co-expressed, suggesting a difference in the etiology of these two BC subtypes.
authors.affiliation: Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy. Electronic address: anna.crispo@tin.it.
authors.forename: A
authors.initials: A
authors.lastname: Crispo
authors.affiliation: Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Montella
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Buono
authors.affiliation: Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Grimaldi
authors.affiliation: Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: D'Aiuto
authors.affiliation: Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Capasso
authors.affiliation: Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Esposito
authors.affiliation: Department of Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Amore
authors.affiliation: Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Nocerino
authors.affiliation: Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, 61 Queen St. East, Toronto, Canada.
authors.forename: L S A
authors.initials: LS
authors.lastname: Augustin
authors.affiliation: Unit of epidemiology, National Cancer Institute, G.-Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Giudice
authors.affiliation: Division of Pathology, National Cancer Institute, G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Di Bonito
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Giuliano
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Forestieri
authors.affiliation: Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: De Laurentiis
authors.affiliation: Department of Breast Surgery, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola 1, 80131 Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rinaldo
authors.affiliation: Scientific Direction, National Cancer Institute, G. Pascale Foundation, Cappella dei Cangiani 1, 80131 Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ciliberto
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: De Placido
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Arpino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D001835:Body Weight; D001943:Breast Neoplasms / Q000737:chemistry / Q000145:classification / Q000453:epidemiology* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D004198:Disease Susceptibility; D004967:Estrogens; D005260:Female; D018734:Genes, erbB-2; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D017698:Postmenopause; D011374:Progesterone; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012189:Retrospective Studies; D064726:Triple Negative Breast Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000473:pathology; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D014408:Biomarkers, Tumor; D001786:Blood Glucose; D004967:Estrogens; D007328:Insulin; D011374:Progesterone; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: BMI; Breast cancer; HOMA-I; Insulin resistance; Molecular subtypes