Reversal of Relation Between Body Mass and Endogenous Estrogen Concentrations With Menopausal Status

Potischman, Nancy; Swanson, Christine A.; Siiteri, Pentti K.; Hoover, Robert N.

doi:10.1093/jnci/88.11.756

Cited by 209 publications

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“…Obesity can result in decreased circulatory estrogen levels causing anovulatory cycles. 44,45 In addition, obesity also leads to a state of relative insulin resistance, chronic hyperinsulinemia and an increase in IGF-1 bioactivity because of insulin-mediated decreases in IGF-binding protein 1 (IGFBP-1) and IGFBP-2. Insulin has been shown to be a growth factor for breast cancer cells and level of Cpeptide, a marker of hyperinsulinemia and insulin resistance predicted breast cancer risk.…”

Section: Discussionmentioning

confidence: 99%

Risk factors according to estrogen receptor status of breast cancer patients in Trivandrum, South India

Dey

Boffetta

Mathews

et al. 2009

Intl Journal of Cancer

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Estrogen receptor (ER) status is an important biomarker in defining subtypes of breast cancer differing in antihormonal therapy response, risk factors and prognosis. However, little is known about association of ER status with various risk factors in the developing world. Our case-control study done in Kerala, India looked at the associations of ER status and risk factors of breast cancer. From 2002 to 2005, 1,208 cases and controls were selected at the Regional Cancer Center (RCC), Trivandrum, Kerala, India. Information was collected using a standardized questionnaire, and 3-way analyses compared ER1/ER2 cases, ER1 cases/controls and ER2 cases/controls using unconditional logistic regression to calculate odds ratios and 95% confidence intervals. The proportion of ER2 cases was higher (64.1%) than ER1 cases. Muslim women were more likely to have ER2 breast cancer compared to Hindus (OR 5 1.48, 95% CI 5 1.09, 2.02), an effect limited to premenopausal group (OR 5 1.87, 95% CI 5 1.26, 2.77). Women with higher socioeconomic status were more likely to have ER1 breast cancer (OR 5 1.48, 95% CI 5 1.11, 1.98). Increasing BMI increased likelihood of ER2 breast cancer in premenopausal women (p for trend < 0.001). Increasing age of marriage was positively associated with both ER1 and ER2 breast cancer. Increased breastfeeding and physical activity were in general protective for both ER1 and ER2 breast cancer. The findings of our study are significant in further understanding the relationship of ER status and risk factors of breast cancer in the context of the Indian subcontinent. ' UICCKey words: estrogen receptor; breast cancer; India Estrogen receptor (ER) status of breast tumors has been instrumental in defining an important subtype of breast cancer with differences observed in risk factors, treatment and prognosis. [1][2][3][4][5][6][7] Numerous studies in the past have looked at differences in etiology and risk factors pertaining to presence or absence of ER-alpha. Most of these studies were conducted in Western populations as early as 1980s. [1][2][3][4][5] Around the same time, it was also discovered that ER1 tumors that lacked progesterone receptor (PR) expression were less responsive to endocrine therapy compared to tumors that expressed PR. 8 This led to studies in the past decade that looked at the link of various risk factors of breast cancer and combined ER/PR information to better explain the underlying differences between the various subtypes of breast cancer. 9-13 Chen and Colditz 14 have emphasized the importance of taking into account the ER/PR status information of breast tumors both for effective treatment as well as risk prediction for instituting prophylactic measures. Although there might be numerous ways to subtype breast cancer, the classification into ER1 and ER2 cancer remains a key divider. 14 However, information related to ER status is lacking for populations in developing countries. In fact, in most developing countries, determination of hormone receptor status is not a part of standard pro...

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Section: Discussionmentioning

confidence: 99%

Risk factors according to estrogen receptor status of breast cancer patients in Trivandrum, South India

Dey

Boffetta

Mathews

et al. 2009

Intl Journal of Cancer

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“…Recent studies indicated that in premenopause, the excess oestrogen synthesis in the adipose tissue would be downregulated by luteinizing hormone (LH) and follicular stimulating hormone (FSH). 20,28 However, Potischman et al 29 observed that serum total oestradiol levels decrease with premenopausal obesity. The latter observation may be due to the fact that in premenopausal women, who are naturally oestrogenized, anovulation due to obesity results in a decrease in oestrogen and progesterone production.…”

