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. 2025 May 29.
doi: 10.1038/s41366-025-01814-5. Online ahead of print.

Factors influencing traditional adiposity indicators and mammary adipocyte size in women with breast cancer

Kaoutar Ennour-Idrissi  1   2   3 , Sofia Laforest  3   4   5 , André Tchernof  4   6 , Francine Durocher  3   7 , Caroline Diorio  8   9   10
Affiliations

Factors influencing traditional adiposity indicators and mammary adipocyte size in women with breast cancer

Kaoutar Ennour-Idrissi et al. Int J Obes (Lond). .

Abstract

Background: Mammary adipocyte size reflects both local excess of adiposity and adipose tissue dysfunction relevant to breast cancer biology.

Objective: To identify modifiable factors that are associated with both traditional adiposity indicators and mammary adipocyte size in women with breast cancer, and to compare the individual and simultaneous effect of these factors.

Methods: Data were collected prospectively from 160 consecutive breast cancer patients (biobank of a breast cancer reference center): factors that may influence body weight and composition (telephone interview), dietary intakes (DHQ-I) and adiposity measurements (anthropometric indices and mammary adipocyte size). Relationships between determinants of adiposity identified in the literature were summarized in a directed acyclic graph. Principal component analysis was conducted to capture dietary intakes from major nutrient intakes. Robust univariate and multivariable linear regression models were used to estimate the associations.

Results: Menopausal status, ever smoking, tumour grade and higher weight at 18 years old were consistently associated with higher adiposity. Higher animal fat intakes was consistently associated with higher body mass index (BMI). High educational attainment was consistently associated with lower BMI and waist-to-height ratio. Higher physical activity was associated with lower adiposity and adipocyte cell size, whereas higher age was associated with higher adiposity and adipocyte cell size only in univariate models. Only menopausal status was consistently associated with higher mammary adipocyte size.

Conclusions: While excess adiposity is a complex condition that cannot be attributed to a single factor, menopausal status seems to be the main determinant of excess adiposity in women with breast cancer and the only independent determinant of mammary adipocyte size. Among lifestyle factors, ever smoking was the strongest independent determinant of higher adiposity, followed by high intakes of fats, particularly animal fats. If targeted efficiently, some of these modifiable factors could reduce the burden among breast cancer patients.

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Conflict of interest statement

Competing interests: The authors have no relevant financial or non-financial interests to disclose related to the present work. AT is co-director of the Research Chair in Bariatric and Metabolic Surgery at Laval University. AT receives research funding from Johnson & Johnson, Medtronic, GI Windows and Biowtin for studies on obesity or bariatric surgery, and acted as consultant for Bausch Health, Biotwin and Novo Nordisk. The authors declare that they have no competing interests. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Research Ethics Committee of the CHU de Québec—Laval University Research Center (2012/DR-002-1259). Consent to participate: Informed consent was obtained from all individual participants included in the study.

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