Obesity and mortality after locoregional breast cancer diagnosis

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

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

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/m 2 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/m 2 vs. 18.5–24.9 kg/m 2 = 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.

Original languageEnglish (US)
Pages (from-to)647-657
Number of pages11
JournalBreast Cancer Research and Treatment
Volume172
Issue number3
DOIs
StatePublished - Dec 1 2018
Externally publishedYes

Keywords

  • All-cause mortality
  • Breast cancer
  • Breast cancer mortality
  • Obesity

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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