Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Obesity, Mammography Use and Accuracy, and Advanced Breast Cancer Risk

Obesity, Mammography Use and Accuracy, and Advanced Breast Cancer Risk BackgroundBeing overweight or obese is associated with increased breast cancer risk and disease severity among postmenopausal women, but whether extent of mammography use and accuracy modify this association and further contribute to increases in disease severity at diagnosis among overweight and obese women is unclear.MethodsWe prospectively collected data during 19962005 on 287115 postmenopausal women not using hormone therapy (HT) who underwent 614562 mammography examinations; 4446 women were diagnosed with breast cancer within 12 months of a mammography examination. We calculated rates per 1000 mammography examinations of large (>15 mm), advanced-stage (IIb, III, or IV), high-grade (3 or 4), estrogen receptor (ER)positive and negative, and screen-detected and nonscreen-detected breast cancer across body mass index (BMI, kg/m2) groups defined as normal (18.524.9), overweight (25.029.9), obese class I (30.034.9), and obese class II/III (35.0), adjusting for age, race/ethnicity, and mammography registry and use. All statistical tests were two-sided.ResultsAdjusted rates per 1000 mammography examinations of overall breast cancer increased across BMI groups (6.6 normal, 7.4 overweight, 7.9 obese I, 8.5 obese II/III; Ptrend < .001), as did rates of advanced disease, including large invasive (2.3 normal, 2.6 overweight, 2.9 obese I, 3.2 obese II/III; Ptrend < .001), advanced-stage (0.8 normal, 0.9 overweight, 1.3 obese I, 1.5 obese II/III; Ptrend < .001), and high nuclear grade (1.5 normal, 1.7 overweight, 1.7 obese I, 1.9 obese II/III; Ptrend .10) tumors. Rates of ER-positive tumors increased across BMI groups (Ptrend < .001); rates of ER-negative tumors did not. Rates of screen-detected cancers were higher among overweight and obese women than normal and underweight women, but rates of nonscreen-detected (false-negative) cancers were similar. Rates of advanced breast cancer increased across BMI groups regardless of extent of mammography use.ConclusionsPatterns of mammography use and mammography accuracy are not the primary reasons for higher rates of advanced breast cancer among overweight and obese postmenopausal women not using HT; thus, biologic differences in breast tumor development and/or progression may be important. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JNCI: Journal of the National Cancer Institute Oxford University Press

Loading next page...
 
/lp/oxford-university-press/obesity-mammography-use-and-accuracy-and-advanced-breast-cancer-risk-zfyMbluxAx

References (54)

Publisher
Oxford University Press
Copyright
The Author 2008. Published by Oxford University Press.
ISSN
0027-8874
eISSN
1460-2105
DOI
10.1093/jnci/djn388
pmid
19033562
Publisher site
See Article on Publisher Site

Abstract

BackgroundBeing overweight or obese is associated with increased breast cancer risk and disease severity among postmenopausal women, but whether extent of mammography use and accuracy modify this association and further contribute to increases in disease severity at diagnosis among overweight and obese women is unclear.MethodsWe prospectively collected data during 19962005 on 287115 postmenopausal women not using hormone therapy (HT) who underwent 614562 mammography examinations; 4446 women were diagnosed with breast cancer within 12 months of a mammography examination. We calculated rates per 1000 mammography examinations of large (>15 mm), advanced-stage (IIb, III, or IV), high-grade (3 or 4), estrogen receptor (ER)positive and negative, and screen-detected and nonscreen-detected breast cancer across body mass index (BMI, kg/m2) groups defined as normal (18.524.9), overweight (25.029.9), obese class I (30.034.9), and obese class II/III (35.0), adjusting for age, race/ethnicity, and mammography registry and use. All statistical tests were two-sided.ResultsAdjusted rates per 1000 mammography examinations of overall breast cancer increased across BMI groups (6.6 normal, 7.4 overweight, 7.9 obese I, 8.5 obese II/III; Ptrend < .001), as did rates of advanced disease, including large invasive (2.3 normal, 2.6 overweight, 2.9 obese I, 3.2 obese II/III; Ptrend < .001), advanced-stage (0.8 normal, 0.9 overweight, 1.3 obese I, 1.5 obese II/III; Ptrend < .001), and high nuclear grade (1.5 normal, 1.7 overweight, 1.7 obese I, 1.9 obese II/III; Ptrend .10) tumors. Rates of ER-positive tumors increased across BMI groups (Ptrend < .001); rates of ER-negative tumors did not. Rates of screen-detected cancers were higher among overweight and obese women than normal and underweight women, but rates of nonscreen-detected (false-negative) cancers were similar. Rates of advanced breast cancer increased across BMI groups regardless of extent of mammography use.ConclusionsPatterns of mammography use and mammography accuracy are not the primary reasons for higher rates of advanced breast cancer among overweight and obese postmenopausal women not using HT; thus, biologic differences in breast tumor development and/or progression may be important.

Journal

JNCI: Journal of the National Cancer InstituteOxford University Press

Published: Dec 3, 2008

There are no references for this article.