Alcohol, Height, and Adiposity in Relation to Estrogen and Prolactin Levels in Postmenopausal Women

Hankinson, Susan E.; Willett, Walter C.; Manson, JoAnn E.; Hunter, David J.; Colditz, Graham A.; Stampfer, Meir J.; Longcope, Christopher; Speizer, Frank E.

doi:10.1093/jnci/87.17.1297

Cited by 495 publications

(323 citation statements)

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“…Two-thirds of breast tumours are oestrogen-dependent, and aromatase inhibitors can help block the growth of these tumours by lowering the amount of oestrogen in the body (Yeu and Santen, 1996). As it is known that exemestane and the other aromatase inhibitors reduce circulating oestrogen levels, and that oestrogens have direct effects on adipocytes and the other cellular constituents of adipose tissue, there may be an association between exemestane use, reduced circulating oestrogen levels and body weight changes (Siiteri, 1987;Selby, 1990;Hankinson et al, 1995). However, if such an association exists, our data do not offer any evidence as to whether the expected decrease in oestrogen levels was the cause or effect of body weight changes.…”

Section: Discussionmentioning

confidence: 57%

Exemestane after tamoxifen as adjuvant hormonal therapy in postmenopausal women with breast cancer: effects on body composition and lipids

et al. 2006

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Recent studies have shown that administering the aromatase inhibitor exemestane after 2 -3 years of tamoxifen therapy significantly improves disease-free survival in postmenopausal women with primary breast cancer in comparison with standard 5-year tamoxifen treatment. Although many of the adverse effects associated with exemestane and tamoxifen have been analysed, there are no comparative data concerning body weight and body composition. The aim of this randomised study was to evaluate the longitudinal changes in body composition and lipid profiles in postmenopausal women switched from tamoxifen to exemestane. In total, 60 overweight or obese postmenopausal patients were enrolled. Their anthropometric data, body composition, including fat mass (FM) and fat-free mass (FFM), and lipid profiles, caloric intake and physical activity were assessed 1 week before randomisation, and 6 and 12 months later. In all, 55 patients (27 on tamoxifen and 28 on exemestane) completed the 1-year study period. Fat mass had significantly decreased by month 12 in the exemestane, but not in the tamoxifen group; the between-group difference was statistically significant (Po0.01). The FFM/FM ratio had significantly increased in the exemestane group, but not the tamoxifen group; the between-group difference was statistically significant (Po0.05). Triglycerides and high-density lipoprotein cholesterol significantly decreased (Po0.01; Po0.05), and low-density lipoprotein cholesterol significantly increased (Po0.01) in the exemestane group at the end of the 1-year study period. Our findings suggest that switching patients to adjuvant exemestane treatment after at least 2 years of tamoxifen therapy may be associated with an advantage over continuing adjuvant tamoxifen treatment in terms of body composition.

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Section: Discussionmentioning

confidence: 57%

Exemestane after tamoxifen as adjuvant hormonal therapy in postmenopausal women with breast cancer: effects on body composition and lipids

et al. 2006

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“…Previous human studies have shown that both acute and chronic alcohol consumption increases circulating E2 levels in non-pregnant women (Hankinson et al, 1995), possibly by alcohol-induced increase in aromatase activity (Purohit, 2000). A positive association between alcohol intake during pregnancy and pregnancy oestrogen levels in humans has also been reported (Petridou et al, 1992;Wuu et al, 2002).…”

Section: Discussionmentioning

confidence: 93%

“…Another dietary factor that might modify pregnancy E2 levels is alcohol. Alcohol intake increases serum oestrogen levels (Hankinson et al, 1995), possibly by stimulating aromatase activity (Purohit, 2000), and alcohol has been consistently linked to increased risk of developing breast cancer (Smith-Warner et al, 1998;Singletary and Gapstur, 2001;Hamajima et al, 2002). Studies in humans indicate that mothers reporting having consumed some alcohol during pregnancy have higher pregnancy E2 levels than women who do not drink any alcohol during pregnancy (Petridou et al, 1992;Wuu et al, 2002).…”

