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Table 2: Weight gain and the risk of breast cancer

  

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: Many studies have linked weight gain in adulthood with an increased risk of breast cancer in postmenopausal women. To date, the few studies that have addressed weight gain and premenopausal breast cancer have had mixed results.

Learn more about weight gain and breast cancer risk.

Learn about the strengths and weaknesses of different types of studies.

See how this risk factor compares with other risk factors for breast cancer.

Study selection criteria: Prospective cohort studies with at least 1,000 breast cancer cases and meta-analyses.

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk. 

Study 

Study Population
(number of participants) 

Follow-up
(years) 

Time of Weight Gain 

Categories of Weight Gain Compared 

Relative Risk of Breast Cancer in Women who Gained the Most Weight Compared to Women who Gained the Least 
RR (95% CI)
 

Premenopausal 

Postmenopausal 

Prospective cohort studies 

Nurses' Health Study [1]

84,143
(4,393 cases)

26

From age 18

11-22 lbs.
vs.
little weight change (less than 4.4 lbs. gain or loss)

 

1.15 (1.01-1.31)

       

22-44 lbs.
vs.
little weight change

 

1.15 (1.01-1.30)

       

44-55 lbs.
vs.
little weight change

 

1.21 (1.05-1.40)

       

More than 55 lbs.
vs.
little weight change

 

1.45 (1.27-1.66)* 

 

49,514
(2,376 cases)

24

From age at menopause

22 lbs. or more
vs.
little weight change

 

1.18 (1.03-1.35)

Multiethnic Cohort [2]

82,971
(3,080 cases)

8-11

From age 21

20.1-31 lbs.
vs.
8-20 lbs.
 

1.13 (0.99-1.27) 

        31.1-49.9 lbs.
vs.
8-20 lbs. 
 

1.23 (1.07-1.40) 

         50 or more lbs.
vs.
8-20 lbs.
 

1.39 (1.18-1.64) 

Iowa Women's Health Study [3]

36,658
(2,286 cases)

16

From age 18

29-45 lbs.
vs.
13 lbs. or less

  Age 55-64:
1.13 (0.85-1.48)

Age 65-74:
1.31 (1.11-1.55)

Age 75-84:
1.42 (1.10-1.84)
 
       

More than 45 lbs.
vs.
13 lbs. or less

 

Age 55-64:
1.47 (1.13-1.91)

Age 65-74:
1.78 (1.52-2.08)

Age 75-84:
1.79 (1.40-2.30)

NIH-AARP Diet and Health Study [4]

99,039
(2,111 cases)

4

From age 18

66-88 lbs.
vs.
little weight change (+/- 4.2 lbs.)

 

1.87 (1.29-2.72) 

     

From age 50

66-88 lbs.
vs.
little weight change (+/- 4.2 lbs.)

 

1.89 (1.20-2.97) 

     

Between ages 35 and 50

66-88 lbs.
vs.
little weight change (+/- 4.2 lbs.)

 

2.29 (1.51-3.46) 

Cancer Prevention Study-II (CPS-II) [5]

65,756
(1,934 cases)

7-9

From age 18

71 lbs. or more
vs.
little weight change

 

2.13 (1.50-3.01)§ 

Nurses' Health Study and Nurses' Health Study II [6]

165,608
(1,811 cases)

14-28

From age 18

33-43.9 lbs. vs.
little weight change

0.86 (0.68-1.07)

 
       

44-54.9 lbs. vs.
little weight change

0.88 (0.66-1.18)  
        55 lbs. or more
vs.
little weight change

0.74 (0.52-1.04)

 

EPIC Cohort [7]

98,352
(1,358 cases)

5.8

From age 20

More than 44 lbs.
vs.
little weight change (+/- 4.4 lbs.)

0.87 (0.51-1.49)

1.22 (0.96-1.56)|| 

CPS-II [8]

44,161
(1,200 cases) 

9

From age 18

21-40 lbs.
vs.
5-20 lbs.


 

Ductal carcinoma:
1.28 (1.08-1.53)§ 

Lobular and mixed ductal/lobular carcinoma:
0.99 (0.70-1.39)§ 


 

 

 

 

41-60 lbs.
vs.
5-20 lbs.


 

Ductal carcinoma:
1.65 (1.37-2.00)§ 

Lobular and mixed ductal/lobular carcinoma:
1.08 (0.73-1.61)§ 


 

 

 

 

61 lbs. or more
vs.
5-20 lbs.


 

Ductal carcinoma:
1.89 (1.53-2.34)§ 

Lobular and mixed ductal/lobular carcinoma:
1.54 (1.01-2.33)§ 

Black Women’s Health Study [9]

52,080
(1,062 cases)

10

From age 18

55 lbs. or more
vs.
less than 22 lbs.

