Skip to main content
SpringerLink
Log in

Weight change and risk of postmenopausal breast cancer (United States)

  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective: Although many studies have shown that higher weight increases the risk of postmenopausal breast cancer, some aspects of this association are unclear. In order to examine the risk associated with different patterns of weight change, we analyzed data from a large case–control study of postmenopausal breast cancer.

Methods: Participants included women aged 50–79 years (n = 5031) who are newly diagnosed with invasive breast cancer in Massachusetts, New Hampshire, and Wisconsin. Similarly-aged population controls (n = 5255) were selected at random from driver's license files and Medicare beneficiary lists. Height, weight, and information on other breast cancer risk factors were ascertained by structured telephone interviews from 1992 to 1995, and logistic regression was used to estimate multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI).

Results: Women in the top quintile groups for height at age 20, recent weight, and recent body mass index had significantly increased risks of breast cancer. Among women who reached their highest adult weight at younger ages (≤45 years), increasing weight loss since that age was associated with a reduced risk of postmenopausal breast cancer (OR 0.90, CI 0.84–0.98, per 5 kg). However, weight loss among women whose highest weight occurred after age 45 was not associated with risk (OR 1.00, CI 0.95–1.05, per 5 kg). Weight gain since the lowest adult weight increased risk by 8% for each 5 kg of gain (OR 1.08, CI 1.06–1.11). Temporary weight cycling (weight loss followed by weight gain) was not associated with increased risk.

Conclusions: Weight gain clearly increased risk of postmenopausal breast cancer. These data lend further support to efforts aimed at helping women avoid weight gain as they age.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lubin F, Ruder AM, Wax Y, Modan B (1985) Overweight and changes in weight throughout adult life in breast cancer etiology. Am J Epidemiol 122: 579–588.

    Google Scholar 

  2. Schatzkin A, Palmer JR, Rosenberg R, et al. (1987) Risk factors for breast cancer in Black women. J Natl Cancer Inst 78: 213–217.

    Google Scholar 

  3. Swanson CA, Brinton LA, Taylor PR, et al. (1989) Body size and breast cancer risk assessed in women participating in the Breast Cancer Detection Demonstration Project. Am J Epidemiol 130: 1133–1141.

    Google Scholar 

  4. Hsieh C, Trichopoulos D, Katsouyanni K, Yuasa S (1990) Age at menarche, age at menopause, height and obesity as risk factors for breast cancer: associations and interactions in an international case-control study. Int J Cancer 46: 796–800.

    Google Scholar 

  5. Chu SY, Lee NC, Wingo PA, Senie RT, Greenberg RS, Peterson HB (1991) The relationship between body mass and breast cancer among women enrolled in the Cancer and Steroid Hormone Study. J Clin Epidemiol 44: 1197–1206.

    Google Scholar 

  6. Brinton LA, Swanson CA (1992) Height and weight at various ages and risk of breast cancer. Ann Epidemiol 2: 597–609.

    Google Scholar 

  7. Franceschi S, Favero A, La Vecchia C, et al. (1996) Body size indices and breast cancer risk before and after menopause. Int J Cancer 67: 181–186.

    Google Scholar 

  8. Trentham-Dietz A, Newcomb PA, Storer BE, et al. (1997) Body size and risk of breast cancer. Am J Epidemiol 145: 1011–1019.

    Google Scholar 

  9. Siiteri PK (1987) Adipose tissue as a source of hormones. Am J Clin Nutr 45: 277–282.

    Google Scholar 

  10. Judd HL, Shamonki IM, Frumar AM, LaGasse LD (1982) Origin of serum estradiol in postmenopausal women. Obstet Gynecol 59: 680–686.

    Google Scholar 

  11. Hunter DJ, Willett WC (1993) Diet, body size and breast cancer. Epidemiol Rev 15: 110–132.

    Google Scholar 

  12. Huang Z, Hankinson SE, Colditz GA, et al. (1997) Dual effects of weight and weight gain on breast cancer risk. JAMA 278: 1407–1411.

    Google Scholar 

  13. van den Brandt PA, Dirx MJM, Ronckers CM, van den Hoogen P, Goldbohm RA (1997) Height, weight, weight change, and post-menopausal breast cancer risk: the Netherlands Cohort Study. Cancer Causes Control 8: 39–47.

    Google Scholar 

  14. Barnes-Josiah D, Potter JD, Sellers TA, Himes JH (1995) Early body size and subsequent weight gain as predictors of breast cancer incidence (Iowa, United States). Cancer Causes Control 6: 112–118.

    Google Scholar 

  15. Folsom AR, Kaye SA, Prineas RJ, Potter JD, Gapstur SM, Wallace RB (1990) Increased incidence of carcinoma of the breast associated with abdominal adiposity in postmenopausal women. Am J Epidemiol 131: 794–803.

    Google Scholar 

  16. Harris RE, Namboodiri KK, Wynder EL (1992) Breast cancer risk: effects of estrogen replacement therapy and body mass. J Natl Cancer Inst 84: 1575–1582.

    Google Scholar 

  17. Magnusson C, Baron J, Persson I, et al. (1998) Body size in different periods of life and breast cancer risk in post-menopausal women. Int J Cancer 76: 29–34.

    Google Scholar 

  18. Hankinson SE, Willett WC, Manson JE, et al. (1998) Plasma sex steroid hormone levels and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 90: 1292–1299.

    Google Scholar 

  19. Chetkowski RJ, Meldrum DR, Steingold KA, et al. (1986) Biologic effects of transdermal estradiol. N Engl J Med 314: 1615–1620.

    Google Scholar 

  20. Jurgens RW, Downey LJ, Abernethy WD, Cutler NR, Conrad J (1992) A comparison of circulating hormone levels in postmenopausal women receiving hormone replacement therapy. Am J Obstet Gynecol 167: 459–460.

    Google Scholar 

  21. Breslow NE, Day NE (1980) Statistical Methods in Cancer Research, vol. 1: The Analysis of Case-Control Studies. Lyon: IARC; IARC Scientific Publication 32, pp. 196, 248-279.

    Google Scholar 

  22. Titus-Ernsto. L, Egan KM, Newcomb PA, et al. (1998) Exposure to breast milk in infancy and adult breast cancer risk. J Natl Cancer Inst 90: 921–924.

    Google Scholar 

  23. Newcomb PA, Egan KM, Titus-Ernstoff L, et al. (1999) Lactation in relation to postmenopausal breast cancer. Am J Epidemiol 150: 174–182.

    Google Scholar 

  24. Willett W (1990) Nutritional Epidemiology. New York: Oxford University Press, pp. 228, 333-335.

    Google Scholar 

  25. Armstrong BK, White E, Saracci R (1995) Principles of Exposure Measurement in Epidemiology. Oxford, New York: Monographs in Epidemiology and Biostatistics, vol. 21, pp. 78–114.

  26. Kyogoku S, Hirohata T, Takeshita S, Hirota Y, Shigematsu T (1990) Anthropometric indicators of breast cancer risk in Japanese women in Fukuoka. Jpn J Cancer Res 81: 731–737.

    Google Scholar 

  27. Mannisto S, Pietinen P, Pyy M, Palmgren J, Eskelinen M, Uusitupa M (1996) Body-size indicators and risk of breast cancer according to menopause and estrogen-receptor status. Int J Cancer 68: 8–13.

    Google Scholar 

  28. Ziegler RG, Hoover RN, Nomura AMY, et al. (1996) Relative weight, weight change, height, and breast cancer risk in Asian-American women. J Natl Cancer Inst 88: 650–660.

    Google Scholar 

  29. Ballard-Barbash R, Schatzkin A, Taylor PR, Kahle LL (1990) Association of change in body mass with breast cancer. Cancer Res 50: 2152–2155.

    Google Scholar 

  30. London SJ, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Speizer FE (1989) Prospective study of relative weight, height and risk of breast cancer. JAMA 262: 2853–2858.

    Google Scholar 

  31. Pa.enbarger RS, Kampert JB, Chang H (1980) Characteristics that predict risk of breast cancer before and after the menopause. Am J Epidemiol 112: 258–268.

    Google Scholar 

  32. Le Marchand L, Kolonel LN, Earle ME, Mi M-P (1988) Body size at di.erent periods of life and breast cancer risk. Am J Epidemiol 128: 137–152.

