Skip to main content

Advertisement

SpringerLink
Log in

Body fat distribution and breast cancer risk: findings from the Nigerian breast cancer study

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

The relationship between overall obesity and breast cancer risk has been well recognized, but the role of central obesity in breast cancer development is uncertain.

Methods

Between 1998 and 2009, 1,233 invasive breast cancer cases and 1,101 community controls were recruited into the Nigerian Breast Cancer Study at Ibadan, Nigeria. Logistic regressions were used to calculate multivariate odds ratio (OR) and 95% confidence intervals (CI), adjusting for age, body mass index (BMI), and other known risk factors for breast cancer.

Results

The OR for the highest quartile group of waist circumference relative to the lowest was 2.39 (95% CI, 1.59–3.60; P-trend <0.001). Comparing women with waist/hip ratio (WHR) in the lowest quartile group, the OR for women in the highest quartile category was 2.15 (95% CI, 1.61–2.85; P-trend <0.001). An inverse association was observed between hip circumference and breast cancer, with an OR of 0.36 for the highest quartile (95% CI, 0.24–0.55; P-trend <0.001). The effects of these three measures existed in both pre- and postmenopausal women. Of note, we found a significant interaction between WHR and BMI (P-interaction = 0.016): the OR comparing the highest to the lowest WHR quartile was 2.81 (95% CI, 1.90–4.16) for women with BMI < 25 kg/m2 and 1.70 (95% CI, 1.11–2.61) for women with BMI ≥ 25 kg/m2.

Conclusions

These results suggest that central adiposity, measured by waist circumference and waist/hip ratio, was an important risk factor for breast cancer in Nigerian women, and the effect of central adiposity was strong in normal-weight women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ries L, Melbert D, Krapcho M et al (2008) SEER Cancer Statistics Review, 1975–2005. National Cancer Institute, Bethesda

    Google Scholar 

  2. Parkin DM, Whelan SL, Ferlay J et al. (2005) Cancer Incidence in Five Continents, vol I to VIII. IARC CancerBase No. 7, Lyon

  3. Adebamowo CA, Adekunle OO (1999) Case-controlled study of the epidemiological risk factors for breast cancer in Nigeria. Br J Surg 86(5):665–668

    Article  PubMed  CAS  Google Scholar 

  4. Adebamowo CA, Ajayi OO (2000) Breast cancer in Nigeria. West Afr J Med 19(3):179–191

    PubMed  CAS  Google Scholar 

  5. Jemal A, Ward E, Thun MJ (2007) Recent trends in breast cancer incidence rates by age and tumor characteristics among U.S. women. Breast Cancer Res 9(3):R28

    Article  PubMed  Google Scholar 

  6. Parkin DM, Sitas F, Chirenje M et al (2008) Part I: cancer in indigenous Africans–burden, distribution, and trends. Lancet Oncol 9(7):683–692

    Article  PubMed  Google Scholar 

  7. Huang Z, Willett WC, Colditz GA et al (1999) Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses’ health study. Am J Epidemiol 150(12):1316–1324

    PubMed  CAS  Google Scholar 

  8. Muti P, Stanulla M, Micheli A et al (2000) Markers of insulin resistance and sex steroid hormone activity in relation to breast cancer risk: a prospective analysis of abdominal adiposity, sebum production, and hirsutism (Italy). Cancer Causes Control 11(8):721–730

    Article  PubMed  CAS  Google Scholar 

  9. Sonnenschein E, Toniolo P, Terry MB et al (1999) Body fat distribution and obesity in pre- and postmenopausal breast cancer. Int J Epidemiol 28(6):1026–1031

    Article  PubMed  CAS  Google Scholar 

  10. Mannisto S, Pietinen P, Pyy M et al (1996) Body-size indicators and risk of breast cancer according to menopause and estrogen-receptor status. Int J Cancer 68(1):8–13

    Article  PubMed  CAS  Google Scholar 

  11. Ng EH, Gao F, Ji CY et al (1997) Risk factors for breast carcinoma in Singaporean Chinese women: the role of central obesity. Cancer 80(4):725–731

    Article  PubMed  CAS  Google Scholar 

  12. Wu AH, Yu MC, Tseng CC et al (2007) Body size, hormone therapy and risk of breast cancer in Asian-American women. Int J Cancer 120(4):844–852

    Article  PubMed  CAS  Google Scholar 

  13. Kaaks R, Van Noord PA, Den Tonkelaar I et al (1998) Breast-cancer incidence in relation to height, weight and body-fat distribution in the Dutch “DOM” cohort. Int J Cancer 76(5):647–651

    Article  PubMed  CAS  Google Scholar 

  14. Lahmann PH, Hoffmann K, Allen N et al (2004) Body size and breast cancer risk: findings from the European prospective investigation into cancer and nutrition (EPIC). Int J Cancer 111(5):762–771

