HindawiPublishingCorporation JournalofOncology Volume2013,ArticleID906495,19pages http://dx.doi.org/10.1155/2013/906495 Review Article Role of Obesity in the Risk of Breast Cancer: Lessons from Anthropometry AminaAmadou,1PierreHainaut,2andIsabelleRomieu1 1NutritionalEpidemiologyGroup,NutritionandMetabolismSection,InternationalAgencyforResearchonCancer, 150CoursAlbertomas,69372LyonCedex08,France 2InternationalPreventionResearchInstitute,95CoursLafayette,69006Lyon,France CorrespondenceshouldbeaddressedtoIsabelleRomieu;romieui@iarc.fr Received9October2012;Accepted29November2012 AcademicEditor:DagrunEngeset Copyright©2013AminaAmadouetal. is is an open access article distributed under the Creative Commons Attribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Anestimated1.38millionnewcasesofbreastcancer(BC)arediagnosedeachyearinwomenworldwide.Ofthese,themajority are categorized as invasive ductal cell carcinoma. Subgroups of BC are frequently distinguished into �ve “intrinsic” subtypes, namely, luminal A, luminal B, normal-like, HER2-positive, and basal-like subtypes. Epidemiological evidence has shown that anthropometricfactorsareimplicatedinBCdevelopment.Overallconsistentpositiveassociationshavebeenobservedbetween highbodymassindex(BMI)andwaist-to-hipratio(WHR)andtheriskofBCamongpostmenopausalwomen,whilecon�icting resultspersistforpremenopausalBC, bothforBMIandforotheranthropometricparametersaswellasacrossethnicgroups. Furthermore,someevidencesuggeststhatbodysize,bodyshape,andweightgainduringchildhoodoradolescencemayplayarole intheriskofBC.Inthispaper,wedescribetheevidencelinkinganthropometricindicesatdifferentagesandBCrisk,inorder toimproveourunderstandingoftheroleofbodyfatdistributionintheriskofBC,investigatedifferencesintheseassociations accordingtomenopausalstatusandethnicgroups,anddiscussthepotentialbiologicalmechanismslinkingbodysizeandBCrisk. 1.Introduction eincidenceratesofBCshowaheterogeneousdistribu- tion,whileWesterncountriespresentthehighestincidence Breastcancer(BC)isthemostfrequentlydiagnosedcancerin rates, the lowest incidences are observed in low resource womenworldwide,accountingfor23 (1.38million)ofthe countries. BC ranks as the ��h cause of death from cancer totalnewcancercasesin2008[1,2].emajorityofinvasive overall(458,000deaths),butisstillthemostfrequentcauseof breast neoplasms are categorized as%“invasive ductal cell cancerdeathinwomeninbothdeveloping(269,000deaths) carcinoma,nototherwisespeci�ed”(ICD-O8500/3)[3].is and developed regions (189,500 deaths) [1]. Incidence and entityhaslongbeenrecognizedtoincludetumorswithhet- mortality rates have increased in low-incidence countries, erogeneous molecular characteristics, characterized by dis- particularlyinLatinAmerica(LA)andAfricaandespecially tinctpatternsofgeneexpression[4]andofgenomic/genetic amongyoungerwomen.DatafromLAshowthatthehighest alterations[5].SubgroupsofBCarefrequentlydistinguished BC incident rates are among women aged 30–49. In this intoluminal A (estrogen/progesterone-positive),luminal B, area,BCisthemostcommoncanceramongwomen,andthe HER2+,andso-called“triplenegative”subtypes[6].Among leadingcauseofcancermortalitycompoundedbyproblems these subtypes, HER2+ and basal-like subtypes tend to be of access to screening, diagnosis, and treatment [8, 9]. In more common among premenopausal women, as well as Mexicoforexample,BCdeathhasincreased3.6foldbetween in women of African ancestry. Luminal subtypes are more 1995 and 2005. In Africa, a recent study among Gambian commoninpostmenopausalwomenandamongCaucasians women showed an increase of 6.5 in the incidence rate [7]. of BC from 1990 to 2006 [10] compared to 1.5 annually % % 2 JournalofOncology increaseworldwide[11].Asiancountriesarealsorecording indicesatdifferentagesandBCriskinordertoimproveour signi�cant annual increases, for example 2 in Japan and understandingoftheroleofbodyfatdistributionintheriskof 3–5 inChina[11]. BC,toinvestigatedifferencesintheseassociationsaccording e risk factors related to reproductive%factors such as tomenopausalstatusandethnicgroups,andtohighlightthe dela%yedchildbearing,lowerparity,andreducedbreastfeeding potential biological mechanisms linking body size and BC arebecomingmoreprevalentincountriesineconomictran- risk. sitionbutdonotfullyexplaintheincreaseofBCincidence rates.Otherriskfactorssuchaschangesinlifestyle,physical 2.Methods activity,andanthropometryaswellasethnicityandgenetic susceptibility play a role in the development of BC [12– To review the epidemiologic literature on the association 16]. In particular, overweight and obesity have been clearly of overweight, obesity, fat distribution, and BC risk, we associatedwithanincreasedoverallriskofBC. conducted a MEDLINE and PUBMED search including all Overweightandobesityhavebecomemajorpublichealth publications using height, weight, BMI, WC, HC, WHR, challenges throughout the world in both high and low anthropometricfactors,bodyshape,earlylifebodysize,BC, income countries, with over 1 billion overweight and 315 premenopausal,premenopausalBC,case-control,andcohort million obese adults currently estimated worldwide [17, studiesaskeywords.Ourpaperfollowsthepreferredreport- 18]. In the United States (US) for example, obesity is now ingitemsforsystematicreviewsandmeta-analysis(PRISMA) consideredasthesecondleadingcauseofpreventabledeath statementguidelinesdescribedbyLiberatietal.[52].Wethen aer tobacco consumption. Over two-thirds of the adult examinedthereferencesfromtheidenti�edarticles,previous population is overweight, with approximately one-third of review and meta-analysis between anthropometric factors adults and almost 17 of children and adolescents obese andpremenopausalandpostmenopausalBC.eliterature [17,18].Moststudiesontheassociationbetweenobesityand searchincludedallpublicationsfrom1997to2011andrecent BCriskhavebeencond%uctedonCaucasianpopulationsfrom publicationsuptoFebruary2012. Europe,Canada,andtheUS.However,alimitednumberof studiesinotherethnicgroupssuggestsomedifferencesinthe �.�e��t�o��Me�s��e�e�t��d��eo��es�t� prevalenceofobesityandfatdistributionamongwomen.For example studies in the US show that American women of Overweightandobesityarede�nedasabnormalorexcessive AfricanorHispanicoriginaremorelikelytobeobesethan fat accumulation that may impair health [61]. ere are Caucasian women [19]. Given the disparities in prevalence differentwaystomeasureobesity;BMIisthemostcommonly rates of obesity, it is expected that among women, 69 of usedandiscalculatedasweight(kg)dividedbyheight(m ). Caucasians,87 ofAfricanAmericans,and80 ofHispanics eWorldHealthOrganization(WHO)classi�esthedegree willbeoverweightin2015[19]. % 2 of adiposity in terms of the BMI as follows: underweight, Anthropom%etricindices,height,weight,bo%dymassindex less than 18.5; normal, 18.5–24.9; overweight, 25.0–29.9; (BMI),waistcircumference(WC),hipcircumference(HC), obese, more than 30.0kg/m (Table 1(a)). While BMI is or waist-to-hip ratio (WHR), are commonly used as tools usuallyassociatedwithgeneralobesity,WCandWHRhave for assessing overweight/obesity and recently methods for 2 beenusedasmeasuresofcentralorintra-abdominalobesity, evaluating body shape and body size at different ages have de�ned as waist–hip ratio above 0.90 for males and above also been used. Several studies and meta-analyses have 0.85 for females (Table 1(b)). However, there is evidence of examined the associations between anthropometric indices important ethnic variations in body fat distribution, espe- and BC among both pre- and postmenopausal women. ciallyinAsiansascomparedtoCaucasians.InAsianadults, Overall consistent positive associations have been observed differences in body build and body composition result in a between BMI and WHR and the risk of BC among post- differentrelationshipbetweenBMIandbodyfatdistribution menopausalwomen[20–29],whilecon�ictingresultspersist relativetoCaucasians[62–64].InastudyofyoungJapanese forpremenopausalBC,bothforBMIandforotheranthro- and Australian men, Kagawa and colleagues reported that pometric parameters [29–36]. Possible differences in these Japanesemenwereestimatedtohaveanequivalentamount associationscouldberelatedtodifferentialrolesoffatandfat of body fat as the Australian men at BMI values about 1.5 distributiononmetabolismandtotheircontributiontoBC development among pre- and postmenopausal women [31, units lower than those of the Australians (23.5kg/m and 32]. Waist circumference (WC) and WHR, which correlate 28.2kg/m , resp.) [65]. Similarly, studies among Ch2inese with central (abdominal) obesity have been associated with reported s2imilar relationship between BMI and body fat increased BC risk in postmenopausal women [32, 37–39], distribution [43]. ese observations suggest that Asian but not in premenopausal women for whom both null peoplearemorelikelytohavehigherlevelsofbodyfatoverall [23, 38, 39] and increased risk have been reported [31, 32, andmoreabdominalfatandlowerleanmassthantheother 37, 40]. Furthermore, the relation between premenopausal ethnic groups for a given BMI [41–43]. Consequently, the BC and anthropometry has shown inconsistencies across level of BMI that the WHO recommends for overweight ethnic groups [41–43]. ese inconsistencies may be due and obesity in Caucasians may not be applicable for Asian to important ethnic variations in body fat distribution. adults.eWHOWesternPaci�cRegionalO�ce(WPRO) We conducted a systematic review of published studies to has proposed a de�nition of obesity in Asian populations evaluatethestrengthofassociationsbetweenanthropometric withoverweightde�nedasBMI23.0–24.9kg/m andobesity 2 JournalofOncology 3 T1:(a)Combinedrecommendationsofbodymassindexandwaistcircumferencecut-offpointsmadeforoverweightorobesity,and associationwithdiseaserisk.(b)WorldHealthOrganisationcut-offpointsandriskofmetaboliccomplications. (a) Bodymassindex Obesityclass Diseaserisk(relativetonormalweightandwaistcircumference) Men 102cm Men 102cm Women 88cm Women 88cm < > Underweight 18.5 < > Normal 18.5–24.9 < Overweight 25.0–29.9 Increased High 30.0–34.9 I High Veryhigh Obesity 35.0–39.9 II Veryhigh Veryhigh Extremeobesity 40 III Extremelyhigh Extremelyhigh (b) > Indicator Cut-offpoints Riskofmetaboliccomplications Waistcircumference Men 94cm;women 80cm Increased Waistcircumference Men 102cm;women 88cm Substantiallyincreased Waist-hipratio Men >0.90cm;women>0.85cm Substantiallyincreased > > ≥ ≥ Author, year Ethnicity/race RR 95% CI Cohort studies Lahman et al., 2004 [23] Caucasian 1.31 1.08–1.59 Tehard and Clavel-Chapelon, 2006 [28] Caucasian 1.44 1.04–1.99 Palmer et al., 2006 [35] African-American 0.78 0.58–1.05 Kuriyama et al., 2005 [46] Asian 2.67 1.03–6.92 Iwasaki et al., 2007 [47] Asian 2.28 0.94–5.52 Kawai et al., 2010 [22] Asian 2.54 1.16–5.55 Case-control studies Friedenreich et al., 2002 [48] Caucasian 0.99 0.74–1.32 Hall et al., 2000 [40] Caucasian 1.08 0.58–2.01 Berstad et al., 2010 [30] Caucasian 0.75 0.53–1.06 Wenten et al., 2002 [50] Caucasian 2.77 0.86–8.91 Slattery et al., 2007 [36] Caucasian 1.61 1.05–2.46 Hall et al., 2000 [40] African-American 0.68 0.33–1.41 Berstad et al., 2010 [30] African-American 1.26 0.69–2.31 Ogundiran et al., 2010 [34] African 0.76 0.48–1.21 Adebamowo et al., 2003 [49] African 1.82 0.77–4.28 Chow et al., 2005 [20] Asian 1.73 1.04–2.87 Wu et al., 2007 [39] Asian 1.35 0.95–1.93 Mathew et al., 2008 [24] Asian 1.29 1.00–1.67 Wenten et al., 2002 [50] Hispanic 1.32 0.47–3.72 Slattery et al., 2007 [36] Hispanic 0.80 0.44–1.45 Meta-analysis studies Van Den Brandt et al., 2000 [29] Caucasian 1.26 1.08–1.47 Suzuki et al., 2009 [27] All 1.33 1.19–1.48 Renehan et al., 2008 [25] All 1.12 1.05–1.19 0 2 4 6 8 RR F1:ForestplotoftheassociationbetweenBMIandbreastcancerriskinpostmenopausalwomen.esizeofeachboxindicatesthe relativeweightofeachstudy;thehorizontalbarsshowthe95 con�denceintervals(CI).RR:relativerisk;95 CI:95 con�denceintervals. % % % 4 JournalofOncology Variablesofadjustmentorcomment Studycenter,age,educationalattainment,smokingstatus,alcoholconsumption,parity,ageat�rstpregnancy,ageatmenarche,andcurrentpilluse FHBC,ageatmenarche,ageat�rstbirth,parity,historyofbenignbreastdisease,alcoholconsumption,numberofyearsofeducation,maritalstatus,andphysicalactivity Age,educationstatus,ageatmenopause,ageatmenarche,parity,ageat�rstbirth,BMIatage18years,OC,HRT,smoking,alcohol,andphysicalactivitylevel Age,timeperiod,parity/ageat�rstbirth,FHBC,personalhistoryofbenignBC,height,alcoholintake,OCuse,birthweight,ageatmenopause,andHRTuse Age,smoking,alcohol,consumptionofmeat,�sh,fruits,greenoryellowconsumptionofbean-pastesoup,typeofhealth,parity,ageatmenarche,andageatFFTpregnancy Age,area,numberofbirths,ageat�rstbirth,andheight Age,education,smoking,alcohol,andtimespentwalking,Menstrualandreproductivefactors,HRT,andFHBC Age,ageatmenarche,parity,ageat�rstbirth,andfamilyhistoryofbreastcancer Age,totalcaloricintake,physicalactivity,educationallevel,HRT,diagnosedwithbenignBC,FHBC,alcohol,andcurrentsmoke dedinthepaper. RR(95CI) %1.31(1.08–1.59)0.66(0.45–0.98) 0.94(0.74–1.21)0.85(0.60–1.20) 1.44(1.04–1.99)1.03(0.83–1.28) 0.85(0.74–0.98) 0.93(0.90–0.95)0.91(0.89–0.93) 2.67(1.03–6.92) 2.28(0.94–5.53) 2.54(1.16–5.55) 0.55(0.37–0.82)0.78(0.58–1.05)1.01(0.74–1.40) 0.99(0.74–1.32)1.43(1.07–1.93) u cl n i n e menopausalwome Rangeofexposure 30versus2530versus25><><0.84versus0.730.84versus0.73><><30versus18.50.82versus0.74 ≥<≥ boveversusaverag 0.1unitincrease0.1unitincrease 30versus25 ≥< 30versus19 ><25versus20 25versus20≥<37versus250.87versus0.71≥<≥<31.3versus24.1≥<0.83versus0.75 ≥<≥< st A o p n i Y dies 10Y–20 stu ure 12 5–10 racteristicsof Typeofexpos BMInon-HRTHRTWHRnon-HRTHRT BMIWHR Weightatage BodyfatnessChildhoodAdolescent BMI BMI BMI BMIatage18CurrentBMIWHR BMIWHR a h c 2:Selected Cases/controlsorP-years 1,405/103,344 860/41497 2503/35941 4974/188,860 65/9,666 441/55,537 108/10,106 455/59,000 771/762  T Population