Open Access Open Badges Research article

Interactive effect of genetic susceptibility with height, body mass index, and hormone replacement therapy on the risk of breast cancer

Sophia Harlid12, Salma Butt3, Malin IL Ivarsson124, Jorunn Erla Eyfjörd5, Per Lenner6, Jonas Manjer3, Joakim Dillner18 and Joyce Carlson27*

Author Affiliations

1 Department of Medical Microbiology, Lund University, Malmö, Sweden

2 Department of Clinical Chemistry, Lund University, Malmö, Sweden

3 Department of Surgery, Lund University, Malmö, Sweden

4 Region Skånes Biobank, Wallenberg Laboratory, Malmö, Sweden

5 Cancer Research Laboratory, Faculty of Medicine, University of Iceland, Reykjavik, Iceland

6 Department of Oncology, Norrlands University Hospital, Umeå, Sweden

7 Labmedicin Skåne, Clinical Chemistry in Lund, Lund, Sweden

8 Departments of Laboratory Medicine, Medical Epidemiology & Biostatistics, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden

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BMC Women's Health 2012, 12:17  doi:10.1186/1472-6874-12-17

Published: 22 June 2012



Breast cancer today has many established risk factors, both genetic and environmental, but these risk factors by themselves explain only part of the total cancer incidence. We have investigated potential interactions between certain known genetic and phenotypic risk factors, specifically nine single nucleotide polymorphisms (SNPs) and height, body mass index (BMI) and hormone replacement therapy (HRT).


We analyzed samples from three different study populations: two prospectively followed Swedish cohorts and one Icelandic case–control study. Totally 2884 invasive breast cancer cases and 4508 controls were analysed in the study. Genotypes were determined using Mass spectrometry-Maldi-TOF and phenotypic variables were derived from measurements and/or questionnaires. Odds Ratios and 95% confidence intervals were calculated using unconditional logistic regression with the inclusion of an interaction term in the logistic regression model.


One SNP (rs851987 in ESR1) tended to interact with height, with an increasingly protective effect of the major allele in taller women (p = 0.007) and rs13281615 (on 8q24) tended to confer risk only in non users of HRT (p-for interaction = 0.03). There were no significant interactions after correction for multiple testing.


We conclude that much larger sample sets would be necessary to demonstrate interactions between low-risk genetic polymorphisms and the phenotypic variables height, BMI and HRT on the risk for breast cancer. However the present hypothesis-generating study has identified tendencies that would be of interest to evaluate for gene-environment interactions in independent materials.