    Google Scholar 

  33. Ingram D, Nottage E, Ng S, Sparrow L, Roberts A, Willcox D (1989) Obesity and breast disease: the role of the female sex hormones. Cancer 64: 1049–1053.

    Google Scholar 

  34. Radimer K, Siskind V, Bain C, Schofield F (1993) Relation between anthropometric indicators and risk of breast cancer among Australian women. Am J Epidemiol 138: 77–89.

    Google Scholar 

  35. Kumar NB, Lyman GH, Allen K, Cox CE, Schapira DV (1995) Timing of weight gain and breast cancer risk. Cancer 76: 243–249.

    Google Scholar 

  36. Powell-Griner E, Anderson JE, Murphy W (1997) State-and sex-specific prevalence of selected characteristics-Behavioral Risk Factor Surveillance System, 1994 and 1995. MMWR CDC Surveill Summ 46: 1–29.

    Google Scholar 

  37. Schapira DV, Kumar NB, Lyman GH, Cox CE (1990) Abdominal obesity and breast cancer risk. Ann Intern Med 112: 182–186.

    Google Scholar 

  38. Reeves MJ, Newcomb PA, Remington PL, Marcus PM (1995) Determinants of breast cancer detection among Wisconsin (United States) women, 1988-90. Cancer Causes Control 6: 103–111.

    Google Scholar 

  39. Egan KM, Newcomb PA, Titus-Ernstoff L, et al. (1999) The relation of breast size to breast cancer risk in postmenopausal women. Cancer Causes Control 10: 115–118.

    Google Scholar 

  40. Prentice AM, Jebb SA, Goldberg GR, et al. (1992) Effects of weight cycling on body composition. Am J Clin Nutr 56: 209S–216S.

    Google Scholar 

  41. Muls E, Kempen K, Vansant G, Saris W (1995) Is weight cycling detrimental to health? A review of the literature in humans. Int J Obes 19: S46–S50.

    Google Scholar 

  42. Jeffrey RW (1996) Does weight cycling present a health risk? Am J Clin Nutr 63 (Suppl.): 452S–455S.

    Google Scholar 

  43. National Task Force on the Prevention and Treatment of Obesity (1994) Weight cycling. JAMA 272: 1196–1202.

    Google Scholar 

  44. Wing RR (1992) Weight cycling in humans: a review of the literature. Ann Behav Med 14: 113–119.

    Google Scholar 

  45. Kushi LH, Kaye SA, Folsom AR, et al. (1988) Accuracy and reliability of self-measurements of body girths. Am J Epidemiol 128: 740–748.

    Google Scholar 

  46. Rimm EB, Stampfer MJ, Colditz GA, Chute CG, Litin LB, Willett WC (1990) Validity of self-reported waist and hip circumferences in men and women. Epidemiology 1: 466–473.

    Google Scholar 

  47. Must A, Willett WC, Dietz WH (1993) Remote recall of childhood height, weight, and body build by elderly subjects. Am J Epidemiol 138: 56–64.

    Google Scholar 

  48. Davis H, Gergen PJ (1994) The weights and heights of Mexican-American adolescents: the accuracy of self-reports. Am J Public Health 84: 459–462.

    Google Scholar 

  49. Stewart A (1982) The reliability and validity of self-reported weight and height. J Chron Dis 35: 295–309.

    Google Scholar 

  50. Stunkard AJ, Albaum JM (1981) The accuracy of self-reported weights. Am J Clin Nutr 34: 1593–1599.

    Google Scholar 

  51. Maehle BO, Tretli S (1996) Pre-morbid body-mass-index in breast cancer: reversed effect on survival in hormone receptor negative patients. Breast Cancer Res Treat 41: 123–130.

    Google Scholar 

  52. Haybittle J, Houghton J, Baum M (1997) Social class and weight as prognostic factors in early breast cancer. Br J Cancer 75: 729–733.

    Google Scholar 

  53. Bastarrachea J, Hortobagyi GN, Smith TL, Kau SW, Suzdar AU (1994) Obesity as an adverse prognostic factor for patients receiving adjuvant chemotherapy for breast cancer. Ann Intern Med 120: 18–25.

