More adipose tissue increases breast cancer risk after menopause
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SAN DIEGO — Higher amounts of visceral and subcutaneous adipose tissue are associated with an increased risk for breast cancer among postmenopausal women, according to a presenter at ObesityWeek 2022.
In findings from nearly 10,000 women who enrolled in the Women’s Health Initiative from 1993 to 1998, the risk for breast cancer for postmenopausal women with excess visceral adipose tissue was nearly twice as high as that for those with excess subcutaneous adipose tissue, and the risk for breast cancer with excess visceral adipose tissue was even greater for non-Hispanic Black women.
“It is critically important to note that our findings were independent of BMI and that postmenopausal women with a normal BMI were still at significantly increased risk of postmenopausal breast cancer if they carried excess abdominal fat from either depot,” Jennifer W. Bea, PhD, associate professor of health promotion sciences at the University of Arizona and co-leader of the cancer prevention and control program at the University of Arizona Cancer Center, told Healio. “A normal BMI is not a free pass, and it would be useful to evaluate cancer preventive behaviors and body composition among postmenopausal women, even if they have a BMI between 18.5 kg/m2 and 25 kg/m2.”
Researchers analyzed data from 9,950 postmenopausal women without a history of cancer from the WHI (mean age, 63.3 years; mean BMI, 28.2 kg/m2). Baseline DXA scans were used to measure visceral and subcutaneous adipose tissue areas.
There were 738 incident cases of breast cancer reported over 27 years of follow-up. Women diagnosed with breast cancer had higher mean baseline visceral adipose tissue (178.75 cm2 vs. 165.53 cm2) and subcutaneous adipose tissue (405.53 cm2 vs. 378.97 cm2) than women without breast cancer.
In a multivariable-adjusted model, each 100 cm2 increase in visceral adipose tissue (adjusted HR = 1.36; 95% CI, 1.24-1.5) and subcutaneous adipose tissue (aHR = 1.19; 95% CI, 1.12-1.26) were associated with an increase in breast cancer risk. After an additional adjustment for BMI, excess visceral (HR = 1.31; 95% CI, 1.13-1.51) and subcutaneous adipose tissue (HR = 1.15; 95% CI, 1.04-1.26) remained associated with an increased risk for breast cancer. Higher visceral adipose tissue was more strongly associated with an increased risk for breast cancer among Black women, and the risk climbed further after controlling for BMI (aHR = 1.95; 95% CI, 1.19-3.21).
Bea said more studies are needed to confirm the findings before clinical recommendations are made.
“Head-to-head comparison of anthropometric and other more direct body composition measures with these abdominal visceral adipose tissue and subcutaneous adipose tissue measures is still needed to make clinical recommendations for the best measurement related to postmenopausal breast cancer risk,” Bea said. “We are working on those analyses now. We are also examining other cancers for their relation with abdominal visceral adipose tissue and subcutaneous adipose tissue in the prevention setting.”
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Bea JW, et al. O-075. Presented at: ObesityWeek; Nov. 1-4, 2022; San Diego.
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