Format

Send to:

Choose Destination
See comment in PubMed Commons below
Ann Oncol. 2014 Oct;25(10):1901-14. doi: 10.1093/annonc/mdu042. Epub 2014 Apr 27.

Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies.

Author information

  • 1Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK d.chan@imperial.ac.uk.
  • 2Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
  • 3Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
  • 4Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Jersey, USA.
  • 5Division of Biostatistics, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.
  • 6Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Washington, USA.
  • 7Department of Oncology, Oslo University Hospital, Oslo Faculty of Health Sciences, Department of Community Medicine, University of Tromso, Tromso, Norway.
  • 8School of Mathematics and Statistics, University of Newcastle, Newcastle upon Tyne, UK.

Abstract

BACKGROUND:

Positive association between obesity and survival after breast cancer was demonstrated in previous meta-analyses of published data, but only the results for the comparison of obese versus non-obese was summarised.

METHODS:

We systematically searched in MEDLINE and EMBASE for follow-up studies of breast cancer survivors with body mass index (BMI) before and after diagnosis, and total and cause-specific mortality until June 2013, as part of the World Cancer Research Fund Continuous Update Project. Random-effects meta-analyses were conducted to explore the magnitude and the shape of the associations.

RESULTS:

Eighty-two studies, including 213 075 breast cancer survivors with 41 477 deaths (23 182 from breast cancer) were identified. For BMI before diagnosis, compared with normal weight women, the summary relative risks (RRs) of total mortality were 1.41 [95% confidence interval (CI) 1.29-1.53] for obese (BMI >30.0), 1.07 (95 CI 1.02-1.12) for overweight (BMI 25.0-<30.0) and 1.10 (95% CI 0.92-1.31) for underweight (BMI <18.5) women. For obese women, the summary RRs were 1.75 (95% CI 1.26-2.41) for pre-menopausal and 1.34 (95% CI 1.18-1.53) for post-menopausal breast cancer. For each 5 kg/m(2) increment of BMI before, <12 months after, and ≥12 months after diagnosis, increased risks of 17%, 11%, and 8% for total mortality, and 18%, 14%, and 29% for breast cancer mortality were observed, respectively.

CONCLUSIONS:

Obesity is associated with poorer overall and breast cancer survival in pre- and post-menopausal breast cancer, regardless of when BMI is ascertained. Being overweight is also related to a higher risk of mortality. Randomised clinical trials are needed to test interventions for weight loss and maintenance on survival in women with breast cancer.

© The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

KEYWORDS:

body mass index; meta-analysis; survival after breast cancer; systematic literature review

PMID:
24769692
[PubMed - indexed for MEDLINE]
PMCID:
PMC4176449
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk