The Who, What, Where, When and Sometimes, Why.

Weight gain and breast cancer risk

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: Weight gain in adulthood appears to increase the risk of breast cancer. This increased risk is most clearly seen in breast cancers that occur after menopause.

Women who use menopausal hormone therapy (MHT) have an increased risk of breast cancer. This increased risk may mask an increased risk from body weight. For this reason, many studies report findings by MHT use. MHT may also be called postmenopausal hormone therapy or hormone replacement therapy (HRT).

Learn more about weight gain and breast cancer risk.

Learn more about menopausal hormone therapy and breast cancer risk.

Learn about the strengths and weaknesses of different types of studies.

See how this risk factor compares with other risk factors for breast cancer.

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Komen Perspectives

Read Komen’s perspective on body weight and breast cancer risk.*

* Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.

Study selection criteria: Prospective cohort studies with at least 1,000 breast cancer cases and meta-analyses.

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk. 

Study

Study Population
(number of participants)

Follow-up
(years)

Time of Weight Gain

Categories of Weight Gain Compared

 Relative Risk of Breast Cancer in Women who Gained the Most Weight Compared to Women who Gained the Least 
RR (95% CI)

Before Menopause

After Menopause

Prospective cohort studies

Women’s Health Initiative Observational Study [1]

80,943 
(5,564 cases)

20

From age
18-50

More than 10 lbs.
vs.
little weight change (less than 10 lbs. gain or loss)

 

1.11
(1.03-1.20)

Nurses’ Health Study [2-3]

74,177 
(4,965 cases)

22‡

From age
18

11 to less than 22 lbs.
vs.
little weight change (less than 11 lbs. gain or loss)

1.03
(0.85-1.26)

1.08
(1.00-1.17)

 

 

 

 

22 to less than 33 lbs.
vs.
little weight change (less than 11 lbs. gain or loss)

1.05
(0.88-1.29)

1.25
(1.12-1.38)

 

 

 

 

33 to less than 44 lbs.
vs.
little weight change (less than 11 lbs. gain or loss)

1.00
(0.78-1.29)

1.23
(1.05-1.44)

 

 

 

 

More than 44 lbs.
vs.
little weight change (less than 11 lbs. gain or loss)

1.05
(0.85-1.30)

1.17
(0.97-1.41)

 

49,514
(2,376 cases)

24

From age at menopause

22 lbs. or more
vs.
little weight change

 

1.18
(1.03-1.35)

EPIC Cohort [4]

205,723
(4,663 cases)

8

From age
40-50

9-55 lbs.
vs.
little weight change (4-5 lbs. gain or loss)

1.37
(1.02-1.85)

1.24
(1.07-1.43)†

California Teachers Study [5]

109,862
(3,844 cases)

13-14

From age 18

10-24 lbs.
vs.
less than 10 lbs. gain or loss

 

1.42
(1.19-1.70)§,||

 

 

 

 

25 lbs. or more
vs.
less than 10 lbs. gain or loss

1.04
(0.79-1.37)§

 

Multiethnic Cohort [6]

82,971
(3,080 cases)

8-11

From age 21

20.1-31
vs.
8-20 lbs.

 

1.13
(0.99-1.27)¶

    

31.1-49.9
vs.
8-20 lbs. 

 

1.23
(1.07-1.40)¶

    

 50 or more
vs.
8-20 lbs.

 

1.39
(1.18-1.64)¶

Iowa Women’s Health Study [7]

36,658
(2,286 cases)

16

From age 18

29-45
vs.
13 lbs. or less

 

Age 55-64:
1.13
(0.85-1.48)

Age 65-74:
1.31
(1.11-1.55)

Age 75-84:
1.42
(1.10-1.84)

    

More than 45
vs.
13 lbs. or less

 

Age 55-64:
1.47
(1.13-1.91)

Age 65-74:
1.78
(1.52-2.08)

Age 75-84:
1.79
(1.40-2.30)

NIH-AARP Diet and Health Study [8]

99,039
(2,111 cases)

4

From age 18

66-88 lbs.
vs.
little weight change (4 lbs. gain or loss)

 

1.87
(1.29-2.72)**

  

 

From age 50

66-88 lbs.
vs.
little weight change (4 lbs. gain or loss)

 

1.89
(1.20-2.97)**

  

 

Between ages 35-50

66-88 lbs.
vs.
little weight change (4 lbs. gain or loss)

 

2.29
(1.51-3.46)**

Cancer Prevention Study-II (CPS-II) [9]

65,756
(1,934 cases)

7-9

From age 18

71 lbs. or more
vs.
little weight change

 

2.13
(1.50-3.01)†

Nurses’ Health Study and Nurses’ Health Study II [10]

165,608
(1,811 cases)

14-28

From age 18

33-43.9 lbs.
vs.
little weight change

0.86
(0.68-1.07)

 
  

 

 

44-54.9 lbs.
vs.
little weight change

0.88
(0.66-1.18)

 
    

55 lbs. or more
vs.
little weight change

0.74
(0.52-1.04)

 

CPS-II [11]

44,161
(1,200 cases) 

9

From age 18

21-40
vs.
5-20 lbs.

