{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:22:44Z","timestamp":1793298164389,"version":"4.5.0"},"reference-count":39,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Epidemiologic data suggest an association of obesity with breast cancer (BC); however, obesity\u2019s contribution to early onset and risk of diagnosis with specific molecular subtypes by race is uncertain.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the race-specific association of body mass index with early onset and diagnosis of specific molecular subtypes.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This retrospective cohort study included patients with BC diagnosed between October 1, 2017, and March 31, 2022, at 3 University of South Alabama Mitchell Cancer Institute clinics. Participants were also prospectively enrolled for serum leptin measurement.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was age at BC onset and specific subtype diagnosis. The secondary outcome was race-specific differences. Odds ratios (ORs) for associations of body mass index with age at onset and subtype were estimated using the Fisher exact test. Race was self-reported.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 1085 study patients, 332 (30.6%) were Black with a median age of 58 (IQR, 50-66) years, and 753 (69.4%) were White with a median age of 63 (IQR, 53-71) years. A total of 499 patients (46.0%) had obesity, with Black women with obesity receiving more frequent BC diagnosis than their White counterparts (OR, 2.40; 95% CI, 1.87-3.15; P<\/jats:italic>\u2009&amp;lt;\u2009.001). In addition, Black women had a significantly higher incidence of early-onset disease (OR, 1.95; 95% CI, 1.33-2.86; P<\/jats:italic>\u2009=\u2009.001) than White women, and obesity increased this risk significantly in Black women (OR, 2.92; 95% CI, 1.35-6.22; P<\/jats:italic>\u2009=\u2009.006). Black women with obesity also had a significantly higher risk of luminal A BC (OR, 2.53; 95% CI, 1.81-3.56; P<\/jats:italic>\u2009&amp;lt;\u2009.001) and triple-negative BC (TNBC) (OR, 2.48; 95% CI, 1.43-4.22; P<\/jats:italic>\u2009=\u2009.002) diagnosis than White counterparts. Black women, with or without BC, had significantly higher serum leptin levels (median [IQR], 55.3 [40.3-66.2] ng\/mL and 29.1 [21.1-46.5] ng\/mL, respectively, P<\/jats:italic>\u2009&amp;lt;\u2009.001) than White women (median [IQR], 33.4 [18.9-47.7] ng\/mL and 16.5 [10.0-22.9] ng\/mL, respectively), which was associated with higher odds of luminal A disease (OR, 5.25; 95% CI, 1.69-14.32, P<\/jats:italic>\u2009=\u2009.003). Higher odds of early-onset disease (OR, 3.50; 95% CI, 0.43-23.15; P<\/jats:italic>\u2009=\u2009.33 for trend), and TNBC diagnosis (OR, 6.00; 95% CI, 0.83-37.27; P<\/jats:italic>\u2009=\u2009.14 for trend) were also seen, although these outcomes were not statistically significant.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of patients with BC, obesity and high serum leptin levels were associated with an enhanced risk of early-onset BC and diagnosis of luminal A and TNBC subtypes in Black women. These findings should help in developing strategies to narrow the existing disparity gaps.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.21846","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T15:48:26Z","timestamp":1722268106000},"page":"e2421846","source":"Crossref","is-referenced-by-count":24,"title":["Obesity and Early-Onset Breast Cancer and Specific Molecular Subtype Diagnosis in Black and White Women"],"prefix":"10.1001","volume":"7","author":[{"given":"Sarabjeet Kour","family":"Sudan","sequence":"first","affiliation":[{"name":"Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile"},{"name":"Department of Pathology, Frederick P. 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Whiddon College of Medicine, University of South Alabama, Mobile"},{"name":"Department of Cell and Molecular Biology and Cancer Center and Research Institute, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wade","family":"Davis","sequence":"additional","affiliation":[{"name":"Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile"},{"name":"Department of Pathology, Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin K.","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile"},{"name":"Department of Pathology, Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teja","family":"Poosarla","sequence":"additional","affiliation":[{"name":"Interdisciplinary Clinical Oncology, Mitchell Cancer Institute, University of South Alabama, Mobile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolette P.","family":"Holliday","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranitha","family":"Prodduturvar","sequence":"additional","affiliation":[{"name":"Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Nelson","sequence":"additional","affiliation":[{"name":"Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan P.","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Epidemiology & Biostatistics, School of Medicine, University of Texas Health Science Center at Tyler, Tyler"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay P.","family":"Singh","sequence":"additional","affiliation":[{"name":"Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile"},{"name":"Department of Pathology, Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile"},{"name":"Department of Cell and Molecular Biology and Cancer Center and Research Institute, University of Mississippi Medical Center, Jackson, Mississippi"},{"name":"Department of Biochemistry and Molecular Biology, Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Singh","sequence":"additional","affiliation":[{"name":"Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile"},{"name":"Department of Pathology, Frederick P. Whiddon College of Medicine, University of South Alabama, Mobile"},{"name":"Department of Cell and Molecular Biology and Cancer Center and Research Institute, University of Mississippi Medical Center, Jackson, Mississippi"},{"name":"Department of Biochemistry and Molecular Biology, Frederick P. 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