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High BMI linked with poorer survival in pre-, post-menopausal breast cancers

Issue: June 25, 2014

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Survivors of pre- and post-menopausal breast cancer who were obese demonstrated poorer OS and breast cancer-specific survival compared with those at normal weight, according to results of a meta-analysis.

Researchers observed the association regardless of whether BMI was ascertained before or after diagnosis.

Doris S.M. Chan, MD, of the department of epidemiology and biostatistics in the School of Public Health of Imperial College London, and colleagues used the MEDLINE and EMBASE databases to identify 82 studies of female breast cancer survivors that included data about BMI, as well as total and cause-specific mortality.

The studies included a combined 213,075 breast cancer survivors. Of those survivors, 41,477 died during follow-up, and 23,182 of those deaths were due to breast cancer.

Compared with normal-weight women, researchers determined the RR for total mortality was 1.41 (95% CI, 1.29-1.53) among those who were obese (BMI >30), 1.07 (95% CI, 1.02-1.12) for those who were overweight (BMI, 25-30), and 1.10 (95% CI, 0.92-1.31) for those who were underweight (BMI <18.5).

Among obese women, researchers calculated RRs of 1.75 (95 CI, 1.26-2.41) for those who had pre-menopausal breast cancer and 1.34 (95% CI, 1.18-1.53) for those who had post-menopausal breast cancer.

For each 5 kg/m² increment of BMI prior to diagnosis, risk for total mortality and breast cancer mortality each increased by 17%. For each 5 kg/m² increment of BMI ≥1 year after diagnosis, risk for total mortality increased by 8% and risk for breast cancer mortality increased by 29%.

“Future studies of body fatness and breast cancer outcomes should aim to account for co-morbidities, separate intended and unintended changes of body weight, and collect complete treatment information during study follow-up,” Chan and colleagues wrote. “Randomized clinical trials are needed to test interventions for weight loss and maintenance on survival in women with breast cancer.”

Reference:

Chan DSM. Ann Oncol. 2014;doi:10.1093/neuonc/nou060.

Disclosure:

The researchers report funding from the World Cancer Research Fund/American Institute for Cancer Research, Metagenics/Metaproteomics and Pfizer. They also report grants from Danone and Kellogg’s.