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01-12-2018 | Epidemiology

Obesity and mortality after locoregional breast cancer diagnosis

Authors: A. Holliston Moore, Amy Trentham-Dietz, Marguerite Burns, Ronald E. Gangnon, Caprice C. Greenberg, David J. Vanness, John Hampton, Xiao-Cheng Wu, Roger T. Anderson, Joseph Lipscomb, Gretchen G. Kimmick, Rosemary Cress, J. Frank Wilson, Susan A. Sabatino, Steven T. Fleming

Published in: Breast Cancer Research and Treatment | Issue 3/2018

Abstract

Purpose

Higher mortality after a breast cancer diagnosis has been observed among women who are obese. We investigated the relationships between body mass index (BMI) and all-cause or breast cancer-specific mortality after a diagnosis of locoregional breast cancer.

Methods

Women diagnosed in 2004 with AJCC Stage I, II, or III breast cancer (n = 5394) were identified from a population-based National Program of Cancer Registries (NPCR) patterns of care study (POC-BP) drawing from registries in seven U.S. states. Differences in overall and breast cancer-specific mortality were investigated using Cox proportional hazards regression models adjusting for demographic and clinical covariates, including age- and stage-based subgroup analyses.

Results

In women 70 or older, higher BMI was associated with lower overall mortality (HR for a 5 kg/m² difference in BMI = 0.85, 95% CI 0.75–0.95). There was no significant association between BMI and overall mortality for women under 70. BMI was not associated with breast cancer death in the full sample, but among women with Stage I disease; those in the highest BMI category had significantly higher breast cancer mortality (HR for BMI ≥ 35 kg/m² vs. 18.5–24.9 kg/m² = 4.74, 95% CI 1.78–12.59).

Conclusions

Contrary to our hypothesis, greater BMI was not associated with higher overall mortality. Among older women, BMI was inversely related to overall mortality, with a null association among younger women. Higher BMI was associated with breast cancer mortality among women with Stage I disease, but not among women with more advanced disease.

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Title: Obesity and mortality after locoregional breast cancer diagnosis
Authors: A. Holliston Moore
Amy Trentham-Dietz
Marguerite Burns
Ronald E. Gangnon
Caprice C. Greenberg
David J. Vanness
John Hampton
Xiao-Cheng Wu
Roger T. Anderson
Joseph Lipscomb
Gretchen G. Kimmick
Rosemary Cress
J. Frank Wilson
Susan A. Sabatino
Steven T. Fleming
Publication date: 01-12-2018
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-018-4932-6

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