Impact of obesity on diagnosis and treatment of breast cancer
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In this population-based study, we evaluated the impact of obesity on presentation, diagnosis and treatment of breast cancer. Among all women diagnosed with invasive breast cancer in the canton Geneva (Switzerland) between 2003 and 2005, we identified those with information on body mass index (BMI) and categorized them into normal/underweight (BMI <25 kg/m2), overweight (BMI ≥–<30 kg/m2) and obese (BMI ≥30 kg/m2) women. Using multivariate logistic regression, we compared tumour, diagnosis and treatment characteristics between groups. Obese women presented significantly more often with stage III–IV disease (adjusted odds ratio [ORadj]: 1.8, 95% CI: 1.0–3.3). Tumours ≥1 cm and pN2-N3 lymph nodes were significantly more often impalpable in obese than in normal/underweight patients (ORadj 2.4, [1.1–5.3] and ORadj 5.1, [1.0–25.4], respectively). Obese women were less likely to have undergone ultrasound (ORadj 0.5, [0.3–0.9]) and MRI (ORadj 0.3, [0.1–0.6]) and were at increased risk of prolonged hospital stay (ORadj 4.7, [2.0–10.9]). This study finds important diagnostic and therapeutic differences between obese and lean women, which may impair survival of obese women with breast cancer. Specific strategies are needed to optimize the care of obese women with or at risk of breast cancer.
KeywordsObesity Breast cancer Diagnosis Treatment Population-based
We thank Stina Blagojevic for technical and editorial assistance and the registry team for providing data and support. This study was financially supported by the Swiss Cancer League.
Conflicts of interest
The authors indicate no potential conflict of interest.
- 2.Lahmann PH, Hoffmann K, Allen N, Van Gils CH, Khaw KT, Tehard B, Berrino F, Tjonneland A, Bigaard J, Olsen A, Overvad K, Clavel-Chapelon F, Nagel G, Boeing H, Trichopoulos D, Economou G, Bellos G, Palli D, Tumino R, Panico S (2004) Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer 111(5):762–771CrossRefPubMedGoogle Scholar
- 10.Bouchardy C, Geneva, Switzerland (2003) Cancer incidence in five continents. In: Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB (eds) International agency for research on cancer, vol VIII. IARC, Lyon, pp 448–449Google Scholar
- 11.World Health Organization (WHO) (2008) WHO, global database on body mass index, BMI classification. 30-4-2008Google Scholar
- 12.Sobin LH, Ch Wittekind (eds) (2002) TNM classification of malignant tumours. UICC, New YorkGoogle Scholar
- 13.ICD-O International classification of diseases for oncology (1975) World Health Organization, GenèveGoogle Scholar
- 14.Breslow NE, Day NE (1987) Statistical methods in cancer research: the design and analysis of cohort studies, vol II. International Agency for Research on Cancer, IARC Scientific Publications no 82, LyonGoogle Scholar
- 18.Hahn KM, Bondy ML, Selvan M, Lund MJ, Liff JM, Flagg EW, Brinton LA, Porter P, Eley JW, Coates RJ (2007) Factors associated with advanced disease stage at diagnosis in a population-based study of patients with newly diagnosed breast cancer. Am J Epidemiol 166(9):1035–1044CrossRefPubMedGoogle Scholar
- 28.Honda H, Ohi Y, Umekita Y, Takasaki T, Kuriwaki K, Ohyabu I, Yoshioka T, Yoshida A, Taguchi S, Ninomiya K, Akiba S, Nomura S, Sagara Y, Yoshida H (1999) Obesity affects expression of progesterone receptors and node metastasis of mammary carcinomas in postmenopausal women without a family history. Pathol Int 49(3):198–202CrossRefPubMedGoogle Scholar
- 48.Buist DS, Ichikawa L, Prout MN, Yood MU, Field TS, Owusu C, Geiger AM, Quinn VP, Wei F, Silliman RA (2007) Receipt of appropriate primary breast cancer therapy and adjuvant therapy are not associated with obesity in older women with access to health care. J Clin Oncol 25(23):3428–3436CrossRefPubMedGoogle Scholar