An estrogen model: the relationship between body mass index, menopausal status, estrogen replacement therapy, and breast cancer risk (Q764216)

Summary: We present a mathematical model that lends support to the hypothesis that estrogen levels mediate the complex relationship between the body mass index (BMI), menopausal status, estrogen-only hormone replacement therapy (HRT), and breast cancer risk. The model predicts a decrease in the relative risk of breast cancer of 3\% per unit increase in BMI kg/m\(^{2}\) for premenopausal women and an increase in the relative risk of 4\% per unit increase in BMI for postmenopausal women who are not HRT users. When comparing postmenopausal women who use estrogen-only HRT to postmenopausal women who do not use HRT, the model predicts an increased risk of breast cancer associated with use of estrogen that diminishes with increasing BMI, with a relative risk of 1.6 for women with BMI of 18, 1.2 for women with BMI of 25, and 1.0 for women with BMI \(\geq\) 30. The model predictions agree with data from five major epidemiological studies.