Section: Discussionmentioning

confidence: 99%

“…The latter observation may be due to the fact that in premenopausal women, who are naturally oestrogenized, anovulation due to obesity results in a decrease in oestrogen and progesterone production. [30][31][32] Moreover, in a study on Several anthropometric measurements and breast cancer risk B Tehard et al premenopausal obese women, Potischman et al 29 noted that injected radiolabelled oestrogen was sequestered by adipose tissue, reducing levels of free oestradiol. A global decrease in ovarian activity and oestrogen storage due to obesity would lead to a decreased risk of premenopausal breast cancer.…”

Section: Discussionmentioning

confidence: 99%

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Several anthropometric measurements and breast cancer risk: results of the E3N cohort study

Téhard

Clavel‐Chapelon

2005

Int J Obes

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Objective: To investigate the association between various anthropometric characteristics and breast cancer. Design: Longitudinal prospective cohort study. Follow-up between 1995 and 2000. Subjects: In total, 69 116 women (age: 45-70 years; mean follow-up: 3.6 years), 275 premenopausal and 860 postmenopausal incident invasive breast cancers. Measurements: Self-reported height, weight, breast, thorax, waist and hip circumferences and calculated body mass index (BMI) and waist-to-hip ratio (WHR) at baseline. Results: A slight increase in risk with increasing height was found. Weight, BMI, thorax and waist circumferences and WHR were negatively related to breast cancer risk among premenopausal women. The relationships became non significant after additional adjustment for BMI. An increased risk of premenopausal breast cancer with an android body shape (WHR40.87) might possibly be confined to obese women. Among postmenopausal women, all anthropometric measurements of corpulence were positively associated with breast cancer risk but became non significant after additional adjustment for BMI. No difference in risk of postmenopausal breast cancer according to HRT use was observed.

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“…Many published studies have shown an effect of exogenous estrogens on increasing mammographic density (19), however, the only published study that examined the association between mammographic density and endogenous estrogens observed no association between total estradiol and percent density in both pre-and postmenopausal women, and an inverse association between free estradiol and percent dense tissue in postmenopausal women (20). The hypothesized mechanism of physical activity influencing mammographic density via sex hormone changes applies especially to obese postmenopausal women, who have higher levels of sex hormone concentrations than leaner postmenopausal women, due to the formation of estrogens in fatty tissue (10,21,22). Thus, higher levels of physical activity may be associated with decreased mammographic density levels among obese postmenopausal women by decreasing sex hormone concentrations directly or indirectly by reducing body fat (7).…”

Section: Discussionmentioning

confidence: 99%

Pre-diagnosis physical activity and mammographic density in breast cancer survivors

Irwin

Aiello

McTiernan

et al. 2005

Breast Cancer Res Treat

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Purpose-To investigate the association between physical activity (PA) and mammographic density in the year before diagnosis in a population-based sample of 474 women diagnosed with stage 0-IIIA breast cancer and enrolled in the Health, Eating, Activity, and Lifestyle Study.Methods-We collected information on PA during an interview administered at a baseline visit scheduled within the first year after diagnosis. Participants recalled the type, duration, and frequency of different PAs for the year prior to their diagnosis. Dense area and percent density were estimated, from mammograms imaged approximately one year before diagnosis, as a continuous measure using a computer-assisted software program. Analysis of covariance methods were used to obtain mean density across PA tertiles adjusted for confounders. We stratified analyses by menopausal status and body mass index (BMI) because these factors strongly influence density.Results-We observed a statistically significant decline in mammographic dense area (p for trend = 0.046) and percent density (p for trend = 0.026) with increasing level of sports/recreational PA in postmenopausal women with a BMI ≥ 30 kg/m 2 . Conversely, in premenopausal women with a BMI < 30 kg/m 2 , we observed a statistically significant increase in percent density with increasing level of sports/recreational PA (p for trend = 0.037).Conclusions-Both mammographic dense area and percent density are inversely related to level of sports/recreational PA in obese postmenopausal women. Increasing PA among obese postmenopausal women may be a reasonable intervention approach to reduce mammographic density.

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Reversal of Relation Between Body Mass and Endogenous Estrogen Concentrations With Menopausal Status

Cited by 209 publications

References 0 publications

Risk factors according to estrogen receptor status of breast cancer patients in Trivandrum, South India

Risk factors according to estrogen receptor status of breast cancer patients in Trivandrum, South India

Several anthropometric measurements and breast cancer risk: results of the E3N cohort study

Pre-diagnosis physical activity and mammographic density in breast cancer survivors

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