    Article  PubMed  CAS  Google Scholar 

  15. Harris HR, Willett WC, Terry KL et al (2011) Body fat distribution and risk of premenopausal breast cancer in the Nurses’ health study II. J Natl Cancer Inst 103(3):273–278

    Article  PubMed  Google Scholar 

  16. Nemesure B, Wu SY, Hennis A et al (2009) Body size and breast cancer in a black population–the Barbados national cancer study. Cancer Causes Control 20(3):387–394

    Article  PubMed  Google Scholar 

  17. Palmer JR, Adams-Campbell LL, Boggs DA et al (2007) A prospective study of body size and breast cancer in black women. Cancer Epidemiol Biomarkers Prev 16(9):1795–1802

    Article  PubMed  Google Scholar 

  18. Folsom AR, Kushi LH, Anderson KE et al (2000) Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa women’s health study. Arch Intern Med 160(14):2117–2128

    Article  PubMed  CAS  Google Scholar 

  19. Fagherazzi G, Chabbert-Buffet N, Fabre A et al. (2011) Hip circumference is associated with the risk of premenopausal ER-/PR- breast cancer. Int J Obes (Lond). doi:10.1038/ijo.2011.66

  20. Morimoto LM, White E, Chen Z et al (2002) Obesity, body size, and risk of postmenopausal breast cancer: the women’s health initiative (United States). Cancer Causes Control 13(8):741–751

    Article  PubMed  Google Scholar 

  21. den Tonkelaar I, Seidell JC, Collette HJ et al (1992) Obesity and subcutaneous fat patterning in relation to breast cancer in postmenopausal women participating in the diagnostic investigation of mammary cancer project. Cancer 69(11):2663–2667

    Article  Google Scholar 

  22. Petrek JA, Peters M, Cirrincione C et al (1993) Is body fat topography a risk factor for breast cancer? Ann Intern Med 118(5):356–362

    PubMed  CAS  Google Scholar 

  23. Cooper R, Rotimi C, Ataman S et al (1997) The prevalence of hypertension in seven populations of west African origin. Am J Public Health 87(2):160–168

    Article  PubMed  CAS  Google Scholar 

  24. Senbanjo IO (2007) Overweight and obesity in Nigerian preschool children. J Trop Pediatr 53(2):143–144

    Article  PubMed  CAS  Google Scholar 

  25. Ogunjimi L, Ikorok M, Yusuf O (2010) Prevalence of obesity among Nigeria nurses: the Akwa Ibom State experience. Intern NGO J 5(2):45–49

    Google Scholar 

  26. Perry AC, Applegate EB, Jackson ML et al (2000) Racial differences in visceral adipose tissue but not anthropometric markers of health-related variables. J Appl Physiol 89(2):636–643

    PubMed  CAS  Google Scholar 

  27. Katzmarzyk PT, Bray GA, Greenway FL et al (2010) Racial differences in abdominal depot-specific adiposity in white and African American adults. Am J Clin Nutr 91(1):7–15

    Article  PubMed  CAS  Google Scholar 

  28. Deurenberg-Yap M, Chew SK, Deurenberg P (2002) Elevated body fat percentage and cardiovascular risks at low body mass index levels among Singaporean Chinese, Malays and Indians. Obes Rev 3(3):209–215

    Article  PubMed  CAS  Google Scholar 

  29. Adebamowo CA, Ogundiran TO, Adenipekun AA et al (2003) Waist-hip ratio and breast cancer risk in urbanized Nigerian women. Breast Cancer Res 5(2):R18–R24

    Article  PubMed  Google Scholar 

  30. Huo D, Adebamowo CA, Ogundiran TO et al (2008) Parity and breastfeeding are protective against breast cancer in Nigerian women. Br J Cancer 98(5):992–996

    Article  PubMed  CAS  Google Scholar 

  31. WHO (1998–1999) WHO MONICA Project. MONICA Manual. http://www.ktl.fi/publications/monica/manual/index.htm

  32. van Buuren S, Boshuizen HC, Knook DL (1999) Multiple imputation of missing blood pressure covariates in survival analysis. Stat Med 18(6):681–694

    Article  PubMed  Google Scholar 

  33. Rubin DB (1987) Multiple Imputation for Nonresponse in Surveys, 1st edn. John Wiley, New York

    Book  Google Scholar 

  34. Royston P (2004) Multiple imputation of missing values. Stata J 4(3):227–241

    Google Scholar 

  35. Ogundiran TO, Huo D, Adenipekun A et al (2010) Case-control study of body size and breast cancer risk in Nigerian women. Am J Epidemiol 172(6):682–690

