{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:18:05Z","timestamp":1783487885207,"version":"3.55.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metabolic dysfunction and hepatic steatosis-related phenotypes have increasingly been linked to extrahepatic malignancies, including breast cancer. The association between the Framingham Steatosis Index (FSI), a composite index incorporating age and multiple metabolic components, and prevalent breast cancer in women has not been well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional analysis of female participants in the National Health and Nutrition Examination Survey (NHANES) 1999\u20132018. Multivariable logistic regression models were used to evaluate the association between FSI and prevalent breast cancer, with FSI analyzed as both a continuous variable and by quartiles. Restricted cubic spline analysis and generalized additive modeling were applied to assess potential non-linearity, and two-piecewise logistic regression was used to explore a possible threshold effect. Component-level and AUC analyses compared FSI with its individual components. An exploratory hospital-based supportive dataset was analyzed to assess whether the continuous association showed a similar direction in a different clinical setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 21,042 women in NHANES, 531 (2.5%) reported a history of breast cancer. In the fully adjusted model, each 1-unit increase in FSI was associated with higher odds of prevalent breast cancer (OR 1.10, 95% CI 1.05\u20131.16). After additional adjustment for age, the association was substantially attenuated and no longer statistically significant (OR 1.02, 95% CI 0.96\u20131.07). Higher FSI quartiles were also associated with greater odds of prevalent breast cancer. Restricted cubic spline analysis suggested a non-linear association. In component-level analyses, age showed the strongest association and discriminatory performance among the FSI components, whereas adding FSI to the base model only modestly increased the AUC. In the exploratory hospital-based dataset, FSI was positively associated with breast cancer case status when modeled continuously, but the quartile-based dose-response pattern was not reproduced after full adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the primary NHANES analysis, higher FSI was associated with prevalent breast cancer status in women; however, this association was substantially attenuated after additional adjustment for age. FSI should therefore be interpreted as a composite marker of metabolic-hepatic burden rather than as an age-independent hepatic steatosis effect or causal biomarker.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1849341","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:46:50Z","timestamp":1783486010000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Higher Framingham steatosis index is associated with prevalent breast cancer in women: cross-sectional evidence from NHANES 1999\u20132018 and an exploratory hospital-based dataset"],"prefix":"10.3389","volume":"16","author":[{"given":"Shuling","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Guangxi Medical University Cancer Hospital","place":["Nanning, 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