Determinants of Weight Gain During Adjuvant Endocrine Therapy and Association of Such Weight Gain With Recurrence in Long-term Breast Cancer Survivors

Raghavendra, Akshara Singareeka; Sinha, A. K.; Valle, J. Correia; Shen, Yu; Tripathy, Debu; Barcenas, Carlos H.

doi:10.1016/j.clbc.2017.11.006

Cited by 36 publications

(43 citation statements)

References 74 publications

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“…Our results support previous studies that have found slightly overweight women might maintain a better QOL or observe less QOL changes, than their normal, obese, or even non-cancer counterparts[11]. Our results also support previous studies that found only slight weight gains over time with no association with age[4]. There is also the possibility that participants adjusted to their health status changes over the seven years of participation and thus only small changes in their QOL were reported.…”

Section: Discussionsupporting

confidence: 92%

“…Weight gain is a potential negative outcome of breast cancer treatment, occurring in 50% to 96% of breast cancer patients[3]. More recently, Raghavendra et al[4] found that 33.7% of 1281 long-term survivors in their study gained more than 5% of their pre-treatment weight after 5 years of endocrine therapy. That said, the amount of weight gain and reasons for it remain inconsistently reported in the literature[5-9].…”

Section: Introductionmentioning

confidence: 99%

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Body mass index trends and quality of life from breast cancer diagnosis through seven years’ survivorship

Anbari

Deroche

Armer

2019

WJCO

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BACKGROUNDWeight gain is a potential negative outcome of breast-cancer treatment, occurring in 50%-to-96% of breast-cancer patients, although the amount of weight gain is inconsistently reported in the literature. Research has also shown a relationship between overweight/obesity and breast-cancer mortality. Correspondingly, weight management is a self-care approach known to benefit quality of life (QOL). These research questions and analysis add to existing literature by examining participants’ body mass index (BMI) trend and its relationship with QOL indicators over seven years.AIMTo examine: (1) BMI trends among breast cancer survivors; and (2) The trends’ relationship to QOL indicators over seven years.METHODSDuring the Breast Cancer and Lymphedema Project, 378 patients’ weight and height were recorded by nurses prior to or just after beginning breast cancer treatment and repeated at quarterly-to-semiannual intervals over seven years. Additionally, participants annually completed the 36-Item Short Form Health Survey (SF-36), a valid and reliable tool assessing QOL and health concepts, including physical function, pain, and emotional well-being. BMI trends, change in BMI, and change in SF-36 subscales over seven years were calculated using a random-intercept repeated-measures regression. Patients were placed into BMI categories at each time point: Normal, Overweight and Obese. As patients’ weights changed, they were categorized accordingly.RESULTSDuring the seven-year study and while controlling for age and residence, participants gained an average of 0.3534 kg/m2 (P = 0.0009). This amount remained fairly consistent across BMI categories with those in the normal-weight category (n = 134) gaining 0.4546 kg/m2 (P = 0.0003); Overweight (n = 190) gaining 0.2985 kg/m2 (P = 0.0123); and obese (n = 199) gaining 0.3147 kg/m2, (P = 0.0649). Age (under or over 55) and region (metro/micro vs small/rural) were significantly associated with BMI increase in both the normal and obese categories. There were statistically significant (P < 0.0100) changes in five of the eight SF-36 domains; however, the directions of change were different and somewhat divergent from that hypothesized. Controlling for age and region, these five were statistically significant, so there were no change or differences between the micropolitan/metropolitan and small town/rural groups.CONCLUSIONAlthough only modest increases in mean BMI were observed, mean BMI change was associated with selected QOL indicators, suggesting the continued need for self-care emphasis during breast cancer survivorship.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Body mass index trends and quality of life from breast cancer diagnosis through seven years’ survivorship

Anbari

Deroche

Armer

2019

WJCO

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“…Our results highlighted that younger survivors and women with a higher BW before diagnosis were more likely to have gained weight five years later. This echoes findings in other surveys [46,47]. We also found a significant association between weight gain and lymphedema.…”

