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 D Cress, J. Frank Wilson, Susan A. Sabatino, Steven T. Fleming

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalBreast Cancer Research and Treatment
DOIs
StateAccepted/In press - Jan 1 2018

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Body Mass Index
Obesity
Breast Neoplasms
Mortality
Registries
Proportional Hazards Models
Demography
Population
Neoplasms

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Moore, A. H., Trentham-Dietz, A., Burns, M., Gangnon, R. E., Greenberg, C. C., Vanness, D. J., ... Fleming, S. T. (Accepted/In press). Obesity and mortality after locoregional breast cancer diagnosis. Breast Cancer Research and Treatment. https://doi.org/10.1007/s10549-018-4932-6

Obesity and mortality after locoregional breast cancer diagnosis. / Moore, A. Holliston; Trentham-Dietz, Amy; Burns, Marguerite; Gangnon, Ronald E.; Greenberg, Caprice C.; Vanness, David J.; Hampton, John; Wu, Xiao Cheng; Anderson, Roger T.; Lipscomb, Joseph; Kimmick, Gretchen G.; Cress, Rosemary D; Wilson, J. Frank; Sabatino, Susan A.; Fleming, Steven T.

In: Breast Cancer Research and Treatment, 01.01.2018.

Research output: Contribution to journalArticle

Moore, AH, Trentham-Dietz, A, Burns, M, Gangnon, RE, Greenberg, CC, Vanness, DJ, Hampton, J, Wu, XC, Anderson, RT, Lipscomb, J, Kimmick, GG, Cress, RD, Wilson, JF, Sabatino, SA & Fleming, ST 2018, 'Obesity and mortality after locoregional breast cancer diagnosis', Breast Cancer Research and Treatment. https://doi.org/10.1007/s10549-018-4932-6
Moore AH, Trentham-Dietz A, Burns M, Gangnon RE, Greenberg CC, Vanness DJ et al. Obesity and mortality after locoregional breast cancer diagnosis. Breast Cancer Research and Treatment. 2018 Jan 1. https://doi.org/10.1007/s10549-018-4932-6
Moore, A. Holliston ; Trentham-Dietz, Amy ; Burns, Marguerite ; Gangnon, Ronald E. ; Greenberg, Caprice C. ; Vanness, David J. ; Hampton, John ; Wu, Xiao Cheng ; Anderson, Roger T. ; Lipscomb, Joseph ; Kimmick, Gretchen G. ; Cress, Rosemary D ; Wilson, J. Frank ; Sabatino, Susan A. ; Fleming, Steven T. / Obesity and mortality after locoregional breast cancer diagnosis. In: Breast Cancer Research and Treatment. 2018.
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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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AU - Trentham-Dietz, Amy

AU - Burns, Marguerite

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AU - Greenberg, Caprice C.

AU - Vanness, David J.

AU - Hampton, John

AU - Wu, Xiao Cheng

AU - Anderson, Roger T.

AU - Lipscomb, Joseph

AU - Kimmick, Gretchen G.

AU - Cress, Rosemary D

AU - Wilson, J. Frank

AU - Sabatino, Susan A.

AU - Fleming, Steven T.

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N2 - 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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