WHI: normal BMI with high body fat tied to breast cancer risk

  • JAMA Oncol

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Among postmenopausal women with normal BMI (18.5-24.9 kg/m2) participating in the Women's Health Initiative (WHI), the highest (vs lowest) level of whole-body fat is associated with an 89% increase in breast cancer risk.

Why this matters

  • BMI does not distinguish between adiposity and muscle mass.
  • Normal BMI categorization may not be the best proxy for breast cancer risk in postmenopausal women.

Study design

  • Prospective cohort (N=3460) of postmenopausal women in the WHI with normal BMI who underwent body fat measurement using dual-energy X-ray absorptiometry (DXA).
  • Funding: Breast Cancer Research Foundation; Conquer Cancer Foundation; NIH; others.

Key results

  • After a median follow-up of 16 years, women with the highest (vs lowest) quartile of whole-body fat had an 89% increase in invasive breast cancer risk (aHR, 1.89; 95% CI, 1.21-2.95).
  • Women with the highest (vs lowest) quartile of trunk fat mass had an 88% increase in invasive breast cancer risk (aHR, 1.88; 95% CI, 1.18-2.98).
  • Somewhat higher risks were found for estrogen receptor-positive breast cancer, with corresponding aHRs of 2.21 (95% CI, 1.23-3.67) and 1.98 (95% CI, 1.18-3.31), respectively.

Limitations

  • Observational design.
  • Findings limited to postmenopausal women.

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