ASPO Abstracts
Cardiometabolic Risk Factors and Risk of Breast Cancer by Molecular Subtype: Case-Control Study of the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Nigerian Women (MEND) study
Category: Cancer Health Disparities
Conference Year: 2021
Abstract Body:
Purpose of the Study: We investigated the association of individual (hypertension, waist
circumference, body mass index, high density lipoprotein, low density lipoprotein)
cardiometabolic risk factors (CMF), CMF index score, and breast cancer risk (overall and
by molecular subtype) among Nigerian women.
Methods: Multivariable logistic regression models were used to estimate odds ratios
(ORs) and 95% confidence intervals (95% CI) for the association of each respective
cardiometabolic risk factor and CMF score with breast cancer risk overall and by
molecular subtype (Luminal A, Luminal B, triple-negative, or HER2-enriched) for 256
newly diagnosed breast cancer cases and 246 healthy controls recruited in Nigeria. We
compared the highest vs. lowest quartile or tertile for each respective factor, and varying
combinations of the risk factors.
Results: Cases were significantly more likely to have a waist circumference higher than
35 inches (61.2%) compared to controls (38.8%), and 28.5% of cases had 4 or more risk
factors compared to 22.8% of controls. Women with 2 – 3 cardiometabolic risk factors
(AOR = 0.19, 95% CI = 0.06 – 0.59) had significantly reduced odds of breast cancer. High
LDL (AOR = 0.52, 95% CI = 0.36 – 0.76) was also associated with reduced odds of
breast cancer. High waist circumference (AOR = 3.86, 95% CI = 2.06 – 7.25) and
hypertension (AOR = 2.59, 95% CI = 1.23 – 5.44) were associated with increased odds of
overall breast cancer in fully adjusted models. Having 2 – 3 cardiometabolic risk factors
(AOR = 0.31, 95% CI = 0.10 – 0.98) was associated with reduced odds of Luminal B
breast cancer. Hypertension (AOR = 3.37; 95% CI = 1.24 – 9.14) was positively
associated with Luminal A breast cancer, while high waist circumference (AOR = 2.31,
95% CI = 1.00 – 5.33) was significantly associated with triple-negative breast cancer.
Conclusion: The association of cardiometabolic risk factors with risk of breast cancer
appears to be mixed among African women. High waist circumference and hypertension
are modifiable risk factors that should be further evaluated as part of cancer prevention
strategies in women of African descent.
Keywords: Cardiometabolic risk factor, breast cancer, Nigeria, molecular subtype