 

Ductal carcinoma:
1.28
(1.08-1.53)† 

Lobular and mixed ductal/lobular carcinoma:
0.99
(0.70-1.39)†

    

41-60
vs.
5-20 lbs.

 

Ductal carcinoma:
1.65
(1.37-2.00)†

Lobular and mixed ductal/lobular carcinoma:
1.08
(0.73-1.61)†

    

61 or more
vs.
5-20 lbs.

 

Ductal carcinoma:
1.89
(1.53-2.34)†

Lobular and mixed ductal/lobular carcinoma:
1.54
(1.01-2.33)†

Black Women’s Health Study [12]

52,080
(1,062 cases)

10

From age 18

55 or more
vs.
less than 22 lbs.

1.17
(0.90-1.52)

1.09
(0.81-1.48)

Meta-analyses

Vrieling et al. [13]

7 studies

 

From age 18††

Various

 

For hormone receptor-positive tumors:
2.33
(2.05-2.60)

For hormone receptor-negative tumors:
1.34
(1.06-1.63)

† Results are for women who never used menopausal hormone therapy (MHT).

‡ Estimated from person-years.

§ All breast cancers were estrogen receptor-positive.

|| Relative risk for women who never used MHT. Among MHT users, there was no increase in risk.

¶ Among women who never used MHT, a weight gain of 50 or more pounds had a relative risk of 1.60 (1.36-1.87).

** Results are for women not currently taking MHT.

†† Five of 7 studies measured weight gain from age 18. One study measured weight gain from age 20 and one study measured weight gain from age 50.

References

  1. Welti LM, Beavers DP, Caan BJ, Sangi-Haghpeykar H, Vitolins MZ, Beavers KM. Weight fluctuation and cancer risk in postmenopausal women: the Women’s Health Initiative. Cancer Epidemiol Biomarkers Prev. 26(5):779-786, 2017.
  2. Rosner B, Eliassen AH, Toriola AT, et al. Weight and weight changes in early adulthood and later breast cancer risk. Int J Cancer. 140(9):2003-2014, 2017.
  3. Eliassen AH, Colditz GA, Rosner B, et al. Adult weight change and risk of postmenopausal breast cancer. JAMA. 296(2):193-201, 2006. 
  4. Emaus MJ, van Gils CH, Bakker MF, et al. Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study. Int J Cancer. 135(12):2887-99, 2014.
  5. Horn-Ross PL, Canchola AJ, Bernstein L, Neuhausen SL, Nelson DO, Reynolds P. Lifetime body size and estrogen-receptor-positive breast cancer risk in the California Teachers Study cohort. Breast Cancer Res. 18(1):132, 2016. 
  6. White KK, Park SY, Kolonel LN, Henderson BE, Wilkens LR. Body size and breast cancer risk: The multiethnic cohort. Int J Cancer. 131(5):E705-16, 2012.
  7. Sweeney C, Blair CK, Anderson KE, et al. Risk factors of breast cancer in elderly women. Am J Epidemiol. 160(9):868-75, 2004.
  8. Ahn J, Schatzkin A, Lacey JV Jr, et al. Adiposity, adult weight change, and postmenopausal breast cancer risk. Arch Intern Med. 167(19):2091-102, 2007.
  9. Feigelson HS, Jonas CR, Teras LR, Thun MJ, Calle EE. Weight gain, body mass index, hormone replacement therapy, and postmenopausal breast cancer in a large prospective study. Cancer Epidemiol Biomarkers Prev. 13(2):220-4, 2004.
  10. Michels KB, Terry KL, Eliassen AH, Hankinson SE, Willett WC. Adult weight change and incidence of premenopausal breast cancer. Int J Cancer. 130(4):902-9, 2012.
  11. Feigelson HS, Patel AV, Teras LR, et al. Adult weight gain and histopathologic characteristics of breast cancer among postmenopausal women. Cancer. 107(1):12-21, 2006.
  12. Palmer JR, Adams-Campbell LL, Boggs DA, Wise LA, Rosenberg L. A prospective study of body size and breast cancer in black women. Cancer Epidemiol Biomarkers Prev. 16(9):1795-802, 2007. 
  13. Vrieling A, Buck K, Kaaks R, Chang-Claude J. Adult weight gain in relation to breast cancer risk by estrogen and progesterone receptor status: a meta-analysis. Breast Cancer Res Treat. 123(3):641-9, 2010.

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