Section: Body Weight Evolutionsupporting

confidence: 90%

Evolution of physical activity and body weight changes in breast cancer survivors five years after diagnosis – VICAN 2 & 5 French national surveys

et al. 2021

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Background: Regular physical activity (PA) and healthy body weight have proven benefits on survival in breast cancer (BC) survivors. We aimed to define predictors of long-term PA and weight gain in a representative sample of BC survivors. Methods: Data were analysed from 723 women with BC who participated in both the 2012 and 2015 French National VICAN surveys. Results: Five years after diagnosis, 26.0, 60.6, and 13.4 % of BC survivors reported regular, occasional and no PA, respectively. Moreover, 27.4 % had a weight gain 5 kg. In multinomial logistic regressions, regular and occasional PA were both associated with not having depressive disorders, with higher post-traumatic growth, and with a healthy and stable Body Mass Index. Occasional PA was associated with the use of non-conventional medicine, and regular PA with better mental quality of life and normal arm mobility. Weight gain 5 kg was associated with younger age, heavier body weight at diagnosis, and lymphedema 5 years after diagnosis. Conclusions: Mental well-being is associated with successful long-term patient investment in PA. Psychological support and early management of disease sequelae are needed to help ensure BC survivors engage in and maintain healthy lifestyles.

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“…Schvartsman et al found age differences related to weight changes during adjuvant chemotherapy, where women over 50 years old were more likely to lose weight during adjuvant chemotherapy, whereas women under 30 years old gained weight (8). In one study, Asian women had the lowest risk of weight gain post breast cancer diagnosis (5).…”

Section: Introductionmentioning

confidence: 99%

Weight changes according to treatment in a diverse cohort of breast cancer patients.

Fukui

White

Frankland

et al. 2021

JCO

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e12513 Background: Weight changes are common among breast cancer patients. The majority of studies to date have focused on weight gain after a breast cancer diagnosis and its implications on health in survivors. Fewer studies have examined weight loss and its related characteristics. Weight changes have been reported to be influenced by several factors such as age, treatment, stage and pre-diagnostic weight. We evaluated weight changes during key treatment time points in early stage breast cancer patients. Methods: We characterized 389 female patients diagnosed in Hawaii with early stage breast cancer from 2003-2017 in the Multiethnic Cohort (MEC) linked with Kaiser Permanente Hawaii electronic medical record data. We evaluated weight changes from surgery to 4 years post-diagnosis with six time points along a patient’s treatment trajectory (chemotherapy, radiation, endocrine, or surgery alone) and annually thereafter, adjusting for age, race/ethnicity and initial body mass index (BMI). Results: We found key time points of significant weight change for breast cancer patients according to their adjuvant treatment. In patients who had surgery alone (S), surgery-radiation (SR), or surgery-endocrine therapy (SE), the percentage of patients with stable weight, while generally comprising the majority, consistently decreased over time. However, the percentages of patients with weight loss and weight gain during this time steadily increased up to 4 years after initial surgery. Weight loss was more common than weight gain by about 2 fold in these treatment groups (weight loss 33.2%-42% vs weight gain 11.6%-21.4%). For patients with surgery-chemotherapy (SC), there was significant increase in patients with weight loss seen within the first 3 months after surgery (16.2% to 43.7%), during the time when patients receive chemotherapy. And this weight loss trend persisted until year 4. Weight gain was less commonly seen in this treatment group. Conclusions: We identified key time points during breast cancer treatment that may provide a therapeutic window to positively influence outcomes. Tailored weight management interventions should be utilized to promote overall health and long term survivorship.

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Determinants of Weight Gain During Adjuvant Endocrine Therapy and Association of Such Weight Gain With Recurrence in Long-term Breast Cancer Survivors

Abstract: Premenopausal BC patients had an increased risk of weight gain after 5 years of ET; however, BC patients with a weight gain of > 5% did not have an increased risk of disease recurrence.

Cited by 36 publications

References 74 publications

Body mass index trends and quality of life from breast cancer diagnosis through seven years’ survivorship

Body mass index trends and quality of life from breast cancer diagnosis through seven years’ survivorship

Evolution of physical activity and body weight changes in breast cancer survivors five years after diagnosis – VICAN 2 & 5 French national surveys

Weight changes according to treatment in a diverse cohort of breast cancer patients.

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