{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:19:02Z","timestamp":1787548742894,"version":"build-2736575974"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"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>Most studies to date have examined individual comorbidities in relation to breast cancer risk but have largely ignored that these conditions often cluster in the same person. Looking at comorbidity patterns rather than isolated diseases may therefore offer a better understanding of breast cancer risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this case\u2013control study, latent class analysis (LCA) was performed in the pooled case\u2013control sample based on 10 comorbidities\/conditions, including diabetes mellitus, hypertension, coronary heart disease, benign breast disease, breast lump, nipple discharge, history of gynecological tumors, severe lobular hyperplasia of the breast, papillomatous lesions of the breast, and dysfunctional uterine bleeding. Multivariable unconditional logistic regression was then used to examine the association between the identified latent classes and breast cancer risk and to test for potential interaction with body mass index (BMI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The LCA identified three comorbidity patterns in the pooled study sample: a low-comorbidity pattern, a metabolic comorbidity pattern, and a gynecologic\u2013breast comorbidity pattern, accounting for 53.90%, 19.90%, and 26.20% of the study participants, respectively. Compared with the low-comorbidity pattern, both the metabolic comorbidity pattern (aOR = 2.55, 95% CI: 1.69\u20133.84) and the gynecologic\u2013breast comorbidity pattern (aOR = 3.32, 95% CI: 2.25\u20134.89) were associated with higher breast cancer risk. Furthermore, a significant interaction was observed between BMI and the metabolic comorbidity pattern, suggesting that the association between this pattern and breast cancer risk varied across BMI categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that a comorbidity-pattern-based approach can improve the understanding of breast cancer risk. Identifying specific comorbidity or clinical conditions, particularly the metabolic and gynecologic\u2013breast comorbidity patterns, could inform personalized risk stratification and targeted prevention strategies for breast cancer. While BMI modified the association between the metabolic comorbidity pattern and breast cancer risk, no evidence of BMI-related effect modification was observed for the gynecologic\u2013breast comorbidity pattern.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1908221","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:23:25Z","timestamp":1787545405000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comorbidity patterns and risk of breast cancer: a case\u2013control study exploring interaction with BMI using latent class analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Yaling","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Nursing, The Affiliated Cancer Hospital of Xinjiang Medical University","place":["Urumqi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery (Second Ward), The Affiliated Cancer Hospital of Xinjiang Medical University","place":["Urumqi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinchun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Affiliated Cancer Hospital of Xinjiang Medical University","place":["Urumqi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanhua","family":"Wu","sequence":"additional","affiliation":[{"name":"The Affiliated Cancer Hospital of Xinjiang Medical University","place":["Urumqi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Affiliated Cancer Hospital of Xinjiang Medical University","place":["Urumqi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jncc.2025.02.002","article-title":"Global burden of female breast cancer: new estimates in 2022, temporal trend and future projections up to 2050 based on the latest release from GLOBOCAN","volume":"5","author":"Zhang","year":"2025","journal-title":"J Natl Cancer Cent"},{"key":"B3","doi-asserted-by":"publisher","first-page":"48","DOI":"10.25082\/ccr.2020.01.004","article-title":"Financial distress among breast cancer survivors","volume":"2","author":"Coughlin","year":"2020","journal-title":"Curr Cancer Rep"},{"key":"B4","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s12916-019-1474-7","article-title":"Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study","volume":"18","author":"Freisling","year":"2020","journal-title":"BMC Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdaf012","article-title":"Sex differences in the impact of multimorbidity on long-term mortality for patients with colorectal cancer: a population registry-based cohort study","volume":"47","author":"Ng","year":"2025","journal-title":"J Public Health (Oxf)"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1370\/afm.983","article-title":"Defining comorbidity: implications for understanding health and health services","volume":"7","author":"Valderas","year":"2009","journal-title":"Ann Fam Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.4103\/ijmpo.ijmpo_168_16","article-title":"Metabolic syndrome and breast cancer risk","volume":"38","author":"Wani","year":"2017","journal-title":"Indian J Med Paediatr Oncol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1038\/s43856-024-00529-4","article-title":"Identifying multi-resolution clusters of diseases in ten million patients with multimorbidity in primary care in England","volume":"4","author":"Beaney","year":"2024","journal-title":"Commun Med (Lond)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1038\/s41698-025-01235-7","article-title":"Comprehensive genomic insights into the genetic causality and comorbidity in urological