ASSOCIATION OF OVERWEIGHT AND

OBESITY WITH BREAST CANCER IN INDIA

P Singh, Umesh Kapil, NK Shukla, SVS Deo, SN Dwivedi

Indian Journal of Community Medicine/vol36/issue4/oct2011

Presenter: Dr Fredrick Stephen

PG in Community Medicine

MGMCRI

Pondicherry

INTRODUCTION

Breast cancer is one of the most common incident cancer

and cause of death.

Body fat is an important locus of endogenous estrogen

production hence could increase the risk of breast cancer.

Obesity leads to increased levels of fat tissue in the body that

can store toxins and serve as a continuous source of

carcinogens.

Free estrogen levels are raised in obese women especially in

those with abdominal obesity.

.

AIMS AND OBJECTIVES

To study the association of overweight

and obesity with breast cancer in India

Study design

Hospital Based Matched Case Control Study

CasesN=320

ControlsN=320

Matching

MATERIALS AND METHODOLOGY

Place of Study: All India Institute of Medical Sciences New

Delhi

Type of Study : Hospital Based Matched Case control Study

Study Period : 2001-2003 (Three years)

Place of Recruitment

Cases Controls

320 Newly Diagnosed Breast

Cancer patients from the OPD,

hospital admissions of the dept of

Surgery/ Surgical oncology at AIIMS

320 normal healthy individuals

accompanying the patients in the Dept of

Medicine, Surgery and Gastroenterology

at AIIMS and comprehensive Rural Health

Services project at Ballabgarh Hospital,

Faridabad, Haryana

Inclusion Criteria

Cases Controls

Proven cases of breast Cancer by

Histopathology/ Cytopathology

The attendants of patients who did

not suffer from any major illness in

the past

Not undergone any treatment

specific for breast cancer

No long course of vitamin or mineral

supplementation during the last one

year

Not suffered from any major chronic

illness in the past before the

diagnosis of breast cancer

Not under Corticosteroid therapy or

suffering from hepatic disorders or

severe malnutrition

No long course of vitamin or mineral

supplementation during the last one

year

Not under Corticosteroid therapy or

suffering from hepatic disorders or

severe malnutrition.

Exclusion Criteria

Cases Controls

Subjects who are already on

treatment for Breast Cancer or

corticosteroid therapy.

Subjects who couldn’t be

matched with the cases as per

the criteria ( 2 years and

socioeconomic factors)

Severely ill, malnourished

subjects

Who had taken vitamins and

mineral supplementation during

the past 1 year.

Not given consent for the

investigative procedures.

Not given consent for the

investigative procedures.

RESULTS

Socio Demographic Factors

Sl no. Factors Cases Controls

1. Age (Mean) 45.5 40.98

2. Area of Residence Urban Area (61.9%) -

3. Occupation Housewives (95.9%) Housewives (95.6%)

4. literacy Illiterates (37.2%) Illiterates (35.9%)

5. Socioeconomic Status Lower Middle (46%) Lower Middle

(36.3%)

Table 1: Mean anthropometric measurements of the

breast cancer patients (cases) and controls

Sl no. Measurements Breast cancer

Patients

(n=320)

Mean ± SD

Controls

(n=320)

Mean ± SD

P

1 Weight (kg) 59.75 ± 10.92 56.44 ± 11.24 0.000

2 Height (cm) 153.54 ± 4.83 153.14 ± 3.70 0.24

3 BMI (kg/m2) 25.35 ± 4.54 24.03 ± 4.57 0.000

4 MUAC (cm) 26.04 ± 3.41 24.48 ± 2.85 0.000

Table 2: Unadjusted relative risk for breast cancer

patients(cases) according to body mass index

Sl no Body Mass

Index

(kg/m2)

Cases

(n=320)

Controls

n=320

Odds

ratio

95% CI

1 <25 145 (45.3%) 161 (50.3%) 1.00 0.76-1.47

2 25-29.9 132 (41.3%) 138 (43.1%) 1.06 1.28-4.01

3 ≥30 43 (13.4%) 21 (6.6%) 2.27

CONCLUSION

• The breast cancer patients had a statistically higher mean weight,

BMI, and MUAC as compared to the controls.

• Obesity and weight gain are positively associated with serum

concentrations of endogenous estrogens thus affecting breast

cancer growth and metastasis.

• The results of the study revealed a strong association of

overweight and obesity with breast cancer in the Indian population.

• Weight control may be a modifiable risk factor for breast cancer

prevention and so has significant public health impact in women.

LIMITATIONS

The socio demographic profile provided by the study is

insufficient and not presented in tables.

Matching between cases and controls was not followed as

per the criteria ( socioeconomic status ).

Majority of the cases were from urban areas (61.9%)

In spite of high Illiteracy rates, a semi structured

questionnaire was administered to the subjects

LEARNING

Association of anthropometric factors of weight,

height, and BMI with Breast cancer.

Hospital based matched case control study.

Univariate Logistic regression analysis.

Matching.

THANK YOU