Weight Change in Breast Cancer Survivors Compared to Cancer-Free Women: A Prospective Study in Women at Familial Risk of Breast Cancer

Gross, Amy L.; May, Betty J.; Axilbund, Jennifer E.; Armstrong, Deborah K.; Roden, Richard B.S.; Visvanathan, Kala

doi:10.1158/1055-9965.epi-15-0212

Cited by 39 publications

(25 citation statements)

References 44 publications

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“…Furthermore, only 35% of those whose consumption of fruit and vegetables was below recommendations reported eating more healthy foods after diagnosis, while less than a third of overweight or obese women reported increased efforts to maintain a healthy body weight. Previous reports have also suggested that many breast cancer survivors gain weight following treatment [17], and that survivors may experience greater weight gain than cancer-free women of the same age [24]. These findings, along with ours, demonstrate that although many women are motivated to make healthy changes following a breast cancer diagnosis, there is still room for improvement through dietary interventions and increased health promotion efforts.…”

Section: Discussionsupporting

confidence: 79%

Age- and treatment-related associations with health behavior change among breast cancer survivors

et al. 2017

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Objective The aim of this study was to identify demographic and treatment-related factors associated with health-promoting behavior changes after a breast cancer diagnosis. Changes in health behaviors were also evaluated according to weight, exercise, diet and alcohol consumption patterns before breast cancer diagnosis. Materials and methods We examined self-reported behavior changes among 1,415 women diagnosed with breast cancer in the NIEHS Sister Study cohort. Women reported changes in exercising, eating healthy foods, maintaining a healthy body weight, drinking alcohol, smoking, getting enough sleep, spending time with family and friends, and participating in breast cancer awareness events. Results: On average, women were 3.7 years from their breast cancer diagnosis. Overall, 20–36% reported positive changes in exercise, eating healthy foods, maintaining a healthy weight, or alcohol consumption. However, 17% exercised less. With each 5-year increase in diagnosis age, women were 11–16% less likely to report positive change in each of these behaviors (OR=0.84–0.89; p<0.05), except alcohol consumption (OR=0.97; CI: 0.81, 1.17). Women who underwent chemotherapy were more likely to report eating more healthy foods (OR =1.47; 95% CI 1.16–1.86), drinking less alcohol (OR=2.01; 95% CI: 1.01, 4.06), and sleeping enough (OR=1.41; 95% CI: 1.04, 1.91). The majority of women (50–84%) reported no change in exercise, eating healthy foods, efforts to maintain a healthy weight, alcohol consumption, sleep patterns, or time spent with family or friends. Conclusions Many women reported no change in cancer survivorship guideline-supported behaviors after diagnosis. Positive changes were more common among younger women or those who underwent chemotherapy.

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Section: Discussionsupporting

confidence: 79%

Age- and treatment-related associations with health behavior change among breast cancer survivors

et al. 2017

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“…Although we examined changes in weight from before to after diagnosis in women with an incident breast cancer diagnosis, prior studies have recruited women with a prevalent breast cancer diagnosis, and focused their analyses on weight changes occurring in the postdiagnosis period. In the Breast and Ovarian Surveillance Service (BOSS) Cohort Study, prospective cohort of individuals with a familial risk of breast and/or ovarian cancer, significantly greater gains in self‐reported weight were observed in survivors of breast cancer (303 women) than age‐matched women without breast cancer (307 women) from the same cohort . However, to our knowledge, other studies, using either self‐reported or standardized measured weight, have reported no significant differences in postdiagnosis weight gain between survivors of breast cancer and age‐matched women without breast cancer.…”

Section: Discussionmentioning

confidence: 83%

Changes in cardiovascular disease risk and risk factors among women with and without breast cancer

