Obesity Does Not Influence Management of Advanced Breast Cancer in the Elderly

Tangalakis, Laurel L.; Cortina, Chandler S.; Son, Jennifer D.; Poirier, Jennifer; Madrigrano, Andrea

doi:10.1016/j.clbc.2018.12.020

Cited by 1 publication

(1 citation statement)

References 16 publications

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“…Several studies have reported similar findings of radiation therapy among breast cancer patients in general. [10][11][12] For example, Haakinson et al found in their study of 1352 patients with invasive breast cancer that obesity did not affect the rate of radiation therapy on bivariate analysis (P = .695). 10 Similarly, Tangalakis et al found that among 118 breast cancer patients with pathologically proven axillary disease, mean BMI was no different between patients undergoing and not undergoing radiation therapy (P = .40).…”

Section: Discussionmentioning

confidence: 99%

Is There a Bias Against Obese Patients in the Treatment of Breast Cancer?

Wang

Huang

Chagpar

2020

The American Surgeon™

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Background Patient and tumor characteristics often coincide with obesity, potentially affecting treatment decision-making in obese breast cancer patients. Independent of all of these factors, however, it is unclear whether obesity itself impacts the decision to offer patients undergoing mastectomy breast reconstruction, postmastectomy radiation therapy (PMRT), or neoadjuvant chemotherapy. We sought to determine whether implicit bias against obese breast cancer patients undergoing mastectomy plays a role in their treatment. Methods Medical records of breast cancer patients undergoing mastectomy from January 2010 to April 2018 from a single institution were retrospectively reviewed, separated into obese (BMI ≥30) and nonobese (BMI <30) categories, and compared using nonparametric statistical analyses. Results Of 972 patients, 291 (31.2%) were obese. Obese patients were more likely to have node-positive, triple-negative breast cancers ( P = .026) and were also more likely to have other comorbidities such as a history of smoking ( P = .026), hypertension ( P < .001), and diabetes ( P < .001). Receipt of immediate reconstruction and contralateral prophylactic mastectomy did not vary between obese and nonobese patients. While obese patients were more likely to undergo neoadjuvant chemotherapy (26.5% vs. 18.1%, P = .004) and PMRT (33.0% vs. 23.4%, P = .003), this did not remain significant when controlling for comorbidities and clinicopathologic confounders. Conclusion Obese patients present with more aggressive tumors and often have concomitant comorbidities. Independent of these factors, however, differences in the treatment of patients undergoing mastectomy do not seem to be affected by an implicit bias against obese patients.

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