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Research table: Weight gain and breast cancer risk

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: Weight gain in adulthood is linked to an increased risk of breast cancer. This increased risk is most clearly seen in breast cancers that occur after menopause.

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.

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Komen Perspectives

Read Komen’s perspective on body weight and breast cancer risk.*

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* Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date.

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

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

Menopausal hormone therapy (MHT) is FDA-approved for the short-term relief of menopausal symptoms. Women who use MHT have an increased risk of breast cancer. This increased breast cancer risk related to MHT may make it difficult to see an increased risk related to body weight in study data. For this reason, many studies report findings by MHT use. MHT may also be called postmenopausal hormone therapy or hormone replacement therapy (HRT).

Learn more about menopausal hormone therapy and breast cancer 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)

Before Menopause

After Menopause

Prospective cohort studies

Nurses’ Health Study [1-2]

74,177
(4,965 cases)

22†

From age
18

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

1.03
(0.85-1.26)

1.08
(1.00-1.17)

 

 

 

 

22 to less than 33 lbs.
vs.
little weight change
(less than 11 lbs. gain or loss)

1.05
(0.88-1.29)

1.25
(1.12-1.38)

 

 

 

 

33 to less than 44 lbs.
vs.
little weight change
(less than 11 lbs. gain or loss)

1.00
(0.78-1.29)

1.23
(1.05-1.44)

 

 

 

 

More than 44 lbs.
vs.
little weight change
(less than 11 lbs. gain or loss)

1.05
(0.85-1.30)

1.17
(0.97-1.41)

 

49,514
(2,376 cases)

24

From age at menopause

22 lbs. or more
vs.
little weight change

 

1.18
(1.03-1.35)

Women’s Health Initiative Observational Study [3]

70,397
(4,319 cases)

25

From age
18-50

More than 11 lbs.
vs.
little weight change
(11 lbs. or less gain or loss)

 

1.15
(1.08-1.23)

EPIC Cohort [4-5]

150,257
(6,532 cases)

14

From age
20-50

11-22 lbs.
vs.
little weight change
(5 lbs. gain or loss)

1.03
(0.87-1.22)

1.01
(0.81-1.25)‡

 

 

 

 

More than 22 lbs.
vs.
little weight change
(5 lbs. gain or loss)

0.99
(0.84-1.16)

1.40
(1.16-1.68)‡

 

205,723
(4,663 cases)

8

From age
40-50

9-55 lbs.
vs.
little weight change
(4-5 lbs. gain or loss)

1.37
(1.02-1.85)

1.24
(1.07-1.43)‡

California Teachers Study [6]

109,862
(3,844 cases)

13-14

From age 18

10-24 lbs.
vs.
less than 10 lbs. gain or loss

 

1.42
(1.19-1.70)§,||

 

 

 

 

25 lbs. or more
vs.
less than 10 lbs. gain or loss

1.04
(0.79-1.37)§

 

Multiethnic Cohort [7]

82,971
(3,080 cases)

8-11

From age 21

20.1-31
vs.
8-20 lbs.

  

1.13
(0.99-1.27)
       

31.1-49.9
vs.
8-20 lbs.

  

1.23
(1.07-1.40)
       

50 or more
vs.
8-20 lbs.

  

1.39
(1.18-1.64)

Iowa Women’s Health Study [8]

36,658
(2,286 cases)

16

From age 18

29-45
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
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 [9]

99,039
(2,111 cases)

4

From age 18

66-88 lbs.
vs.
little weight change
(4 lbs. gain or loss)

  

1.87
(1.29-2.72)¶
   

 

From age 50

66-88 lbs.
vs.
little weight change
(4 lbs. gain or loss)

  

1.89
(1.20-2.97)¶
   

 

Between ages 35-50

66-88 lbs.
vs.
little weight change
(4 lbs. gain or loss)

  

2.29
(1.51-3.46)¶

Cancer Prevention Study-II (CPS-II) [10]

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 [11]

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)

  

CPS-II [12]

44,161
(1,200 cases) 

9

From age 18

21-40
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
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 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)‡

PROCRAS Study (UK) [13]

47,042
(1,142 cases)

6

From age 20

11-21
vs.
less than 11 lbs.