    Google Scholar 

  54. Freni SC, Eberhardt MS, Turturro A, Hine RJ (1996) Anthropometric measures and metabolic rate in association with risk of breast cancer (United States). Cancer Causes Control 7: 358–365.

    Google Scholar 

  55. Key TJA, Pike MC (1988) The role of oestrogens and progestagens in the epidemiology and prevention of breast cancer. Eur J Cancer Clin Oncol 24: 29–43.

    Google Scholar 

  56. Thomas HV, Reeves GK, Key TJA (1997) Endogenous estrogen and postmenopausal breast cancer: a quantitative review. Cancer Causes Control 8: 922–928.

    Google Scholar 

  57. Thomas HV, Key TJ, Allen DS, et al. (1997) Re: Reversal of relation between body mass and endogenous estrogen concentrations with menopausal status. J Natl Cancer Inst 89: 396–397.

    Google Scholar 

  58. Ota DM, Jones LA, Jackson GL, Jackson PM, Kemp K, Bauman D (1986) Obesity, non-protein-bound estradiol level, and distribution of estradiol in the sera of breast cancer patients. Cancer 57: 558–562.

    Google Scholar 

  59. Lobo RA (1997) The postmenopausal state and estrogen deficiency. In: Lindsay R, Dempster DW, Jordan VC, eds. Estrogens and Antiestrogens. Philadelphia, PA: Lippincott-Rave, pp. 63–72.

    Google Scholar 

  60. Vermeulen A, Verdonck L (1979) Factors affecting sex hormone levels in postmenopausal women. J Steroid Biochem 11: 899–904.

    Google Scholar 

  61. Grodin JM, Siiteri PK, MacDonald PC (1973) Source of estrogen production in postmenopausal women. J Clin Endocrinol Metab 36: 207–214.

    Google Scholar 

  62. Kaaks R (1996) Nutrition, hormones, and breast cancer: is insulin the missing link? Cancer Causes Control 7: 605–625.

    Google Scholar 

  63. Cauley JA, Lucas FL, Kuller LH, Stone K, Browner W, Cummings SR (1999) Elevated serum estradiol and testosterone concentrations are associated with a high risk for breast cancer. Study of Osteoporotic Fractures Research Group. Ann Intern Med 130: 270–277.

    Google Scholar 

  64. Mezzetti M, La Vecchia C, Decarli A, Boyle P, Talamini R, Franceschi S (1998) Population attributable risk for breast cancer: diet, nutrition, and physical exercise. J Natl Cancer Inst 90: 389–394.

    Google Scholar 

  65. Brownson RC, Reif JS, Alavanja MCR, Bal DG (1993) Cancer. In: Brownson RC, Remington PL, Davis JR, eds. Chronic Disease Epidemiology and Control. Washington, DC: American Public Health Association, pp. 150–153.

    Google Scholar 

  66. Brinton LA, Malone KE, Stanford JL, Liff J, Schoenberg JB (1994) Re: “Should we consider a subject's knowledge of the etiologic hypothesis in the analysis of case-control studies?” Am J Epidemiol 140: 1054–1055.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Wisconsin Comprehensive Cancer Center, 1300 University Avenue, MSC Room, 4760, Madison, WI, USA

    Amy Trentham-Dietz

  2. Cancer Research Center, Seattle, WA, USA

    Polly A. Newcomb

  3. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Kathleen M. Egan, Meir Stampfer & Walter C. Willett

  4. Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    Linda Titus-Ernstoff & John A. Baron

  5. Cancer Research Center, Seattle, WA, USA

    Barry E. Storer

  6. Channing Laboratory, Harvard Medical School and the Department of Medicine, Brigham and Women's Hospital, and the Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    Meir Stampfer & Walter C. Willett

Authors
  1. Amy Trentham-Dietz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Polly A. Newcomb
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathleen M. Egan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Linda Titus-Ernstoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John A. Baron
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Barry E. Storer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Meir Stampfer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Walter C. Willett
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Trentham-Dietz, A., Newcomb, P.A., Egan, K.M. et al. Weight change and risk of postmenopausal breast cancer (United States). Cancer Causes Control 11, 533–542 (2000). https://doi.org/10.1023/A:1008961931534

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1008961931534

Search

Navigation