Background:Obesity is a risk factor for breast cancer mortality in postmenopausal women. However, it remains unclear which specific components of adipose tissue and skeletal muscle are associated with risk. This study assessed the associations between MRI-assessed adiposity, skeletal mass, and breast cancer risk in a population-based cohort.Methods:We analyzed data from 15,669 postmenopausal women in the UK Biobank who underwent MRI for body composition assessment. Age- and multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional-hazards regression to evaluate the associations between body composition and breast cancer risk, adjusting for relevant confounders. Sensitivity analyses were conducted by excluding breast cancer cases diagnosed within 2 years of the MRI scan. To explore nonlinear relationships, we applied restricted cubic splines with three knots to model associations between visceral adipose tissue (VAT), muscle-fat infiltration (MFI), and breast cancer risk.Results:The mean age of participants was 58.6 years (SD = 5.2; range = 40–69). Higher VAT was significantly associated with increased breast cancer risk (3rd vs. 1st tertile aHR = 1.24, 95% CI: 1.10–1.45). Elevated MFI was also linked with greater risk (3rd vs. 1st tertile aHR = 1.53, 95% CI: 1.25–1.87). These associations persisted after excluding early cancer cases. We observed a J-shaped relationship between VAT, MFI, and breast cancer risk.Conclusions:Higher levels of VAT and MFI are associated with elevated breast cancer risk in postmenopausal women, suggesting that imaging-derived body composition measures may enhance risk prediction and inform prevention strategies.
背景：肥胖是绝经后女性乳腺癌死亡的风险因素。然而，目前尚不清楚脂肪组织和骨骼肌的哪些具体成分与风险相关。本研究基于人群队列，评估了MRI评估的脂肪含量、骨骼肌质量与乳腺癌风险之间的关联。 方法：我们分析了英国生物银行中15,669名接受MRI身体成分评估的绝经后女性的数据。采用Cox比例风险回归模型，估计了年龄调整和多变量调整的风险比（HR）及其95%置信区间（CI），以评估身体成分与乳腺癌风险之间的关联，并对相关混杂因素进行了调整。通过排除MRI扫描后2年内诊断的乳腺癌病例进行了敏感性分析。为探索非线性关系，我们应用了具有三个节点的限制性立方样条来模拟内脏脂肪组织（VAT）、肌肉脂肪浸润（MFI）与乳腺癌风险之间的关联。 结果：参与者的平均年龄为58.6岁（标准差=5.2；范围=40–69岁）。较高的VAT与乳腺癌风险增加显著相关（第三分位数 vs. 第一分位数，调整后HR=1.24，95% CI: 1.10–1.45）。升高的MFI也与更高的风险相关（第三分位数 vs. 第一分位数，调整后HR=1.53，95% CI: 1.25–1.87）。在排除早期癌症病例后，这些关联仍然存在。我们观察到VAT、MFI与乳腺癌风险之间存在J形关系。 结论：较高的VAT和MFI水平与绝经后女性乳腺癌风险升高相关，这表明影像学衍生的身体成分测量可能有助于改善风险预测并为预防策略提供信息。
MRI-Derived Body Composition and Breast Cancer Risk in Postmenopausal Women: UK Biobank Study
肿瘤(癌症)患者之家