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Breast cancer incidence and mortality by metabolic syndrome and obesity: The Women's Health Initiative.
Chlebowski, Rowan T; Aragaki, Aaron K; Pan, Kathy; Simon, Michael S; Neuhouser, Marian L; Haque, Reina; Rohan, Thomas E; Wactawski-Wende, Jean; Orchard, Tonya S; Mortimer, Joanne E; Lane, Dorothy; Kaunitz, Andrew M; Desai, Pinkal; Wild, Robert A; Barac, Ana; Manson, JoAnn E.
Afiliación
  • Chlebowski RT; The Lundquist Institute, Torrance, California, USA.
  • Aragaki AK; Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
  • Pan K; Kaiser Permanente Southern California, Downey, California, USA.
  • Simon MS; Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA.
  • Neuhouser ML; Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
  • Haque R; Department of Health Systems Science, Department of Research & Evaluation, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA.
  • Rohan TE; Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA.
  • Wactawski-Wende J; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
  • Orchard TS; Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, USA.
  • Mortimer JE; Human Nutrition Program, Department of Human Sciences, The Ohio State University, Columbus, Ohio, USA.
  • Lane D; Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, California, USA.
  • Kaunitz AM; Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.
  • Desai P; Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA.
  • Wild RA; Weill Cornell Medical College, New York, New York, USA.
  • Barac A; College of Medicine, The University of Oklahoma, Oklahoma City, Oklahoma, USA.
  • Manson JE; Inova Schar Cancer Institute and Inova Schar Heart and Vascular Institute, Fairfax, Virginia, USA.
Cancer ; 130(18): 3147-3156, 2024 Sep 15.
Article en En | MEDLINE | ID: mdl-38736319
ABSTRACT

BACKGROUND:

In the Women's Health Initiative (WHI) randomized trial, dietary intervention significantly reduced breast cancer mortality, especially in women with more metabolic syndrome (MetS) components. Therefore, this study investigated the associations of MetS and obesity with postmenopausal breast cancer after long-term follow-up in the WHI clinical trials.

METHODS:

A total of 68,132 postmenopausal women, without prior breast cancer and with normal mammogram, were entered into WHI randomized clinical trials; 63,330 women with an entry MetS score comprised the study population. At entry, body mass index (BMI) was determined; MetS score (0, 1-2, and 3-4) included the following (1) high waist circumference (≥88 cm), (2) high blood pressure (systolic ≥130 mm Hg and/or diastolic ≥85 mm Hg, or hypertension history), (3) high-cholesterol history, and (4) diabetes history. Study outcomes included breast cancer incidence, breast cancer mortality, deaths after breast cancer, and results by hormone receptor status.

RESULTS:

After a >20-year mortality follow-up, a higher MetS score (3-4), adjusted for BMI, was significantly associated with more poor prognosis, estrogen receptor (ER)-positive, progesterone receptor (PR)-negative cancers (p = .03), 53% more deaths after breast cancer (p < .001), and 44% higher breast cancer mortality (p = .03). Obesity status, adjusted for MetS score, was significantly associated with more good prognosis, ER-positive, PR-positive cancers (p < .001), more total breast cancers (p < .001), and more deaths after breast cancer (p < .001), with higher breast cancer mortality only in women with severe obesity (BMI, ≥35 kg/m2; p < .001).

CONCLUSIONS:

MetS and obesity status have independent, but differential, adverse associations with breast cancer receptor subtypes and breast cancer mortality risk. Both represent separate targets for breast cancer prediction and prevention strategies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Índice de Masa Corporal / Posmenopausia / Síndrome Metabólico / Obesidad Límite: Aged / Female / Humans / Middle aged Idioma: En Revista: Cancer Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Índice de Masa Corporal / Posmenopausia / Síndrome Metabólico / Obesidad Límite: Aged / Female / Humans / Middle aged Idioma: En Revista: Cancer Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos