Body fatness at young ages and risk of breast cancer throughout life

Abstract

Body fatness at young ages may be related to breast cancer risk independently of adult adiposity. The authors conducted a prospective analysis among 188,860 women (7,582 breast cancer cases) in the Nurses' Health Study (1988-2004) and Nurses' Health Study II (1989-2005) who recalled their body fatness at ages 5, 10, and 20 years using a 9-level pictogram (level 1: most lean; level 9: most overweight). Body fatness at young ages was inversely associated with risk of both premenopausal and postmenopausal breast cancer (per 1-unit increase in adolescent body fatness, relative risk (RR) = 0.88 and RR = 0.91, respectively; P(trend) < 0.0001). Among all women, the RR for adolescent body fatness of level 6.5 or higher versus level 1 was 0.57 (per 1-unit increase, RR = 0.90; P(trend) < 0.0001) and was unaffected by adjustment for current body mass index. The association was stronger for women with birth weights under 8.5 pounds (<3.9 kg) than for women with birth weights of 8.5 pounds or more (> or =3.9 kg) (per 1-unit increase, RR = 0.89 and RR = 0.94, respectively; P(interaction) = 0.04) and stronger for estrogen receptor-negative tumors than for estrogen receptor-positive tumors (per 1-unit increase, RR = 0.86 and RR = 0.92, respectively; P(heterogeneity) = 0.03). Body fatness at young ages has a strong and independent inverse relation to breast cancer risk throughout life.

Figure 1.

Figure drawing used to assess body fatness at ages 5, 10, and 20 years in the Nurses’ Health Study (1988) and Nurses’ Health Study II (1989). (Reproduced from Stunkard et al. (26) with permission from Lippincott Williams & Wilkins, Philadelphia, Pennsylvania).