Table 3.
Multivariable-adjusted hazard ratios and 95% confidence intervals for breast cancer subtypes by menopausal status at both anthropometric measure and diagnosis: Nurses’ Health Study (1986-2016) and Nurses’ Health Study II (1993-2017)
| Measure, tertiles | Pre-pre |
Pre-post |
Post-post |
||||||
|---|---|---|---|---|---|---|---|---|---|
| No. of cases | Continuous, 90th vs 10th percentilea | Continuous, 90th vs 10th percentilea | No. of cases | Continuous, 90th vs 10th percentilea | Continuous, 90th vs 10th percentilea | No. of cases | Continuous, 90th vs 10th percentilea | Continuous, 90th vs 10th percentilea | |
| MV-adjustedb | MV-adjusted and BMI adjustedc | MV-adjustedb | MV-adjusted and BMI adjustedc | MV-adjustedb | MV-adjusted and BMI adjustedc | ||||
| HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | ||||
| Waist circumference, cm | |||||||||
| ER+, PR+ | 699 | 0.86 (0.72 to 1.04) | 1.13 (0.87 to 1.47) | 1074 | 1.08 (0.95 to 1.24) | 0.99 (0.83 to 1.18) | 1647 | 1.44 (1.29 to 1.61) | 1.27 (1.09 to 1.46) |
| ER+, PR- | 66 | 0.35 (0.17 to 0.73) | 0.46 (0.22 to 0.96) | 203 | 0.93 (0.68 to 1.26) | 0.85 (0.61 to 1.18) | 383 | 0.93 (0.72 to 1.19) | 0.81 (0.62 to 1.06) |
| ER-, PR- | 162 | 1.50 (1.07 to 2.10) | 1.99 (1.35 to 2.94) | 254 | 1.09 (0.83 to 1.43) | 1.00 (0.75 to 1.34) | 416 | 1.00 (0.79 to 1.26) | 0.88 (0.68 to 1.13) |
| Pheterogeneityd | <.001 | <.001 | .63 | .64 | <.001 | <.001 | |||
| Luminal A | 436 | 0.73 (0.57 to 0.93) | 0.98 (0.71 to 1.35) | 817 | 1.00 (0.86 to 1.17) | 0.89 (0.73 to 1.09) | 1089 | 1.28 (1.11 to 1.48) | 1.14 (0.95 to 1.36) |
| Luminal B | 190 | 0.84 (0.59 to 1.19) | 1.12 (0.75 to 1.69) | 324 | 1.23 (0.97 to 1.54) | 1.09 (0.84 to 1.42) | 415 | 1.40 (1.13 to 1.73) | 1.24 (0.98 to 1.58) |
| HER2-type | 33 | 1.43 (0.69 to 2.98) | 1.95 (0.91 to 4.21) | 76 | 0.90 (0.54 to 1.48) | 0.80 (0.48 to 1.33) | 99 | 0.88 (0.55 to 1.42) | 0.79 (0.48 to 1.27) |
| Basal-like | 47 | 2.60 (1.47 to 4.58) | 3.58 (1.94 to 6.63) | 25 | 2.31 (1.01 to 5.31) | 2.05 (0.88 to 4.74) | 91 | 1.04 (0.62 to 1.74) | 0.90 (0.53 to 1.53) |
| Pheterogeneityd | .001 | .001 | .13 | .13 | .29 | .28 | |||
| Hip circumference, cm | |||||||||
| ER+, PR+ | 699 | 0.80 (0.66 to 0.96) | 0.97 (0.73 to 1.29) | 1074 | 1.15 (1.00 to 1.32) | 1.07 (0.88 to 1.30) | 1647 | 1.36 (1.21 to 1.52) | 1.11 (0.94 to 1.31) |
| ER+, PR- | 66 | 0.54 (0.29 to 1.00) | 0.65 (0.33 to 1.25) | 203 | 0.85 (0.62 to 1.18) | 0.79 (0.56 to 1.13) | 383 | 1.01 (0.79 to 1.29) | 0.82 (0.63 to 1.08) |
| ER-, PR- | 162 | 1.23 (0.87 to 1.72) | 1.50 (1.00 to 2.26) | 254 | 1.10 (0.83 to 1.44) | 1.02 (0.75 to 1.39) | 416 | 0.98 (0.77 to 1.25) | 0.80 (0.62 to 1.04) |
| Pheterogeneityd | .03 | .03 | .23 | .23 | .01 | .01 | |||
| Luminal A | 436 | 0.66 (0.51 to 0.84) | 0.76 (0.54 to 1.08) | 817 | 1.05 (0.90 to 1.23) | 0.98 (0.78 to 1.22) | 1089 | 1.26 (1.09 to 1.46) | 1.01 (0.83 to 1.23) |