Caucasian Caucasian Caucasian Caucasian Asian Asian Asian African-American Caucasian n ol udydesig ohort ohort ohort ohort ohort ohort ohort ohort ase-contr St C C C C C C C C C r, 4] 5] 5] Firstauthor,yeaandcountry Lahmann2004Germany[23] Tehard2006France[28] Bardia2008UnitedStates[4 Baer2010UnitedStates[4 Kuriyama2005Japan[46] Iwasaki2007Japan[47] Kawai2010Japan[22] Palmer2007UnitedStates[3 Friedenreich2002Canada[48] JournalofOncology 5 Variablesofadjustmentorcomment Ageatmenarche,nulliparity,breastfeeding,Abortionormiscarriage,BMI,WHR,oralcontraceptive,HRT,FHBC,smoking,alcohol,education,medicalradiationtothechest Age,ageatmenarche,parity/ageatFFTpregnancy,lactation,andeducation Age,race,education,studysite,FHBC,parity,ageatmenopause,andHRT Age,ethnicity,education,menarche,parity,ageatFFTP,breastfeeding,menopausalstatus,ageatmenopause,FHBC,benignbreastdisease,contraceptive,alcohol Age,ageatmenarche,ageatFFTpregnancy,height Age;FHBC;totalMET-hours;parity;OC;breastfeeding;ageat�rstlivebirth; monthsofHRTuse Age,center,physicalactivitylevel,energyintake,alcoholintake,ageatmenopause,parity,andHeight Age,menopausalstatus,ageatmenarche,parity,numberofbirth,ageatFFTbirth,HRT,OC,breastfeeding,smoking,height,weight,andBMI Age,numberofpregnancies,familyhistoryofbreastcancer,income,smoking,alcohol,useofOC,andeducation RR(95CI) % 1.40(1.10–1.70) 0.68(0.33–1.42)1.08(0.58–2.00) 1.62(0.70–3.79)1.64(0.88–3.07) 0.72(0.55–0.96) 0.75(0.53–1.06)1.26(0.55–1.85) 0.76(0.48–1.21) 1.82(0.78–4.31) 2.77(0.86–8.89)1.32(0.47–3.72) 1.61(1.05–2.45)0.80(0.44–1.45) 1.51(0.93–2.46)0.77(0.39–1.50) 8.19(3.40–19.50) 1.73(1.04–2.86)3.82(1.03–14.27) 4.64.6 7777 Continued. Rangeofexposure 0.8versus0.8 >≤ 30.1–59.2versus14.6–230.1–59.2versus14.6–2 0.86–1.34versus0.6–0.0.86–1.34versus0.6–0. 25versus20 ≥<35versus2535versus25≥<≥< 28versus21 ≥< 30versus20 ≥<30versus2230versus22≥<≥<30versus2530versus25><><0.9versus0.80.9versus0.8><><0.86versus0.75 >< 23–27versus1931versus19 <<< 2:  n r T ure rs merica Tuser RTuse peofexpos HR MIBlackWhiteHRBlackWhite MIat18yeacentBMICaucasianAfrican-A MI MI MICaucasianHispanic MInon-HR CaucasianHispanicHRnon-HCaucasianHispanic HR MI y W W e W W T B BR B B B B B s ol ntrs 06 25 Cases/coorP-year 436/354 382/419 1,900/2,0 498/266 234/273 687/820 2,325/2,5 130/585 198/353 Population CaucasianAfrican-American CaucasianAfrican-American CaucasianAfrican-American African African CaucasianHispanic CaucasianHispanic Asian Asian n ol ol ol ol ol ol ol ol ol desig contr contr contr contr contr contr contr contr contr y - - - - - - - - - d e e e e e e e e e u as as as as as as as as as St C C C C C C C C C Firstauthor,year,andcountry Huang1999UnitedStates[38] Hall2000UnitedStates[40] Berstad2010UnitedStates[30] Ogundiran2010Nigeria[34] Adebamowo2003Nigeria[49] Wenten2002UnitedStates[50] Slattery2007UnitedStates[36] Ng1997Singapore[33] Chow2005China[20] 6 JournalofOncology Variablesofadjustmentorcomment Age,Asianethnicity,durationofresidenceintheUS,education,menarche,parity,menopausalstatus,ageatmenopause,intakeofteaandsoy,andphysicalactivity Age,center,religion,maritalstatus,educationsocioeconomicstatus,residencestatus,parity,ageat1stchildbirth,durationofbreastfeeding,andphysicalactivity Ameta-analysiswasdonetosummarizetheliteratureonWHRandbreastcancerriskpublishedfromJanuary1966toAugust2002 Lifestylesandreproductivefactors(confoundersthatwerefoundtobesigni�cantinproportionalhazardregressionanalysis)Meta-analysisofcohortandcase-controlstudies(from1970to2007)wasperformedtoclarifytheassociationbetweenbodyweightandtheincidenceofBCde�nedbyER/PRstatusofthetumors