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Research and Evaluation Department, Kaiser Permanente Medical Care Program, Southern California, Pasadena, California 91188 [S. M. E.], and Department of Preventive Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, California 90033 [S. M. E., R. K. R., A. P-H., C. L. C., L. B.]
We evaluated whether our previous reports of increased
postmenopausal breast cancer risk with higher body mass index (BMI) or
of reduced premenopausal and postmenopausal breast cancer risk with
higher physical activity levels varied according to the tumor’s
estrogen receptor (ER) and progesterone receptor (PR) status.
Participants enrolled in either of two population-based case-control
studies in Los Angeles County, California: one of premenopausal women
(ages 
40 years), and one of postmenopausal women (ages 55–64 years).
Case participants were diagnosed for the first time with in
situ or invasive breast cancer from 7/1/83 through 12/31/88
(premenopausal women) or from 3/1/87 through 12/31/89
(postmenopausal women). Joint ER/PR status was collected for 424
premenopausal and 760 postmenopausal case participants. The analysis
included 714 premenopausal and 1091 postmenopausal age-matched,
race-matched (white or Hispanic), parity-matched (premenopausal women
only), and residential neighborhood-matched control participants.
Among the postmenopausal women, obesity was associated with an
increased odds of ER+/PR+ breast cancer (odds ratio, 2.45 for women in
the highest versus the lowest body mass index quartile;
95% confidence interval, 1.73–3.47). Body mass index was associated
with neither ER-/PR- tumors among the postmenopausal women nor with
any ER/PR subgroup among the premenopausal women. For both
premenopausal and postmenopausal women, higher recreational physical
activity levels (
17.6 MET-hours/week versus no
activity) were associated with a 30–60% reduction in risk of nearly
all ER/PR subtypes, although the associations were generally of
borderline statistical significance. Examining these potentially
modifiable breast cancer risk factors by tumor ER and PR status may
provide us with greater insight into breast cancer etiology and the
mechanisms underlying the risk factor associations.
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