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dc.contributor.authorPremenopausal Breast Cancer Collaborative Groupen_US
dc.contributor.authorSchoemaker, MJen_US
dc.contributor.authorNichols, HBen_US
dc.contributor.authorWright, LBen_US
dc.contributor.authorBrook, MNen_US
dc.contributor.authorJones, MEen_US
dc.contributor.authorO'Brien, KMen_US
dc.contributor.authorAdami, H-Oen_US
dc.contributor.authorBaglietto, Len_US
dc.contributor.authorBernstein, Len_US
dc.contributor.authorBertrand, KAen_US
dc.contributor.authorBoutron-Ruault, M-Cen_US
dc.contributor.authorBraaten, Ten_US
dc.contributor.authorChen, Yen_US
dc.contributor.authorConnor, AEen_US
dc.contributor.authorDorronsoro, Men_US
dc.contributor.authorDossus, Len_US
dc.contributor.authorEliassen, AHen_US
dc.contributor.authorGiles, GGen_US
dc.contributor.authorHankinson, SEen_US
dc.contributor.authorKaaks, Ren_US
dc.contributor.authorKey, TJen_US
dc.contributor.authorKirsh, VAen_US
dc.contributor.authorKitahara, CMen_US
dc.contributor.authorKoh, W-Pen_US
dc.contributor.authorLarsson, SCen_US
dc.contributor.authorLinet, MSen_US
dc.contributor.authorMa, Hen_US
dc.contributor.authorMasala, Gen_US
dc.contributor.authorMerritt, MAen_US
dc.contributor.authorMilne, RLen_US
dc.contributor.authorOvervad, Ken_US
dc.contributor.authorOzasa, Ken_US
dc.contributor.authorPalmer, JRen_US
dc.contributor.authorPeeters, PHen_US
dc.contributor.authorRiboli, Een_US
dc.contributor.authorRohan, TEen_US
dc.contributor.authorSadakane, Aen_US
dc.contributor.authorSund, Men_US
dc.contributor.authorTamimi, RMen_US
dc.contributor.authorTrichopoulou, Aen_US
dc.contributor.authorUrsin, Gen_US
dc.contributor.authorVatten, Len_US
dc.contributor.authorVisvanathan, Ken_US
dc.contributor.authorWeiderpass, Een_US
dc.contributor.authorWillett, WCen_US
dc.contributor.authorWolk, Aen_US
dc.contributor.authorYuan, J-Men_US
dc.contributor.authorZeleniuch-Jacquotte, Aen_US
dc.contributor.authorSandler, DPen_US
dc.contributor.authorSwerdlow, AJen_US
dc.coverage.spatialUnited Statesen_US
dc.identifier.citationJAMA Oncol, 2018, 4 (11), pp. e181771 - ?en_US
dc.description.abstractImportance: The association between increasing body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and risk of breast cancer is unique in cancer epidemiology in that a crossover effect exists, with risk reduction before and risk increase after menopause. The inverse association with premenopausal breast cancer risk is poorly characterized but might be important in the understanding of breast cancer causation. Objective: To investigate the association of BMI with premenopausal breast cancer risk, in particular by age at BMI, attained age, risk factors for breast cancer, and tumor characteristics. Design, Setting, and Participants: This multicenter analysis used pooled individual-level data from 758 592 premenopausal women from 19 prospective cohorts to estimate hazard ratios (HRs) of premenopausal breast cancer in association with BMI from ages 18 through 54 years using Cox proportional hazards regression analysis. Median follow-up was 9.3 years (interquartile range, 4.9-13.5 years) per participant, with 13 082 incident cases of breast cancer. Participants were recruited from January 1, 1963, through December 31, 2013, and data were analyzed from September 1, 2013, through December 31, 2017. Exposures: Body mass index at ages 18 to 24, 25 to 34, 35 to 44, and 45 to 54 years. Main Outcomes and Measures: Invasive or in situ premenopausal breast cancer. Results: Among the 758 592 premenopausal women (median age, 40.6 years; interquartile range, 35.2-45.5 years) included in the analysis, inverse linear associations of BMI with breast cancer risk were found that were stronger for BMI at ages 18 to 24 years (HR per 5 kg/m2 [5.0-U] difference, 0.77; 95% CI, 0.73-0.80) than for BMI at ages 45 to 54 years (HR per 5.0-U difference, 0.88; 95% CI, 0.86-0.91). The inverse associations were observed even among nonoverweight women. There was a 4.2-fold risk gradient between the highest and lowest BMI categories (BMI≥35.0 vs <17.0) at ages 18 to 24 years (HR, 0.24; 95% CI, 0.14-0.40). Hazard ratios did not appreciably vary by attained age or between strata of other breast cancer risk factors. Associations were stronger for estrogen receptor-positive and/or progesterone receptor-positive than for hormone receptor-negative breast cancer for BMI at every age group (eg, for BMI at age 18 to 24 years: HR per 5.0-U difference for estrogen receptor-positive and progesterone receptor-positive tumors, 0.76 [95% CI, 0.70-0.81] vs hormone receptor-negative tumors, 0.85 [95% CI: 0.76-0.95]); BMI at ages 25 to 54 years was not consistently associated with triple-negative or hormone receptor-negative breast cancer overall. Conclusions and Relevance: The results of this study suggest that increased adiposity is associated with a reduced risk of premenopausal breast cancer at a greater magnitude than previously shown and across the entire distribution of BMI. The strongest associations of risk were observed for BMI in early adulthood. Understanding the biological mechanisms underlying these associations could have important preventive potential.en_US
dc.format.extente181771 - ?en_US
dc.titleAssociation of Body Mass Index and Age With Subsequent Breast Cancer Risk in Premenopausal Women.en_US
dc.typeJournal Article
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfJAMA Oncolen_US
pubs.notesNo embargoen_US
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Breast Cancer Research/Aetiological Epidemiology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Aetiological Epidemiology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Genetics and Epidemiology/Oncogenetics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Oncogenetics
pubs.embargo.termsNo embargoen_US
icr.researchteamAetiological Epidemiologyen_US
dc.contributor.icrauthorSwerdlow, Anthonyen_US
dc.contributor.icrauthorSchoemaker, Minouken_US
dc.contributor.icrauthorWright, Laurenen_US
dc.contributor.icrauthorBrook, Marken_US
dc.contributor.icrauthorJones, Michaelen_US

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