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Associations between serum lipids and breast cancer incidence and survival in the E3N prospective cohort study

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Abstract

Purpose

Several mechanistic studies support a role of cholesterol or its metabolites in breast cancer etiology, but associations have been inconsistent in epidemiological studies. In observational studies, possible reverse causation must be accounted for using a prospective design. We investigated prospective associations between pre-diagnostic serum lipid concentrations [total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides], and both breast cancer risk and survival in the E3N cohort study.

Methods

Analyses were performed on 583 cases from the E3N prospective cohort diagnosed between 1994 and 2005, and 1,043 controls matched on date, age, recruitment center and menopausal status at blood collection. Odds ratios (OR) and 95% confidence intervals were estimated using conditional logistic regression. Risks of recurrence were estimated among cases using Cox proportional hazards model. Models were adjusted for lifestyle risk factors and mutually adjusted for lipid concentrations. Survival analyses were additionally adjusted for tumor characteristics.

Results

Overall, there was no association between any serum lipid and breast cancer risk or survival. In stratified analyses, statistically significant interaction was observed between TC and menopausal status (P interaction = 0.05) and between TC and waist circumference (P interaction = 0.03), although the ORs did not reach statistical significance in any of the strata. There was no statistically significant effect modification by BMI, time between blood donation and diagnosis or ER status.

Conclusions

Our results suggest that serum lipids are not associated with breast cancer risk overall, but that menopausal status and waist circumference should be considered in further studies.

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Fig. 1

Abbreviations

BMI:

Body mass index

CI:

Confidence interval

ER:

Estrogen receptors

HDLC:

High-density lipoprotein cholesterol

LDLC:

Low-density lipoprotein cholesterol

MHT:

Menopause hormone therapy

OR:

Odds ratio

PR:

Progesterone receptor

SBR:

Scarff–Bloom–Richardson

TC:

Total cholesterol

TG:

Triglycerides

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Acknowledgments

The authors are grateful to Rafika Chaït, Lyan Hoang and Celine Kernaleguen for their technical assistance. The authors are also indebted to all participants for providing data and to practitioners for providing pathology reports.

Funding

This work was supported by the Fondation de France. Mathilde His was supported by PhD fellowship from the French League against Cancer. The E3N study is being carried out with financial support from the French League against Cancer, the Mutuelle Générale de l’Education Nationale, the Gustave Roussy Institute, and the National Institute of Health and Medical Research. None of the funding sources had a role in design of the study or collection, analysis and interpretation of the data, or in writing the manuscript.

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Authors and Affiliations

  1. Paris-Saclay University, Paris-Sud Univ, UVSQ, CESP Health across Generations Team, INSERM, Villejuif, France

    Mathilde His, Laureen Dartois, Guy Fagherazzi, Sylvie Mesrine, Marie-Christine Boutron-Ruault & Françoise Clavel-Chapelon

  2. Gustave Roussy, 94805, Villejuif, France

    Mathilde His, Laureen Dartois, Guy Fagherazzi, Sylvie Mesrine, Marie-Christine Boutron-Ruault & Françoise Clavel-Chapelon

  3. Department of Biochemistry, Bichat Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France

    Anne Boutten & Thierry Dupré

  4. Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France

    Laure Dossus

Authors
  1. Mathilde His
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  2. Laureen Dartois
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  3. Guy Fagherazzi
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Corresponding author

Correspondence to Françoise Clavel-Chapelon.

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His, M., Dartois, L., Fagherazzi, G. et al. Associations between serum lipids and breast cancer incidence and survival in the E3N prospective cohort study. Cancer Causes Control 28, 77–88 (2017). https://doi.org/10.1007/s10552-016-0832-4

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  • DOI: https://doi.org/10.1007/s10552-016-0832-4

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