| Luminal B | 190 | 0.82 (0.58 to 1.16) | 0.95 (0.62 to 1.45) | 324 | 1.37 (1.09 to 1.72) | 1.27 (0.96 to 1.68) | 415 | 1.21 (0.96 to 1.51) | 0.96 (0.74 to 1.25) |
| HER2-type | 33 | 1.19 (0.56 to 2.51) | 1.39 (0.63 to 3.08) | 76 | 1.01 (0.61 to 1.68) | 0.94 (0.55 to 1.60) | 99 | 0.93 (0.57 to 1.51) | 0.75 (0.45 to 1.23) |
| Basal-like | 47 | 1.56 (0.85 to 2.86) | 1.83 (0.94 to 3.54) | 25 | 1.65 (0.68 to 4.00) | 1.54 (0.63 to 3.77) | 91 | 0.87 (0.51 to 1.48) | 0.69 (0.40 to 1.18) |
| Pheterogeneityd | .05 | .05 | .22 | .22 | .38 | .37 | |||
| Waist-to-hip ratio | |||||||||
| ER+, PR+ | 699 | 1.04 (0.88 to 1.23) | 1.11 (0.93 to 1.32) | 1074 | 0.97 (0.86 to 1.10) | 0.95 (0.83 to 1.08) | 1647 | 1.17 (1.07 to 1.29) | 1.13 (1.03 to 1.24) |
| ER+, PR- | 66 | 0.45 (0.24 to 0.87) | 0.48 (0.25 to 0.92) | 203 | 1.04 (0.78 to 1.38) | 1.01 (0.76 to 1.35) | 383 | 0.91 (0.73 to 1.12) | 0.86 (0.69 to 1.07) |
| ER-, PR- | 162 | 1.43 (1.07 to 1.93) | 1.50 (1.13 to 2.01) | 254 | 1.07 (0.84 to 1.38) | 1.05 (0.81 to 1.34) | 416 | 0.98 (0.81 to 1.20) | 0.94 (0.77 to 1.15) |
| Pheterogeneityd | .004 | .01 | .76 | .75 | .04 | .03 | |||
| Luminal A | 436 | 0.99 (0.80 to 1.24) | 1.08 (0.86 to 1.35) | 817 | 0.95 (0.82 to 1.10) | 0.92 (0.79 to 1.07) | 1089 | 1.09 (0.97 to 1.23) | 1.05 (0.93 to 1.18) |
| Luminal B | 190 | 0.97 (0.71 to 1.34) | 1.05 (0.76 to 1.44) | 324 | 0.96 (0.77 to 1.21) | 0.93 (0.74 to 1.17) | 415 | 1.25 (1.06 to 1.47) | 1.21 (1.02 to 1.43) |
| HER2-type | 33 | 1.25 (0.64 to 2.42) | 1.33 (0.70 to 2.53) | 76 | 0.89 (0.55 to 1.43) | 0.85 (0.53 to 1.38) | 99 | 0.85 (0.56 to 1.27) | 0.81 (0.54 to 1.22) |
| Basal-like | 47 | 2.07 (1.37 to 3.13) | 2.14 (1.43 to 3.20) | 25 | 1.68 (0.93 to 3.03) | 1.65 (0.90 to 2.99) | 91 | 1.15 (0.74 to 1.77) | 1.08 (0.69 to 1.68) |
| Pheterogeneityd | .04 | .05 | .42 | .40 | .29 | .27 | |||
The incremental units were based on the difference between the 90th percentile and 10th percentile. The increments are 28.6 cm for waist circumference, 24.8 cm for hip circumference, and 0.17 for waist-to-hip ratio. BMI = body mass index; CI = confidence interval; ER = estrogen receptor; HR = hazard ratio; MV = multivariable; PR = progesterone receptor.
Multivariable model adjusted for age at menarche (years, continuous), height (inches, continuous), parity/age at first birth (nulliparous, 1-2 children <25 years, 1-2 children 25+ years, 3+ children <25 years, 3+ children 25+ years), family history of breast cancer (yes/no), benign breast disease diagnosis (yes/no), alcohol intake (none, 1–4, 5–14, 15+ g/day), physical activity (MET-hours/week, quartiles), and smoking (never, past, current).
Adjusted for same variables as in multivariable model (a) plus BMI updated every 2 years (continuous).
Pheterogeneity was assessed using likelihood ratio tests comparing models that assumed a common association between each anthropometric measure and breast cancer subtypes by ER/PR status and by molecular subtype to models that allow for separate associations for each breast cancer subtype.