General and Abdominal Obesity and Survival among Young Women with Breast Cancer

Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Cancer Epidemiology Biomarkers & Prevention (Impact Factor: 4.13). 11/2006; 15(10):1871-7. DOI: 10.1158/1055-9965.EPI-06-0356
Source: PubMed


Among postmenopausal women, obesity is linked to increased risk of breast cancer and poorer subsequent survival. For premenopausal women, obesity may reduce incidence, but less is known about its effect on prognosis, particularly for abdominal obesity. This study investigated whether general or abdominal obesity at diagnosis influenced survival in a cohort of young women with breast cancer. A population-based follow-up study was conducted among 1,254 women ages 20 to 54 who were diagnosed with invasive breast cancer between 1990 and 1992 in Atlanta or New Jersey. Women were interviewed within several months of diagnosis and asked about their weight and height at age 20 and in the year before diagnosis. Study personnel did anthropometric measures at the interview. With 8 to 10 years of follow-up, all-cause mortality status was determined using the National Death Index (n = 290 deaths). Increased mortality was observed for women who were obese [body mass index (BMI), > or =30] at the time of interview compared with women of ideal weight [BMI, 18.5-24.9; stage- and income-adjusted hazard ratio (HR), 1.48; 95% confidence interval (95% CI), 1.09-2.01]. A similar result was seen for the highest versus lowest quartile of waist-to-hip ratio (HR, 1.52; 95% CI, 1.05-2.19). Strong associations with mortality were found for women who were obese at age 20 (HR, 2.49; 95% CI, 1.15-5.37) or who were overweight/obese (BMI, > or =25) at both age 20 and the time of interview (HR, 2.22; 95% CI, 1.45-3.40). This study provides evidence that breast cancer survival is reduced among younger women with general or abdominal obesity.

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    • "Similar results have also been found for gastric cancer and renal cell carcinoma [23,24]. However, high BMI is a poor prognostic factor in breast cancer [25-27]. Obese patients may have better nutritional resources to withstand the stress of cancer metastasis and cachexia [28]. "
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    • "It was also found that these heavier women tended to have larger tumor size, higher histological grade, and were more likely to have markers of high cellular proliferation than the thinner women [34]. Other studies reported similar associations between BMI at the time of diagnosis and poor outcomes among premenopausal women with breast cancer [26,35,36]. Most, but not all, studies have confirmed the association between BMI and breast cancer recurrence and survival in postmenopausal women [28,31,33,37]. "
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    • "); trends were observed in physical activity energy expenditure (À400 versus þ 111 kcal/week) and physical functioning (À0.5 versus þ3.1) mortality for cancers of the breast, esophagus, colon and rectum, cervix, uterus, liver, gallbladder, stomach, pancreas, prostate, kidney, non-Hodgkin's lymphoma , and multiple myeloma, and all cancers combined [25] [26] [27] [28] [29] [30] [31]. Finally, additional weight gain is common during or after treatment for various cancers, and has been found to reduce quality of life (QOL) and exacerbate risk for functional decline, comorbidity, and perhaps even cancer recurrence and cancer-related death [19] [20] [32] [33]. "
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