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Weight loss and breast cancer

Sustained weight loss associated with reduced breast cancer risk

Women who lost 9 kg or more (20+ lbs) had a 26% lower breast cancer risk

A large study has found that women who lost weight after age 50 and kept it off had a lower risk of breast cancer than women whose weight remained stable, helping answer a vexing question in cancer prevention. The reduction in risk increased with the amount of weight lost and was specific to women not using postmenopausal hormones. The study, 'Sustained weight loss and risk of breast cancer in women ≥50 years: a pooled analysis of prospective data', published in the Journal of the National Cancer Institute.

In the US, more than two in three adult women are overweight or obese, and while high BMI is an established risk factor for postmenopausal breast cancer, there has not been adequate evidence to determine if that risk is reversible by losing excess weight. To learn more, investigators from the American Cancer Society, Harvard TH Chan School of Public Health, and others used the Pooling Project of Prospective Studies of Diet and Cancer (DCPP) to estimate the association of sustained weight loss in middle or later adulthood on subsequent breast cancer risk.

Their analysis included 180,885 women aged 50 and older from ten prospective studies. The new analysis is the first with a large enough sample size to examine the important question of whether sustained weight loss can impact breast cancer risk with statistical precision. Weight was assessed three times over approximately ten years: at study enrolment; after about five years; then again about four years later. Sustained weight loss was defined as ≥2kg lost in Interval 1 that was not regained in Interval 2.

The results showed women with sustained weight loss had a lower risk of breast cancer than women whose weight remained stable, and the larger the amount of sustained weight loss, the lower was the risk of breast cancer. Women who lost 2 to 4.5 kg (about 4.4 to 10 lbs) had a 13% lower risk (HR= 0.87, 95% CI: 0.77-0.99) than women with stable weight. Women who lost 4.5 to 9 kg (10- 20 lbs) had a 16% lower risk (HR=0.84, 95% CI: 0.73-0.96). Women who lost 9 kg or more (20+ lbs) had a 26% lower risk (HR=0.74, 95% CI: 0.58-0.94).

In addition, women who lost 9 kg or more and gained some (but not all) of the weight back had a lower risk of breast cancer compared with those whose weight remained stable (HR=0.77, 95% CI: 0.62-0.97).

The authors noted that the risk reduction was linear and specific to women not using postmenopausal hormones and that other patterns of weight loss and gain over the two intervals had a similar risk of breast cancer to women with stable weight.

"Our results suggest that even a modest amount of sustained weight loss is associated with lower breast cancer risk for women over 50," said Dr Lauren Teras, lead author of the study. "These findings may be a strong motivator for the two-thirds of American women who are overweight to lose some of that weight. Even if you gain weight after age 50, it is not too late to lower your risk of breast cancer."

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