    Article  PubMed  Google Scholar 

  36. Okobia MN, Bunker CH, Zmuda JM et al (2006) Anthropometry and breast cancer risk in Nigerian women. Breast J 12(5):462–466

    Article  PubMed  Google Scholar 

  37. Hall IJ, Newman B, Millikan RC et al (2000) Body size and breast cancer risk in black women and white women: the Carolina breast cancer study. Am J Epidemiol 151(8):754–764

    PubMed  CAS  Google Scholar 

  38. John EM, Sangaramoorthy M, Phipps AI et al (2010) Adult body size, hormone receptor status, and premenopausal breast cancer risk in a multiethnic population: the San Francisco bay area breast cancer study. Am J Epidemiol 173(2):201–216

    Article  PubMed  Google Scholar 

  39. Nemesure B, Wu SY, Hambleton IR et al (2009) Risk factors for breast cancer in a black population–the Barbados national cancer study. Int J Cancer 124(1):174–179

    Article  PubMed  CAS  Google Scholar 

  40. Shu XO, Jin F, Dai Q et al (2001) Association of body size and fat distribution with risk of breast cancer among Chinese women. Int J Cancer 94(3):449–455

    Article  PubMed  CAS  Google Scholar 

  41. Lovegrove JA (2002) Obesity, body fat distribution and breast cancer. Nutr Res Rev 15(2):389–412

    Article  PubMed  CAS  Google Scholar 

  42. Kissebah AH, Krakower GR (1994) Regional adiposity and morbidity. Physiol Rev 74(4):761–811

    PubMed  CAS  Google Scholar 

  43. Xue F, Michels KB (2007) Diabetes, metabolic syndrome, and breast cancer: a review of the current evidence. Am J Clin Nutr 86(3):S823–S835

    PubMed  Google Scholar 

  44. Bruning PF, Bonfrer JM, Hart AA et al (1992) Body measurements, estrogen availability and the risk of human breast cancer: a case-control study. Int J Cancer 51(1):14–19

    Article  PubMed  CAS  Google Scholar 

  45. Kirschner MA, Samojlik E, Drejka M et al (1990) Androgen-estrogen metabolism in women with upper body versus lower body obesity. J Clin Endocrinol Metab 70(2):473–479

    Article  PubMed  CAS  Google Scholar 

  46. Haffner SM, Katz MS, Stern MP et al (1989) Relationship of sex hormone binding globulin to overall adiposity and body fat distribution in a biethnic population. Int J Obes 13(1):1–9

    PubMed  CAS  Google Scholar 

  47. Subbaramaiah K, Howe LR, Bhardwaj P et al (2011) Obesity is associated with inflammation and elevated aromatase expression in the mouse mammary gland. Cancer Prev Res 4(3):329–346

    Article  CAS  Google Scholar 

  48. Parker ED, Pereira MA, Stevens J et al (2009) Association of hip circumference with incident diabetes and coronary heart disease: the Atherosclerosis risk in communities study. Am J Epidemiol 169(7):837–847

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The study was funded by the National Cancer Institute at the National Institutes of Health (CA-RO1 89085-01A and P50 CA125183) and the Dr. Ralph and Marian Falk Medical Research Trust. The authors thank the interviewers, data managers, and support staff at the University College Hospital Ibadan and the data managers at the University of Chicago for their diligent and professional work.

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Surgery College of Medicine, University of Ibadan, Ibadan, Nigeria

    Temidayo O. Ogundiran

  2. Department of Health Studies, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL, 60637, USA

    Dezheng Huo

  3. Department of Radiotherapy College of Medicine, University of Ibadan, Ibadan, Nigeria

    Adeniyi Adenipekun, Oladapo Campbell & Rasaaq Oyesegun

  4. Department of Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria

    Effiong Akang

  5. Department of Epidemiology and Preventive Medicine, University of Maryland, College Park, MD, USA

    Clement Adebamowo

  6. Center for Clinical Cancer Genetics and Global Health, Department of Medicine, Hematology/Oncology, University of Chicago, 5841 South Maryland Avenue, MC 2115, Chicago, IL, 60637, USA

    Olufunmilayo I. Olopade

Authors
  1. Temidayo O. Ogundiran
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dezheng Huo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Adeniyi Adenipekun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Oladapo Campbell
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rasaaq Oyesegun
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Effiong Akang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Clement Adebamowo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Olufunmilayo I. Olopade
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Dezheng Huo or Olufunmilayo I. Olopade.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ogundiran, T.O., Huo, D., Adenipekun, A. et al. Body fat distribution and breast cancer risk: findings from the Nigerian breast cancer study. Cancer Causes Control 23, 565–574 (2012). https://doi.org/10.1007/s10552-012-9916-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-012-9916-y

Keywords

Search

Navigation