cancers","volume":"10","author":"Zhang","year":"2025","journal-title":"NPJ Precis Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2023.05.025","article-title":"Part II: A step-by-step guide to latent class analysis","volume":"159","author":"Aflaki","year":"2023","journal-title":"J Clin Epidemiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2026.104710","article-title":"Association between body mass index and risk of breast cancer according to breast cancer subtypes: A systematic review and meta-analysis","volume":"86","author":"Dauccia","year":"2026","journal-title":"Breast"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s11357-023-01032-9","article-title":"Interplay of body mass index and metabolic syndrome: association with physiological age from midlife to late-life","volume":"46","author":"Ler","year":"2024","journal-title":"Geroscience"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.52371","article-title":"Association of cigarette smoking and alcohol consumption with subsequent mortality among Black breast cancer survivors in New Jersey","volume":"6","author":"Zeinomar","year":"2023","journal-title":"JAMA Netw Open"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02407","article-title":"Amount and intensity of leisure-time physical activity and lower cancer risk","volume":"38","author":"Matthews","year":"2020","journal-title":"J Clin Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13010055","article-title":"Physical activity as an imperative support in breast cancer management","volume":"13","author":"Ortega","year":"2021","journal-title":"Cancers"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.3390\/cancers14102569","article-title":"Breast cancer\u2014epidemiology, classification, pathogenesis and treatment (review of literature)","volume":"14","author":"Smolarz","year":"2022","journal-title":"Cancers (Basel)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.gendis.2018.05.001","article-title":"Breast cancer development and progression: risk factors, cancer stem cells, signaling pathways, genomics, and molecular pathogenesis","volume":"5","author":"Feng","year":"2018","journal-title":"Genes Dis"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.13520","article-title":"A retrospective study on breast cancer presentation, risk factors, and protective factors in patients with a positive family history of breast cancer","volume":"26","author":"Liaw","year":"2020","journal-title":"Breast J"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16524","article-title":"Duration of estrogen exposure during reproductive years, age at menarche and age at menopause, and risk of cardiovascular disease events, all-cause and cardiovascular mortality: a systematic review and meta-analysis","volume":"128","author":"Mishra","year":"2021","journal-title":"BJOG"},{"key":"B20","doi-asserted-by":"publisher","first-page":"132","DOI":"10.3390\/healthcare8020132","article-title":"Age-standardized breast cancer detection rates of breast cancer screening program by age group in Korea; comparison with age-standardized incidence rates from the Korea Central Cancer Registry","volume":"8","author":"Kim","year":"2020","journal-title":"Healthcare (Basel)"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.52944","article-title":"Five-year absolute risk-based and age-based breast cancer screening in the US","volume":"9","author":"Alagoz","year":"2026","journal-title":"JAMA Netw Open"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2022-219279","article-title":"Comorbidity patterns, family history and breast cancer risk: a latent class analysis","volume":"12","author":"Dalmartello","year":"2022","journal-title":"J Epidemiol Community Health"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s10555-022-10043-5","article-title":"The obesity\u2013breast cancer link: a multidisciplinary perspective","volume":"41","author":"Devericks","year":"2022","journal-title":"Cancer Metastasis Rev"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.3390\/cancers12061686","article-title":"Obesity and breast cancer: a case of inflamed adipose tissue","volume":"12","author":"Kolb","year":"2020","journal-title":"Cancers (Basel)"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1038\/s41388-024-02954-0","article-title":"Obesity-associated epigenetic alterations and the obesity\u2013breast cancer axis","volume":"43","author":"Lagarde","year":"2024","journal-title":"Oncogene"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.21635","article-title":"Risk factors and preventions of breast cancer","volume":"13","author":"Sun","year":"2017","journal-title":"Int J Biol Sci"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.840431","article-title":"Common multiple primary cancers associated with breast and gynecologic cancers and their risk factors, pathogenesis, treatment and prognosis: a review","volume":"12","author":"Ge","year":"2022","journal-title":"Front Oncol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s43440-021-00317-0","article-title":"Endogenous estrogens\u2014breast cancer and chemoprevention","volume":"73","author":"Starek-\u015awiechowicz","year":"2021","journal-title":"Pharmacol Rep"},{"key":"B29","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1038\/s41392-024-02108-4","article-title":"Breast cancer: pathogenesis and treatments","volume":"10","author":"Xiong","year":"2025","journal-title":"Signal Transduct Target Ther"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1908221\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:23:26Z","timestamp":1787545406000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1908221\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":29,"alternative-id":["10.3389\/fonc.2026.1908221"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1908221","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]},"article-number":"1908221"}}