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Association between body mass index and incidence of breast cancer in premenopausal women: a Japanese nationwide database study

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Abstract

Purpose

The association between body mass index (BMI) and the incidence of premenopausal breast cancer in the Asian population remains unclear. We investigated this association using data from a Japanese nationwide administrative database.

Methods

We retrospectively identified 785,703 females aged < 45 years with available health checkup data on BMI from January 2005 and April 2020 from a Japanese nationwide database. Cox proportional hazards model was used to estimate hazard ratios for breast cancer (total breast cancer, breast cancer with hormonal drug and trastuzumab administration, and breast cancer by age ≤ 45 years) associated with BMI recorded at the first health checkup. We conducted restricted cubic spline analysis without BMI categorization to investigate potential nonlinear associations with adjustment for backgrounds such as smoking and alcohol consumption.

Results

Overall, the median BMI was 20.5 (interquartile range [IQR], 18.9–22.7) kg/m2, and the median age was 37 (IQR, 29–41) years. Breast cancer occurred in 5597 participants (0.71%) at a median age of 44 (IQR, 42–46) years during a median follow-up of 1034 (IQR, 634–1779) days. A BMI of ≥ 22.0 kg/m2 was significantly associated with lower incidences of total breast cancer, breast cancer with hormonal drug administration, and breast cancer by age ≤ 45 years, whereas no significant associations were observed for breast cancer with trastuzumab administration.

Conclusion

This study, which used a Japanese nationwide database, demonstrated that BMI was inversely associated with premenopausal breast cancer development in Japanese women, similar to that observed in Western women.

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Data availability

The data from the JMDC Claims Database are available for anyone who would purchase it from JMDC Inc. (JMDC Inc.; Tokyo, Japan; https://www.jmdc.co.jp/en/index), which is a healthcare venture company in Tokyo, Japan.

Abbreviations

BMI:

Body mass index

CI:

Confidence interval

HR:

Hormone receptor

HER2:

Human epidermal growth factor receptor 2

RCS:

Restricted cubic spline

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Funding

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (21AA2007 and 20AA2005) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (20H03907).

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Authors and Affiliations

  1. Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Takaaki Konishi, Masahiko Tanabe & Yasuyuki Seto

  2. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Takaaki Konishi, Michimasa Fujiogi, Hiroki Matsui & Hideo Yasunaga

  3. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street, Suite 920, Boston, MA, 02114, USA

    Michimasa Fujiogi

  4. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Nobuaki Michihata

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  1. Takaaki Konishi
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  2. Michimasa Fujiogi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by TK, NM, MF, and HM. The first draft of the manuscript was written by TK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takaaki Konishi.

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The authors have no relevant financial or non-financial interests to disclose.

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This is an observational study. This study was approved by the Institutional Review Board of The University of Tokyo [approval number: 10862-(1)].

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The need for informed consent was waived owing to the retrospective nature of the study and the anonymity of the patient database.

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Konishi, T., Fujiogi, M., Michihata, N. et al. Association between body mass index and incidence of breast cancer in premenopausal women: a Japanese nationwide database study. Breast Cancer Res Treat 194, 315–325 (2022). https://doi.org/10.1007/s10549-022-06638-9

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