1.17 (0.90-1.52)

1.09 (0.81-1.48)

Women's Health Initiative [10]

85,917
(1,030 cases)

2.9

From age 18

BMI change more than 9.7
vs.
no BMI change

 

1.92 (1.07-3.43)§

Meta-analyses 

Vrieling et al. [11]

7 studies

 

From age 18

Various

 

For ER+/PR+ tumors:
2.33 (2.05-2.60)

For ER-/PR- tumors:
1.34 (1.06-1.63)

ER+ = estrogen receptor-positive

ER- = estrogen receptor-negative

PR+ = progesterone receptor-positive

PR- = progesterone receptor-negative  

* Weight gain increased breast risk more in postmenopausal women not taking postmenopausal hormones than in those currently taking hormones. Among women who were not taking postmenopausal hormones, a weight gain of 55 pounds or more showed an increase in risk of 1.98 (1.55-2.53). Among women who were currently taking postmenopausal hormones, a weight gain of 55 pounds or more showed an increase in risk of 1.20 (1.01-1.43).

† Weight gain increased breast cancer risk more in postmenopausal women who never used postmenopausal hormones and in women who took postmenopausal hormones in the past than in those currently taking hormones. Among never users, a weight gain of 50 or more pounds had a relative risk of 1.60 (1.36-1.87) and among past users, 1.60 (1.27-2.01). Among women currently taking postmenopausal hormones, a weight gain of 50 or more pounds had a relative risk of 1.14 (0.97-1.35).

‡ Among women not currently taking postmenopausal hormones. Among women using postmenopausal hormones, there was no increase in risk from weight gain.

§ Among women who had never used postmenopausal hormones.

|| Among women who were not currently taking postmenopausal hormones, weight gain of more than 44 pounds compared to little weight change increased risk of breast cancer, 1.52 (1.08-2.13). This increased risk was not seen in women who were currently taking postmenopausal hormones.

¶ Five of seven studies measured weight gain from age 18. One study measured weight gain from age 20 and one study measured from age 50.
 

References  

  1. Eliassen AH, Colditz GA, Rosner B, et al. Adult weight change and risk of postmenopausal breast cancer. JAMA. 296(2):193-201, 2006.
  2. White KK, Park SY, Kolonel LN, Henderson BE, Wilkens LR. Body size and breast cancer risk: The multiethnic cohort. Int J Cancer. 131(5):E705-16, 2012.
  3. Sweeney C, Blair CK, Anderson KE, et al. Risk factors of breast cancer in elderly women. Am J Epidemiol. 160(9):868-75, 2004.
  4. Ahn J, Schatzkin A, Lacey JV Jr, et al. Adiposity, adult weight change, and postmenopausal breast cancer risk. Arch Intern Med. 167(19):2091-102, 2007.
  5. Feigelson HS, Jonas CR, Teras LR, Thun MJ, Calle EE. Weight gain, body mass index, hormone replacement therapy, and postmenopausal breast cancer in a large prospective study. Cancer Epidemiol Biomarkers Prev. 13(2):220-4, 2004.
  6. Michels KB, Terry KL, Eliassen AH, Hankinson SE, Willett WC. Adult weight change and incidence of premenopausal breast cancer. Int J Cancer. 130(4):902-9, 2012. 
  7. Lahmann PH, Schulz M, Hoffmann K, et al. Long-term weight change and breast cancer risk: the European prospective investigation into cancer and nutrition (EPIC). Br J Cancer. 93(5):582-9, 2005.
  8. Feigelson HS, Patel AV, Teras LR, et al. Adult weight gain and histopathologic characteristics of breast cancer among postmenopausal women. Cancer. 107(1):12-21, 2006.
  9. Palmer JR, Adams-Campbell LL, Boggs DA, Wise LA, Rosenberg L. A prospective study of body size and breast cancer in black women. Cancer Epidemiol Biomarkers Prev. 16(9):1795-802, 2007.
  10. Morimoto LM, White E, Chen Z, Chlebowski RT, Hays J, Kuller L, Lopez AM, Manson J, Margolis KL, Muti PC, Stefanick ML, McTiernan A. Obesity, body size, and risk of postmenopausal breast cancer: the Women's Health Initiative (United States). Cancer Causes Control. 13(8):741-51, 2002. 
  11. Vrieling A, Buck K, Kaaks R, Chang-Claude J. Adult weight gain in relation to breast cancer risk by estrogen and progesterone receptor status: a meta-analysis. Breast Cancer Res Treat. 123(3):641-9, 2010. 

Updated 08/14/12