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confidence: 99%

In utero alcohol exposure increases mammary tumorigenesis in rats

et al. 2004

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Findings in humans and animal models suggest that in utero hormonal and dietary exposures increase later breast cancer risk. Since alcohol intake by adult women consistently increases their breast cancer risk, we wondered whether maternal alcohol consumption during pregnancy increases female offspring's mammary tumorigenesis. In our study, pregnant female rats were pair-fed isocaloric diets containing either 0 (control), 16 or 25 g alcohol kg À1 feed between days 7 and 19 of gestation. These alcohol exposures generate blood alcohol levels that correspond to low and moderate alcohol consumption and are lower than those that induce foetal alcohol syndrome. Serum oestradiol levels were elevated in pregnant rats exposed to alcohol (Po0.003). When adult, female offspring of alcohol-exposed dams developed significantly more 7,12-dimethylbenz[a]anthracene -induced mammary tumours, compared to the controls (tumour multiplicity; mean7s.e.m., controls: 2.070.3, 16 g alcohol: 2.770.4 and 25 g alcohol: 3.770.4; Po0.006). In addition, the mammary epithelial tree of the alcohol-exposed offspring was denser (Po0.004) and contained more structures that are susceptible for the initiation of breast cancer (Po0.001). Immunohistochemical assessment indicated that the mammary glands of 22-week-old in utero alcohol-exposed rats contained elevated levels of oestrogen receptor-a (Po0.04) that is consistent with the changes in mammary gland morphology. In summary, maternal alcohol intake during pregnancy increases female offspring's mammary tumorigenesis, perhaps by programming the foetal mammary gland to exhibit persistent alterations in morphology and gene expression. It remains to be determined whether an increase in pregnancy oestradiol levels mediated alcohol's effects on offspring's mammary tumorigenesis.

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“…[47][48][49] Obesity causes an increased production of the estrogen known as estrone via the aromatization of androstenedione in peripheral adipose tissue. 46,50 In addition, obesity is associated with low levels of sex hormone-binding globulin, which results in a significantly higher level of the biologically active, unbound form of estrogen known as estradiol. 46,51,52 Therefore, it is possible that obesity leads to an overall increase in the active levels of estrone and estradiol and that the high levels of these hormones promote the growth of breast tumors in obese women.…”

Section: Discussionmentioning

confidence: 99%

Body mass and stage of breast cancer at diagnosis

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et al. 2001

Intl Journal of Cancer

156

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Obesity is a well-known risk factor for postmenopausal breast cancer. In contrast, the relationship between obesity and stage of breast cancer at diagnosis is less clear. We hypothesized that increased breast size in obese women may delay discovery of breast tumors. Thus, the purpose of our study was to examine whether there is an association between body mass and stage of breast cancer at diagnosis using hospital medical records. Newly diagnosed breast cancer cases (n ‫؍‬ 966) in the Baltimore metropolitan area from 1991 to 1997 were included in our study. Obesity is a well-known risk factor for breast cancer, with the effect being limited to postmenopausal women. [1][2][3][4][5][6][7][8][9] In premenopausal women, there is an inverse association between body mass and the risk of breast cancer, i.e., obese women are less likely to get breast cancer than nonobese women. In contrast, the relationship between obesity and stage at diagnosis in either premenopausal or postmenopausal women is less clear. This is partially because this relationship has not been studied in detail and the results from existing studies are equivocal. For example, several 10 -20 but not all 21,22 studies report that being overweight is associated with late stage at diagnosis. In addition, some studies report that both large tumor size and lymph node involvement are associated with higher body weight, 16,23,24 whereas other studies report that tumor size, but not lymph node involvement are associated with higher body weight. 17,[25][26][27][28] Furthermore, 1 study has reported that lymph node involvement, but not tumor size, is associated with obesity. 29 In obese women with larger breasts, palpation for lumps may be more difficult, resulting in delay in detection and diagnosis of breast cancer. This idea is supported by studies showing that women with large breasts (or bra size as a surrogate) are more likely to be diagnosed at a later stage of breast cancer than women with small breasts. 18,28,30 A study by Reeves et al. 11 reported that the positive association between body mass index (BMI) and stage was confined to tumors that were detected by women themselves. In a recent study, however, Hall et al. 18 reported that the observed positive association was not modified by method of detection.The purpose of our study was to help clarify the relationship between body mass and breast cancer by determining whether there is an association between obesity and stage of breast cancer at diagnosis. We also wished to determine whether there is a positive association between obesity and each of the 3 components for tumor staging (tumor size, node status and distant metastasis) and to explore whether the association between obesity and tumor stage was modified by age. MATERIAL AND METHODS Study subjectsThis is a case series study of breast cancer using data from hospital medical records. Breast cancer cases were obtained from 2 hospitals in the Baltimore metropolitan area. Although all recorded cases of breast cancer were obtained by the investig...

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Alcohol, Height, and Adiposity in Relation to Estrogen and Prolactin Levels in Postmenopausal Women

Cited by 495 publications

References 0 publications

Exemestane after tamoxifen as adjuvant hormonal therapy in postmenopausal women with breast cancer: effects on body composition and lipids

Exemestane after tamoxifen as adjuvant hormonal therapy in postmenopausal women with breast cancer: effects on body composition and lipids

In utero alcohol exposure increases mammary tumorigenesis in rats

Body mass and stage of breast cancer at diagnosis

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