BODY-FAT DISTRIBUTION AND BREAST-CANCER IN THE FRAMINGHAM-STUDY

We examined the relation between central body fat distribution and breastr cancer in a prospective cohort of women who participated in the Framingham Study. At the bseline examination in 1948, a total of 2,201 women aged 30-62 years were analyzed. An index of central to peripheral body fat (the central adiposity ratio) was calculated from the sum of the trunkal skinfolds (chest, subscapular, and abdominal) divided by the sum of the extramity skinfolds (triceps and thigh). These skinfolds were measuired at the fourth examination in 1954. The cohart was followed for up to 28 years and yielded 106 cases of breast cancer. When divided into quartiles based on the central adiposity ratio, only women in the fourth quartile (those with the highest central to peripheral body fat distribution) demonstrated an increased risk for breast cancer. The age- and adiposity-adjusted relative risk estimate for haveing anincrased central adiposity ratio (fourth qwuartile) compared to lower cantral adiposity ratios was 1.8 (95% confidence interval, 1.2-2.6). Adjustment for potential confounders of height, parity, and education did not appreciably alter this estimate (1.7, 1.1.-2.5). There was no associastion between degree of adiposity, as measured by the sum of the five skinfolds or by body mass index (weight in kg divided by height in m2), and subsequents breast cancer. The of this study suggest that increased central to peripheral body fat distribution predicts breast cancer risk independently of the degree of adiposity and may be a more specific marker of a premalignant hormonal pattern than degree of adiposity. [J Natl Cancer inst 82:286-290, 1990] © 1990 Oxford University Press.