The association of increased weight, body mass index, and tissue density with the risk of breast carcinoma in Vermont

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Abstract
BACKGROUND Etiologic studies of breast carcinoma have indicated that weight, body mass index (BMI), and breast tissue density are important determinants of a woman's risk for the disease. This study looked at the independent effects of these risk factors. METHODS Data from the Vermont Breast Cancer Surveillance System (VBCSS), collected between May 1996 and November 1997, were used to identify 529 breast carcinoma cases with no prior history of the disease. Each case was matched to four randomly chosen women of the same age who had mammograms during the same time period and had no biopsy‐confirmed breast carcinoma. Logistic regression was used to assess the effects of weight, BMI, and breast tissue density on breast carcinoma risk for pre‐ and postmenopausal women. RESULTS Weight and BMI were found to be significantly associated with postmenopausal breast carcinoma after adjustment for breast density, and vice versa. The density‐adjusted odds ratio for women weighing over 81 kg, relative to women weighing under 63 kg, was 2.1, with a 95% confidence interval (CI) of 1.3–3.2. Relative to women with breasts consisting entirely of fat, the weight‐adjusted odds ratios for women with heterogeneously dense and extremely dense breasts were 2.3 (CI: 1.3–4.3) and 4.5 (CI: 1.9–10.6), respectively. CONCLUSIONS Among postmenopausal Vermont women, weight, BMI, and breast density were independently associated with breast carcinoma risk. Because breast density and weight or BMI are inversely related, estimates of their independent effects should be used when evaluating a woman's risk for breast carcinoma. Cancer 2000;89:369–75. © 2000 American Cancer Society.