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Weight trajectories in women receiving systemic adjuvant therapy for breast cancer

  • Kirsten A. NyropEmail author
  • Allison M. Deal
  • Shlomit S. Shachar
  • Jihye Park
  • Seul Ki Choi
  • Jordan T. Lee
  • Erin A. O’Hare
  • Amy Wheless
  • Lisa A. Carey
  • Hyman B. Muss
Epidemiology
  • 63 Downloads

Abstract

Background

Weight gain after breast cancer (BC) diagnosis is a well-known phenomenon; however, it is not a universal phenomenon and identification of patients at highest risk for weight gain is needed. This study investigates weight trajectories in early BC patients at 2 years post-primary treatment, examining potential contributing factors such as age, race, and receipt of chemotherapy, anti-HER-2 therapy, and endocrine treatment (ET).

Methods

A single institution cohort of newly diagnosed women age 21 and older with early breast cancer patients (Stage 0–3) were identified by retrospective chart review (diagnosis year 1995 to 2016). Log-binomial regression models for net weight changes at 2 years post-primary treatment including patient demographic, clinical, and treatment characteristics.

Results

The final sample of 625 patients included 29% who were non-White and 37% who were pre-menopausal at diagnosis. Body mass index (BMI) at diagnosis was calculated and found to be normal in 33% (BMI 18 to < 25), overweight in 27% (BMI 25 to < 30), and obese in 40% (BMI 30 and higher). At 2 years, compared to weight at diagnosis, 31% had lost > 2 kg, 34% had stable weight ± 2 kg, and 35% had gained > 2 kg. Factors associated with > 2 kg weight gain were menopausal status (pre-menopausal HR 1.65, 95% CI 1.34–2.04, p < .0001), receiving any chemotherapy (HR 1.36, 95% CI 1.04–1.77), and anthracycline-based chemotherapy followed by ET (HR 1.60, CI 1.01–2.45). Anti-HER-2 therapy and transition from pre- to post-menopausal during the 2-year study period were not significant factors in weight gain. In multivariate analysis, menopausal status remained the only significant variable related to weight gain when adjusted for treatment. For all treatment combinations, pre-menopausal women had significantly more weight gain.

Conclusions and relevance

Weight gain, weight loss, and stable weight in women with early breast cancer vary greatly by treatment plan. However, pre-menopausal patients have the highest risk for weight gain.

Keywords

Breast cancer Weight trajectories Treatment regimens 

Notes

Funding

This study was supported by the Breast Cancer Research Foundation (New York), UNC Lineberger Comprehensive Cancer Center/University Cancer Research Fund, and the UNC SPORE in Breast Cancer (CA58223). Dr. Shachar’s fellowship at UNC was supported by the Friends of Rambam Medical Center and The J&G Zukier Medical Fund Donation, Haifa, Israel.

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

This study did not entail direct contact with humans and therefore did not entail obtaining informed consent.

Supplementary material

10549_2019_5501_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 kb)
10549_2019_5501_MOESM2_ESM.docx (13 kb)
Supplementary material 2 (DOCX 13 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kirsten A. Nyrop
    • 1
    • 5
    Email author
  • Allison M. Deal
    • 1
  • Shlomit S. Shachar
    • 4
  • Jihye Park
    • 2
  • Seul Ki Choi
    • 2
  • Jordan T. Lee
    • 3
  • Erin A. O’Hare
    • 1
  • Amy Wheless
    • 1
  • Lisa A. Carey
    • 1
  • Hyman B. Muss
    • 1
  1. 1.Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Department of Exercise and Sport ScienceUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Rappaport Faculty of MedicineTechnionHaifaIsrael
  5. 5.Division of Hematology-OncologyUniversity of North Carolina at Chapel HillChapel HillUSA

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