{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T09:06:33Z","timestamp":1771405593632,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute at the National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA253302"],"award-info":[{"award-number":["R01CA253302"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute at the National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA253302-02S1"],"award-info":[{"award-number":["R01CA253302-02S1"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute at the National Institutes of Health","doi-asserted-by":"publisher","award":["R25CA217725"],"award-info":[{"award-number":["R25CA217725"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute at the National Institutes of Health","doi-asserted-by":"publisher","award":["P30CA023074"],"award-info":[{"award-number":["P30CA023074"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Elevated abdominal adipose tissue at time of diagnosis is associated with breast cancer mortality. We sought to understand the association between abdominal adipose tissue (subcutaneous, SAT and visceral, VAT) assessed via dual-energy X-ray absorptiometry (DXA) and breast cancer mortality in the prevention setting. Methods: Women enrolled in the Women\u2019s Health Initiative study with baseline whole-body DXA scans were included in the study (n = 9767). Causes of death were adjudicated up to 27 years of follow-up. Competing risk models were used to examine independent associations between baseline VAT, SAT, per 100 cm2, and breast cancer-specific deaths; findings were reported as sub-hazard ratios (SHR) and confidence intervals (CI). Time-varying analyses additionally included DXA at years 3 and 6. Covariates included demographic, lifestyle, and tumor factors. Results: Baseline VAT and SAT ranged from undetectable to 616.25 cm2 and 55.26\u2013952.46 cm2, respectively. There were 738 incident breast cancer cases post-enrollment, and 87 breast cancer-related deaths. Median age at diagnosis was 62 years. In adjusted models, higher baseline VAT and SAT were significantly associated with higher risk breast cancer mortality (49% and 40%, respectively); time-varying models were similar. Conclusions: Higher VAT and SAT were similarly associated with breast cancer mortality in this group of postmenopausal women.<\/jats:p>","DOI":"10.3390\/curroncol33020119","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T07:50:30Z","timestamp":1771401030000},"page":"119","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["DXA-Derived Visceral and Subcutaneous Adipose Tissue and Postmenopausal Breast Cancer Mortality"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9868-1574","authenticated-orcid":false,"given":"Jennifer W.","family":"Bea","sequence":"first","affiliation":[{"name":"Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5958-2015","authenticated-orcid":false,"given":"Shelby G.","family":"Ziller","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan","family":"Decker","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Montana, Missoula, MT 59812, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6989-6579","authenticated-orcid":false,"given":"Denise J.","family":"Roe","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew O.","family":"Odegaard","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, Irvine, CA 92617, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather M.","family":"Ochs-Balcom","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY 14214, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3758-4666","authenticated-orcid":false,"given":"Sarah M.","family":"Lima","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bette","family":"Caan","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Division of Research, Oakland, CA 94588, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3096-9595","authenticated-orcid":false,"given":"Jean","family":"Wactawski-Wende","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY 14214, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret S.","family":"Pichardo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, PA 19104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2572-6727","authenticated-orcid":false,"given":"Holly","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Public Health Sciences Division, Fred Hutch Cancer Center, Seattle, WA 98109, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"ref_1","unstructured":"American Cancer Society (2025, October 08). Key Statistics for Breast Cancer. Available online: https:\/\/www.cancer.org\/cancer\/types\/breast-cancer\/about\/how-common-is-breast-cancer.html."},{"key":"ref_2","unstructured":"American Cancer Society (2018). Cancer Facts & Figures 2018, American Cancer Society."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"j477","DOI":"10.1136\/bmj.j477","article-title":"Adiposity and cancer at major anatomical sites: Umbrella review of the literature","volume":"356","author":"Kyrgiou","year":"2017","journal-title":"BMJ"},{"key":"ref_4","unstructured":"SEER (2025, October 08). Cancer Stat Facts, Available online: https:\/\/seer.cancer.gov\/statfacts\/."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/GME.0000000000000989","article-title":"Is BMI a valid measure of obesity in postmenopausal women?","volume":"25","author":"Banack","year":"2018","journal-title":"Menopause"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/MOL.0b013e3283346ccc","article-title":"The distinction of metabolically \u2018healthy\u2019 from \u2018unhealthy\u2019 obese individuals","volume":"21","year":"2010","journal-title":"Curr. Opin. Lipidol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1093\/aje\/kwv103","article-title":"Risk of Mortality According to Body Mass Index and Body Composition Among Postmenopausal Women","volume":"182","author":"Bea","year":"2015","journal-title":"Am. J. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1001\/jamaoncol.2018.5327","article-title":"Association of Body Fat and Risk of Breast Cancer in Postmenopausal Women with Normal Body Mass Index: A Secondary Analysis of a Randomized Clinical Trial and Observational Study","volume":"5","author":"Iyengar","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"754815","DOI":"10.1155\/2013\/754815","article-title":"Body fat and breast cancer risk in postmenopausal women: A longitudinal study","volume":"2013","author":"Rohan","year":"2013","journal-title":"J. Cancer Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"pkaf007","DOI":"10.1093\/jncics\/pkaf007","article-title":"Abdominal visceral and subcutaneous adipose tissue associations with postmenopausal breast cancer incidence","volume":"9","author":"Bea","year":"2025","journal-title":"JNCI Cancer Spectr"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1002\/oby.20519","article-title":"Clinical utility and reproducibility of visceral adipose tissue measurements derived from dual-energy X-ray absorptiometry in White and African American adults","volume":"21","author":"Katzmarzyk","year":"2013","journal-title":"Obesity"},{"key":"ref_12","first-page":"50","article-title":"Practical and Technical Advantages of DXA Visceral Fat Assessment Compared with Computed Tomography","volume":"36","author":"Kelly","year":"2010","journal-title":"Age"},{"key":"ref_13","unstructured":"Kelly, T.L., Wilson, K.E., and Ruth, C.R. (2010). Estimating Visceral Fat by Dual-Energy X-Ray Absorptiometry. (2010\/0234719A1), U.S. Patent."},{"key":"ref_14","unstructured":"Kelly, T.L., Wilson, K.E., and Ruth, C.R. (2011). Visceral fat measurement. (U.S. Patent 2011\u20130235881)."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1038\/oby.2011.367","article-title":"Dual-energy X-ray performs as well as clinical computed tomography for the measurement of visceral fat","volume":"20","author":"Micklesfield","year":"2012","journal-title":"Obesity"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1038\/s41416-023-02470-0","article-title":"Body composition and cancer survival: A narrative review","volume":"130","author":"Bradshaw","year":"2024","journal-title":"Br. J. Cancer"},{"key":"ref_17","first-page":"230","article-title":"American Cancer Society nutrition and physical activity guideline for cancer survivors","volume":"72","author":"Rock","year":"2022","journal-title":"CA Cancer J. Clin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1001\/jamaoncol.2018.0137","article-title":"Association of Muscle and Adiposity Measured by Computed Tomography with Survival in Patients with Nonmetastatic Breast Cancer","volume":"4","author":"Caan","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/s13244-024-01677-w","article-title":"Reliability, costs, and radiation dose of dual-energy X-ray absorptiometry in diagnosis of radiologic sarcopenia in surgically menopausal women","volume":"15","author":"Stuursma","year":"2024","journal-title":"Insights Imaging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1152\/physrev.00033.2011","article-title":"Pathophysiology of Human Visceral Obesity: An Update","volume":"93","author":"Despres","year":"2013","journal-title":"Physiol. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1161\/CIRCULATIONAHA.106.675355","article-title":"Abdominal visceral and subcutaneous adipose tissue compartments: Association with metabolic risk factors in the Framingham Heart Study","volume":"116","author":"Fox","year":"2007","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1038\/ejcn.2014.227","article-title":"DXA-measured visceral adipose tissue predicts impaired glucose tolerance and metabolic syndrome in obese Caucasian and African-American women","volume":"69","author":"Bi","year":"2015","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.cell.2011.02.013","article-title":"Hallmarks of cancer: The next generation","volume":"144","author":"Hanahan","year":"2011","journal-title":"Cell"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1158\/1055-9965.EPI-25-0581","article-title":"Dual-energy X-ray absorptiometry derived adiposity and colorectal cancer incidence and mortality in postmenopausal women","volume":"34","author":"Ziller","year":"2025","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"The Women\u2019s Health Initiative Study Group (1998). Design of the Women\u2019s Health Initiative clinical trial and observational study. Control. Clin. Trials, 19, 61\u2013109.","DOI":"10.1016\/S0197-2456(97)00078-0"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2775","DOI":"10.1093\/jn\/137.12.2775","article-title":"Dual-energy X-ray absorptiometry is a valid tool for assessing skeletal muscle mass in older women","volume":"137","author":"Chen","year":"2007","journal-title":"J. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S122","DOI":"10.1016\/S1047-2797(03)00048-6","article-title":"Outcomes ascertainment and adjudication methods in the Women\u2019s Health Initiative","volume":"13","author":"Curb","year":"2003","journal-title":"Ann. Epidemiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1158\/1055-9965.EPI-11-0027","article-title":"Racial differences in colorectal cancer incidence and mortality in the Women\u2019s Health Initiative","volume":"20","author":"Simon","year":"2011","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ygyno.2014.01.033","article-title":"Body mass index, physical activity, and mortality in women diagnosed with ovarian cancer: Results from the Women\u2019s Health Initiative","volume":"133","author":"Zhou","year":"2014","journal-title":"Gynecol. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/S1047-2797(98)00055-6","article-title":"Measurement characteristics of the Women\u2019s Health Initiative food frequency questionnaire","volume":"9","author":"Patterson","year":"1999","journal-title":"Ann. Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1249\/MSS.0b013e31828af8bd","article-title":"Changes in physical activity and body composition in postmenopausal women over time","volume":"45","author":"Sims","year":"2013","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1249\/MSS.0b013e31821ece12","article-title":"2011 Compendium of Physical Activities: A second update of codes and MET values","volume":"43","author":"Ainsworth","year":"2011","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3945\/jn.111.145375","article-title":"Dietary patterns are associated with disease risk among participants in the Women\u2019s Health Initiative Observational Study","volume":"142","author":"Horn","year":"2012","journal-title":"J. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1038\/s41416-020-01210-y","article-title":"The association of body fat composition with risk of breast, endometrial, ovarian and colorectal cancers among normal weight participants in the UK Biobank","volume":"124","author":"Arthur","year":"2021","journal-title":"Br. J. Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1002\/cam4.2690","article-title":"The association between DXA-derived body fat measures and breast cancer risk among postmenopausal women in the Women\u2019s Health Initiative","volume":"9","author":"Arthur","year":"2020","journal-title":"Cancer Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1002\/ijc.70073","article-title":"Overall and central adiposity and risk of contralateral breast cancer: The California Breast Cancer Survivorship Consortium","volume":"158","author":"John","year":"2025","journal-title":"Int. J. Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1001\/jama.2023.25881","article-title":"Analysis of Breast Cancer Mortality in the US\u20141975 to 2019","volume":"331","author":"Sun","year":"2024","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1002\/oby.22458","article-title":"Adipose Tissue Distribution and Survival Among Women with Nonmetastatic Breast Cancer","volume":"27","author":"Bradshaw","year":"2019","journal-title":"Obesity"},{"key":"ref_39","first-page":"524","article-title":"Breast Cancer Statistics, 2022","volume":"72","author":"Giaquinto","year":"2022","journal-title":"CA Cancer J. Clin."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1002\/ijc.23943","article-title":"Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status\u2014A meta-analysis","volume":"124","author":"Suzuki","year":"2009","journal-title":"Int. J. Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13058-025-02155-x","article-title":"Macrophages in obesity-related breast cancer: Mechanistic insights and therapeutic opportunities","volume":"27","author":"Dong","year":"2025","journal-title":"Breast Cancer Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.cmet.2013.11.017","article-title":"Local proliferation of macrophages contributes to obesity-associated adipose tissue inflammation","volume":"19","author":"Amano","year":"2014","journal-title":"Cell Metab."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1038\/oby.2009.336","article-title":"Breast volume is an independent predictor of visceral and ectopic fat in premenopausal women","volume":"18","author":"Janiszewski","year":"2010","journal-title":"Obesity"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1038\/ejcn.2011.35","article-title":"Associations between breast adipose tissue, body fat distribution and cardiometabolic risk in women: Cross-sectional data and weight-loss intervention","volume":"65","author":"Schautz","year":"2011","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_45","first-page":"468","article-title":"Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer","volume":"69","author":"Schmitz","year":"2019","journal-title":"CA Cancer J. Clin."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1249\/MSS.0000000000002116","article-title":"Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable","volume":"51","author":"Campbell","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1249\/MSS.0000000000002117","article-title":"American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control","volume":"51","author":"Patel","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1200\/JCO.22.00687","article-title":"Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline","volume":"40","author":"Ligibel","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"725","DOI":"10.31557\/APJCP.2021.22.3.725","article-title":"The Effect of Exercise on Life Quality and Depression Levels of Breast Cancer Patients","volume":"22","author":"Aydin","year":"2021","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1007\/s12282-022-01347-z","article-title":"Impact of exercise interventions on physical fitness in breast cancer patients and survivors: A systematic review","volume":"29","author":"Ficarra","year":"2022","journal-title":"Breast Cancer"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1002\/oby.23287","article-title":"The Breast Cancer Weight Loss trial (Alliance A011401): A description and evidence for the lifestyle intervention","volume":"30","author":"Delahanty","year":"2022","journal-title":"Obesity"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"108074","DOI":"10.1016\/j.cct.2025.108074","article-title":"TeleHealth Resistance Exercise Intervention to Preserve Dose Intensity and Vitality in Elder Breast Cancer Patients (THRIVE-65)","volume":"158","author":"Schmitz","year":"2025","journal-title":"Contemp. Clin. Trials"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1016\/S0140-6736(08)61690-6","article-title":"Closing the gap in a generation: Health equity through action on the social determinants of health","volume":"372","author":"Marmot","year":"2008","journal-title":"Lancet"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/2\/119\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T08:16:43Z","timestamp":1771402603000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/2\/119"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,17]]},"references-count":53,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["curroncol33020119"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33020119","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,17]]}}}