The Relationship of Body Mass Index to Reproductive Factors in Pre‐ and Postmenopausal African‐American Women With and Without Breast Cancer

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Abstract
To date, there are virtually no existing data on the relationship between obesity, menopausal status, and breast cancer in African‐Americans. Therefore, the present study was designed to test the following hypotheses in an African‐American population: (1) there exists a positive association between BMI and breast cancer among postmenopausal women; (2) there exists an inverse association between BMI and breast cancer among premenopausal women; and (3) similar associations between BMI and reproductive factors exist for both pre‐ and postmenopausal breast cancer cases. The study population comprised 357 African‐American women (n=193 breast cancer cases; n=164 controls). No significant differences were observed between premenopausal cases and controls for BMI, obesity categories, and reproductive factors. Among the postmenopausal women, the cases had significantly lower weight and BMI levels than the controls. Age at first pregnancy and parity were significantly lower among postmenopausal cases than their controls. No significant associations were revealed between body mass index and breast cancer for pre‐ and postmenopausal women. In the present study, early age at menarche was the only reproductive factor that was an independent predictor of BMI for both pre‐ and postmenopausal women, irrespective of breast cancer status. Also, these findings strongly suggest the need to consider reproductive factors, particularly age at menarche, as a covariate of BMI and other obesity‐related diseases.