Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women's Health Initiative Randomized Clinical Trials.
Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women's Health Initiative Randomized Clinical Trials.
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DOI：
10.1001/jamaoncol.2015.1546
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发表时间：
2015-08
期刊：
影响因子：
28.4
通讯作者：
Anderson, Garnet L.
中科院分区：
文献类型：
--
作者：
Neuhouser, Marian L.;Aragaki, Aaron K.;Prentice, Ross L.;Manson, JoAnn E.;Chlebowski, Rowan;Carty, Cara L.;Ochs-Balcom, Heather M.;Thomson, Cynthia A.;Caan, Bette J.;Tinker, Lesley F.;Urrutia, Rachel Peragallo;Knudtson, Jennifer;Anderson, Garnet L.
超过⅔的美国女性超重或肥胖，使她们患绝经后乳腺癌的风险增加。在妇女健康倡议(WHI)临床试验中，研究超重和肥胖与绝经后浸润性乳腺癌风险的关系。WHI方案包括测量的身高和体重、基线和年度或两年一次的乳房X光检查，以及判断乳腺癌终点。40个美国临床中心。研究对象为67,142名年龄在50-79岁的绝经后妇女，从1993年到1998年，平均随访13年，到2010年，共观察到3388例浸润性乳腺癌。在基线时测量身高和体重，此后每年测量体重。收集了有关人口统计特征、个人和家庭病史以及个人习惯(吸烟、体育活动)的数据。女性每年或每两年进行一次乳房X光检查。由内科裁判员审阅的医疗记录证实了乳腺癌。超重和肥胖的女性与正常体重的女性相比，浸润性乳腺癌的风险增加。2+3级肥胖的风险最大(BMI和GT；35.0 kg/m2)(浸润性乳腺癌的风险比[HR]=1.58，95%可信区间1.40-1.79)。体重指数≥35.0 kg/m2与ER+/PR+乳腺癌的危险性显著相关(HR=1.86 95%CI 1.6 0~2.17)，但与ER−癌无关。肥胖级别2+3也与晚期疾病相关，包括肿瘤体积较大(HR=2.12，95%CI 1.67-2.69)。(P=0.001)、区域/远处分期(HR=1.94，95%CI 1.52~2.47)、乳腺癌死亡(HR=2.11 95%CI 1.57~2.84)(P<0.05)。在随访期间体重增加5%的基线体重为25.0 kg/m2的女性患乳腺癌的风险增加(HR=1.36，95%可信区间1.1-1.65)，但在已经超重或肥胖的女性中，我们发现在随访期间体重变化(增减)与乳腺癌无关。绝经后激素治疗(HT)对BMI和乳腺癌的关系没有影响，而且从不使用、过去使用和现在使用HT时BMI类别之间的关联方向是相似的。在绝经后妇女中，肥胖与浸润性乳腺癌风险增加有关。这些具有临床意义的发现应该会激励肥胖预防计划。
Over ⅔ of U.S. women are overweight or obese, placing them at increased risk for postmenopausal breast cancer. To investigate the associations of overweight and obesity with risk of postmenopausal invasive breast cancer after extended follow-up in the Women’s Health Initiative (WHI) Clinical Trial. The WHI protocol incorporated measured height and weight, baseline and annual or biennial mammography, and adjudicated breast cancer endpoints. 40 U.S. clinical centers. n=67,142 postmenopausal women aged 50–79 years were enrolled from 1993–1998 with a median of 13 years of follow-up through 2010; 3388 invasive breast cancers were observed. Height and weight were measured at baseline and weight was measured annually thereafter. Data were collected on demographic characteristics, personal and family medical history and personal habits (smoking, physical activity). Women underwent annual or biennial mammograms. Breast cancers were verified by medical records reviewed by physician adjudicators. Women who were overweight and obese had an increased invasive breast cancer risk vs. normal weight women. Risk was greatest for obesity grades 2+3 (BMI>35.0 kg/m2) (hazard ratio [HR] for invasive breast cancer =1.58, 95% CI 1.40–1.79). BMI ≥ 35.0 kg/m2 was strongly associated with risk for ER+/PR+ breast cancers (HR=1.86 95% CI 1.60–2.17), but was not associated with ER− cancers. Obesity grade 2+3 was also associated with advanced disease including larger tumor size (HR=2.12 95%CI 1.67–2.69). (P=0.02), positive lymph nodes (HR=1.89 95%CI 1.46–2.45), (P=0.06), regional/distant stage (HR=1.94, 95%CI 1.52–2.47) (P=0.05) and deaths after breast cancer (HR=2.11 95%CI 1.57–2.84) (P<0.001). Women with baseline BMI<25.0 kg/m2 who gained >5% of bodyweight over the follow-up period had an increased breast cancer risk (HR=1.36 95% CI 1.1–1.65), but among women already overweight or obese we found no association of weight change (gain or loss) with breast cancer during follow-up. There was no effect modification of the BMI-breast cancer relationship by postmenopausal hormone therapy (HT) and the direction of association across BMI categories was similar for never, past and current HT use. Obesity is associated with increased invasive breast cancer risk in postmenopausal women. These clinically meaningful findings should motivate programs for obesity prevention.
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共轭性雌激素和乳腺癌的发病率和乳腺癌的死亡率以及子宫切除术后妇女：妇女健康计划的扩展随访随机性安慰剂对照试验。
DOI：
10.1016/s1470-2045(12)70075-x
发表时间：
2012-05
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Anderson GL;Chlebowski RT;Aragaki AK;Kuller LH;Manson JE;Gass M;Bluhm E;Connelly S;Hubbell FA;Lane D;Martin L;Ockene J;Rohan T;Schenken R;Wactawski-Wende J
通讯作者：
Wactawski-Wende J
DOI：
10.1016/j.jsbmb.2006.09.040
发表时间：
2007-04-01
影响因子：
4.1
作者：
Geisler, Juergen;Haynes, Ben;Lonning, Per Eystein
通讯作者：
Lonning, Per Eystein
影响因子：
3.8
作者：
Feigelson, HS;Jonas, CR;Calle, EE
通讯作者：
Calle, EE
影响因子：
5.6
作者：
Anderson, GL;Manson, J;Prentice, RL
通讯作者：
Prentice, RL
DOI：
10.1186/bcr3462
发表时间：
2013
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
Hefti MM;Hu R;Knoblauch NW;Collins LC;Haibe-Kains B;Tamimi RM;Beck AH
通讯作者：
Beck AH