Anderson

Nichols

Deal

et al. 2018

Cancer

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Background: Cardiovascular disease (CVD) risk is an important health concern among breast cancer survivors. However, few studies have examined whether trajectories of CVD risk and major risk factors are worse among women with a breast cancer diagnosis than those without. Methods: We compared changes in weight, body mass index (BMI), waist circumference, systolic blood pressure, and 10-year CVD risk between women with (N=813) and without (N=1049) an incident breast cancer diagnosis while enrolled in the Sister Study cohort. Blood pressure and adiposity measures were collected by trained examiners at an enrollment visit (≥1 year before breast cancer diagnosis) and a second home visit 4–11 years later (≥1 year after breast cancer diagnosis). The non-laboratory-based Framingham risk score, a measure of 10-year general CVD risk, was calculated at both the enrollment and second visits. All analyses were stratified by menopausal status at enrollment. Results: Women who were premenopausal at enrollment experienced moderate increases in weight, waist circumference, systolic blood pressure, and CVD risk over the study period. Those who were postmenopausal at enrollment had little change in weight, but increases in waist circumference, systolic blood pressure, and CVD risk. In both groups, changes over time did not differ significantly according to breast cancer status. Neither chemotherapy nor endocrine therapy were associated with greater increases in CVD risk or risk factors. Conclusions: In our cohort, changes over time in CVD risk, adiposity measures, and blood pressure were similar between women who developed an incident breast cancer and those who did not.

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“…Given the follow‐up period spanned more than a decade, it is reasonable to think the weight of some women may have changed from diagnosis. Moreover, weight gain during BC treatment is common . Some studies suggested weight gain after BC diagnosis was associated with worst prognosis, although another concluded that weight gain up to 4 years post‐diagnosis was not associated with a higher risk of death .…”

Section: Discussionmentioning

confidence: 99%

Progesterone receptor status modifies the association between body mass index and prognosis in women diagnosed with estrogen receptor positive breast cancer

Oudanonh

Nabi

Ennour‐Idrissi

et al. 2019

Intl Journal of Cancer

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The role of progesterone receptor (PR) status on the association between obesity and prognosis of estrogen receptor positive (ER+) breast cancer (BC) remains poorly understood. We aim to examine whether this association varies according to the tumor PR status. Data for 3,747 women diagnosed with nonmetastatic ER+ invasive BC between 1995 and 2010 were analyzed. Women were classified according to their body mass index (BMI) (<18.5, 18.5–24.9, 25.0–29.9 or ≥30.0 kg/m2). Tumor PR status (PR−, PR+) was evaluated by immunohistochemistry. Hazard ratios (HR) for survival outcomes were estimated using multivariable Cox regression models. Effect modification was assessed on both additive and multiplicative scales using relative excess risk due to interaction and ratio of HRs, respectively. After a median follow‐up of 5.9 years (range: 3.4–9.2), women with PR− tumors and underweight (HR = 2.76, 95% CI: 1.40–4.91), overweight (HR = 2.02, 95% CI: 1.43–2.81) or obese (HR = 2.51, 95% CI: 1.67–3.65) had increased risk of all‐cause mortality, when compared to normal weight women with PR+ tumors. A similar pattern of associations was observed for BC‐specific mortality. In contrast, women with PR+ tumors had similar risks for both mortality outcomes, regardless of BMI. On the additive scale, all‐cause mortality was modified by PR status for overweight and obese women, whereas for BC‐specific mortality, it was only modified for underweight women. The same observations were found on the multiplicative scale. These results suggest that poorer survival associated with low and high BMI among women diagnosed with ER+ BC may depend on the tumor PR status.

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Weight Change in Breast Cancer Survivors Compared to Cancer-Free Women: A Prospective Study in Women at Familial Risk of Breast Cancer

Cited by 39 publications

References 44 publications

Age- and treatment-related associations with health behavior change among breast cancer survivors

Age- and treatment-related associations with health behavior change among breast cancer survivors

Changes in cardiovascular disease risk and risk factors among women with and without breast cancer

Progesterone receptor status modifies the association between body mass index and prognosis in women diagnosed with estrogen receptor positive breast cancer

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