HRT,OC,historyofbenignbreastdisease,FHBC,smokingstatus,education,fatintake,�berintake,energyintake,andalcoholintake Cohortandcase-controlstudiespublishedfrom1966toNovember2007wereincludedintheanalysis.edoseresponsemeta-analysiswasadjustedbygeographicregionandcancersite Age,ethnicity,comorbidity,andmenopausalstatus placementtherapy;OC:oralcontraceptives;FFT: e r RR(95CI) %1.35(0.95–1.93)1.48(1.02–2.15) 1.29(1.00–1.66)1.00(0.64–1.54) 1.50(1.10–2.04) 1.32(1.16–1.49) 1.82(0.85–3.85) 1.33(120–1.48) 1.26(1.09–1.46) 1.12(1.08–1.16)1.15(1.08–1.23)1.09(1.04–1.48)1.31(1.15–1.48) 4.8(1.8–12.7)1.4(0.5–4.1) cer;HRT:hormonal n a c ast Continued. Rangeofexposure 24.60versus20.430.84versus0.76 >≤>≤ 25–29.9versus2530versus25 <>< 0.1unitincrease 0.75versus0.80 0.75versus0.80 0.5unitincrease 21versus31 5unitsincrease5unitsincrease5unitsincrease5unitsincrease 30versus2530versus25≥en in the highest quintile ( 0<.8) compared to lowest women [20, 22, 67]. In a cohort study of 10,106 women, quintile ( 0.8) was 1.40 (95 CI: 1.1–1.7) [38]. A study in conductedinJapan,theRRfordevelopingpostmenopausal Africa(Nigeria)reportedanRRof>2.67;95CI(1.05–6.80)for BC was 2.54; 94 CI (1.16–5.55) in women with BMI of postmeno≤pausalwomenwith%WHR 0.85comparedtothose 25kg/m or above compared to those with less 20.5kg/m withWHR 0.77[71].Incontrast,somestudiesconducted [22]. In2contrast%, there is a lack of data among women2 intheUSdidnotdetectasigni�can>tassociation.Halletal. of African origin, but the notion that increase in BMI reportedanassociation between BMIspect to Hispanics, with an OR of 1.90 (1.00–3.4) for BMI 26.2kg/m versus a case-coand including 898 associated with a decrease of the risk of premenopausal JournalofOncology 9 BC (OR = 0.46, 95 CI: 0.25, 0.84 for BMI 30 versus 7.VariationswithMolecularSubtypesof 25kg/m ) [36]. A more recent study has shown that high BreastCancer BMI was2inversely a%ssociated with risk of BC>in Hispanic n, a case-control study iyou−n4ger women withWHR(0.6–0.77)[40].Others%tudies[55,58,72]didno<≥ 28.8versus21.50.846versus0.736 ≥<>< 2levelsversusnoch2levelsversusnoch≥2levelsversusnoch≥ ≥30versus18.50.82versus0.74 ><≥ 0.2unitincrease 0.1unitincrease 0.84versus0.73 ≥< 29.9versus2530versus25 ≥<≥< 30versus19 26.2versus21.6><0.85versus0.77 ><< e diesinpr ure age7 fatnessto10to20 0to20 5–10Y 10–20Y cteristicsofstu Typeofexpos BMIBMIatage18Bodyshapeat BMIWHR IncreasebodyFromage5Fromage5 Fromage1 BMIWHR BodyfatnessChildhood Adolescent WHRER − BMI BMI BMIWHR a 3:Selectedchar Cases/controlsorP-years 733/99,717 474/73,542 1,318/109,267 275/20,068 2,188/188,860 620/45,799 33/5,214 441/55,537 104/11,889    T opulation aucasian aucasian aucasian aucasian aucasian aucasian sian sian sian P C C C C C C A A A n g si e yd ort ort ort ort ort ort ort ort ort d h h h h h h h h h u o o o o o o o o o St C C C C C C C C C 4 6 Authors,years,andcountry Weiderpassetal.,200Norway-Sweden[53] Lahmannetal.,2004Germany[23] Baeretal.,2005UnitedStates[54] TehardandClavel-Chapelon,200France[28] Baeretal.,2010UnitedStates[45] Harrisetal.,2011UnitedStates[31] Kuriyamaetal.,2005Japan[46] Iwasakietal.,2007Japan[47] Wuetal.,2006Taiwan[55]

Review Article Role of Obesity in the Risk of Breast Cancer: Lessons from Anthropometry - Hindawi

Similar Review Article Role of Obesity in the Risk of Breast Cancer: Lessons from Anthropometry - Hindawi