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Cancer Epidemiol Biomarkers Prev. 2017 Jan;26(1):44-50. doi: 10.1158/1055-9965.EPI-16-0150. Epub 2016 Aug 26.

Postdiagnosis Weight Change and Survival Following a Diagnosis of Early-Stage Breast Cancer.

Author information

1
Division of Research, Kaiser Permanente Northern California, Oakland, California. elizabeth.m.cespedes@kp.org.
2
Division of Research, Kaiser Permanente Northern California, Oakland, California.
3
Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California.
4
Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
5
Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
6
Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada.

Abstract

BACKGROUND:

Achieving a healthy weight is recommended for all breast cancer survivors. Previous research on postdiagnosis weight change and mortality had conflicting results.

METHODS:

We examined whether change in body weight in the 18 months following diagnosis is associated with overall and breast cancer-specific mortality in a cohort of n = 12,590 stage I-III breast cancer patients at Kaiser Permanente using multivariable-adjusted Cox regression models. Follow-up was from the date of the postdiagnosis weight at 18 months until death or June 2015 [median follow-up (range): 3 (0-9) years]. We divided follow-up into earlier (18-54 months) and later (>54 months) postdiagnosis periods.

RESULTS:

Mean (SD) age-at-diagnosis was 59 (11) years. A total of 980 women died, 503 from breast cancer. Most women maintained weight within 5% of diagnosis body weight; weight loss and gain were equally common at 19% each. Compared with weight maintenance, large losses (≥10%) were associated with worse survival, with HRs and 95% confidence intervals (CI) for all-cause death of 2.63 (2.12-3.26) earlier and 1.60 (1.14-2.25) later in follow-up. Modest losses (>5%-<10%) were associated with worse survival earlier [1.39 (1.11-1.74)] but not later in follow-up [0.77 (0.54-1.11)]. Weight gain was not related to survival. Results were similar for breast cancer-specific death.

CONCLUSION:

Large postdiagnosis weight loss is associated with worse survival in both earlier and later postdiagnosis periods, independent of treatment and prognostic factors.

IMPACT:

Weight loss and gain are equally common after breast cancer, and weight loss is a consistent marker of mortality risk. Cancer Epidemiol Biomarkers Prev; 26(1); 44-50. ©2016 AACR SEE ALL THE ARTICLES IN THIS CEBP FOCUS SECTION, "THE OBESITY PARADOX IN CANCER EVIDENCE AND NEW DIRECTIONS".

PMID:
27566419
PMCID:
PMC5224999
DOI:
10.1158/1055-9965.EPI-16-0150
[Indexed for MEDLINE]
Free PMC Article

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