0.90
(0.60-1.35)

1.41
(1.07-1.86)

22-43
vs.
less than 11 lbs.

1.23
(0.87-1.74)

1.62
(1.26-2.09)

44 or more
vs.
less than 11 lbs.

1.28
(0.88-1.87)

2.01
(1.55-2.61)

Black Women’s Health Study [14]

52,080
(1,062 cases)

10

From age 18

55 or more
vs.
less than 22 lbs.

1.17
(0.90-1.52)

1.09
(0.81-1.48)

Pooled and meta-analyses

van den Brandt et al. [15]

1,061,915
(36,297 cases)

  

From ages 18-20 to study entry

22-43
vs.
little weight change

1.07
(0.94-1.22)

1.42
(1.26-1.59)¶

 

From ages 18-20 to study entry

44 lbs. or more
vs.
little weight change

0.85
(0.69-1.05)

1.68
(1.48-1.90)¶

Schoemaker et al. [16]

628,463
(10,886 cases)

  

From ages 18-24 to ages 35-44

22-43
vs.
less than 11 lbs.

0.89
(0.82-0.97)**

 

From ages 18-24 to ages 45-54

22-43
vs.
less than 11 lbs.

0.86
(0.77-0.96)**

 

From ages 25-34 to ages 45-54

22-43
vs.
less than 11 lbs.

0.90
(0.71-1.14)**

 

From ages 35-44 to ages 45-54

22-43
vs.
less than 11 lbs.

1.08
(0.92-1.26)**

Vrieling et al. [17]

7 studies

  

From age 18††

Various

  

For hormone receptor-positive tumors:
2.33
(2.05-2.60)

For hormone receptor-negative tumors:
1.34
(1.06-1.63)

† Estimated from person-years.

‡ Results are for women who never used menopausal hormone therapy (MHT).

§ All breast cancers were estrogen receptor-positive.

|| Relative risk for women who never used MHT. Among MHT users, there was no increase in risk.

¶ Results are for women not currently taking MHT.

** Results for women who gained 44 pounds or more were similar.

†† Five of 7 studies measured weight gain from age 18. One study measured weight gain from age 20 and one study measured weight gain from age 50.

References

  1. Rosner B, Eliassen AH, Toriola AT, et al. Weight and weight changes in early adulthood and later breast cancer risk. Int J Cancer. 140(9):2003-2014, 2017.
  2. Eliassen AH, Colditz GA, Rosner B, et al. Adult weight change and risk of postmenopausal breast cancer. JAMA. 296(2):193-201, 2006. 
  3. Luo J, Chen X, Manson JE,et al. Birth weight, weight over the adult life course and risk of breast cancer. Int J Cancer. 147(1):65-75, 2020.
  4. Ellingjord-Dale M, Christakoudi S, Weiderpass E, et al. Long-term weight change and risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Int J Epidemiol. 50(6):1914-1926, 2022.
  5. Emaus MJ, van Gils CH, Bakker MF, et al. Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study. Int J Cancer. 135(12):2887-99, 2014.
  6. Horn-Ross PL, Canchola AJ, Bernstein L, Neuhausen SL, Nelson DO, Reynolds P. Lifetime body size and estrogen-receptor-positive breast cancer risk in the California Teachers Study cohort. Breast Cancer Res. 18(1):132, 2016. 
  7. 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.
  8. Sweeney C, Blair CK, Anderson KE, et al. Risk factors of breast cancer in elderly women. Am J Epidemiol. 160(9):868-75, 2004.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. Renehan AG, Pegington M, Harvie MN, et al. Young adulthood body mass index, adult weight gain and breast cancer risk: the PROCAS Study (United Kingdom). Br J Cancer. 122(10):1552-1561, 2020.
  14. 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.
  15. van den Brandt PA, Ziegler RG, Wang M, et al. Body size and weight change over adulthood and risk of breast cancer by menopausal and hormone receptor status: a pooled analysis of 20 prospective cohort studies. Eur J Epidemiol. 36(1):37-55, 2021. 
  16. Schoemaker MJ, Nichols HB, Wright LB, et al. Adult weight change and premenopausal breast cancer risk: A prospective pooled analysis of data from 628,463 women. Int J Cancer. 147(5):1306-1314, 2020.
  17. 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 11/08/23

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