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Body weight correlates with mortality in early-stage breast cancer.
Arch Surg. 2004 Sep; 139(9):954-58; discussion 958-60.AS

Abstract

HYPOTHESIS

Body weight correlates with risk of breast cancer death.

DESIGN

A retrospective cohort study using patient medical records, electronic cancer registry data, and archived tissue specimens.

SETTING

A 395-bed, comprehensive community hospital.

PATIENTS

One thousand three hundred seventy-six women, aged 24 to 81 years, who were diagnosed with breast cancer between January 1, 1988, and December 31, 1995, and for whom complete medical records and adequate tissue specimens existed.

MAIN OUTCOME MEASURES

Body weight at the time of diagnosis and patient status (ie, alive and free of breast cancer, living with breast cancer, dead of breast cancer, or dead of other cause) at the time of longest follow-up. Additional data collected, including age at diagnosis, menopausal status, tumor size, tumor grade, lymph node status, stage at diagnosis, race, estrogen-receptor (ER) status, and treatment information, were used to create multivariate Cox proportional hazards models to estimate hazard rate (HR) ratios and 95% confidence intervals (CIs) for breast cancer death. We collected ER status from the patients' medical records, when available, and supplemented the information by using immunohistochemical techniques to determine ER status from archived paraffin-embedded tumor blocks.

RESULTS

Patients were followed up for a median of 6.8 years after diagnosis. Two hundred forty-six patients died from breast cancer. Among patients with early-stage disease (I and IIA), we observed a dose-response relationship of increasing weight with increasing likelihood of dying of breast cancer. Compared with women in the lowest category of weight (< 133 lb [60 kg] at diagnosis), women in the highest category (> or = 175 lb [79 kg]) experienced a 2.5-fold increased risk of dying from breast cancer (HR ratio, 2.54 [95% CI, 1.08-6.00]; trend P = .02). Women with ER-negative cancer experienced an approximately 2-fold higher risk of dying from breast cancer compared with women with ER-positive cancer, regardless of stage at diagnosis. Women in the upper 50th percentile of weight with early-stage disease and with ER-negative tumors had a nearly 5-fold increased risk of dying (HR ratio, 4.99 [95% CI, 2.17-11.48]; P for interaction = .10) compared with women in the lower 50th percentile of weight and ER-positive tumors. The results were similar for body mass index, a measure of obesity in which weight is adjusted for height.

CONCLUSION

Body weight at diagnosis and ER status are important predictors of breast cancer death in early-stage disease.

Authors+Show Affiliations

Department of Research and Evaluation, Kaiser Permanente of Southern California, Pasadena, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15381612

Citation

Enger, Shelley M., et al. "Body Weight Correlates With Mortality in Early-stage Breast Cancer." Archives of Surgery (Chicago, Ill. : 1960), vol. 139, no. 9, 2004, pp. 954-58; discussion 958-60.
Enger SM, Greif JM, Polikoff J, et al. Body weight correlates with mortality in early-stage breast cancer. Arch Surg. 2004;139(9):954-58; discussion 958-60.
Enger, S. M., Greif, J. M., Polikoff, J., & Press, M. (2004). Body weight correlates with mortality in early-stage breast cancer. Archives of Surgery (Chicago, Ill. : 1960), 139(9), 954-58; discussion 958-60.
Enger SM, et al. Body Weight Correlates With Mortality in Early-stage Breast Cancer. Arch Surg. 2004;139(9):954-58; discussion 958-60. PubMed PMID: 15381612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body weight correlates with mortality in early-stage breast cancer. AU - Enger,Shelley M, AU - Greif,Jon M, AU - Polikoff,Jonathan, AU - Press,Michael, PY - 2004/9/24/pubmed PY - 2004/11/4/medline PY - 2004/9/24/entrez SP - 954-58; discussion 958-60 JF - Archives of surgery (Chicago, Ill. : 1960) JO - Arch Surg VL - 139 IS - 9 N2 - HYPOTHESIS: Body weight correlates with risk of breast cancer death. DESIGN: A retrospective cohort study using patient medical records, electronic cancer registry data, and archived tissue specimens. SETTING: A 395-bed, comprehensive community hospital. PATIENTS: One thousand three hundred seventy-six women, aged 24 to 81 years, who were diagnosed with breast cancer between January 1, 1988, and December 31, 1995, and for whom complete medical records and adequate tissue specimens existed. MAIN OUTCOME MEASURES: Body weight at the time of diagnosis and patient status (ie, alive and free of breast cancer, living with breast cancer, dead of breast cancer, or dead of other cause) at the time of longest follow-up. Additional data collected, including age at diagnosis, menopausal status, tumor size, tumor grade, lymph node status, stage at diagnosis, race, estrogen-receptor (ER) status, and treatment information, were used to create multivariate Cox proportional hazards models to estimate hazard rate (HR) ratios and 95% confidence intervals (CIs) for breast cancer death. We collected ER status from the patients' medical records, when available, and supplemented the information by using immunohistochemical techniques to determine ER status from archived paraffin-embedded tumor blocks. RESULTS: Patients were followed up for a median of 6.8 years after diagnosis. Two hundred forty-six patients died from breast cancer. Among patients with early-stage disease (I and IIA), we observed a dose-response relationship of increasing weight with increasing likelihood of dying of breast cancer. Compared with women in the lowest category of weight (< 133 lb [60 kg] at diagnosis), women in the highest category (> or = 175 lb [79 kg]) experienced a 2.5-fold increased risk of dying from breast cancer (HR ratio, 2.54 [95% CI, 1.08-6.00]; trend P = .02). Women with ER-negative cancer experienced an approximately 2-fold higher risk of dying from breast cancer compared with women with ER-positive cancer, regardless of stage at diagnosis. Women in the upper 50th percentile of weight with early-stage disease and with ER-negative tumors had a nearly 5-fold increased risk of dying (HR ratio, 4.99 [95% CI, 2.17-11.48]; P for interaction = .10) compared with women in the lower 50th percentile of weight and ER-positive tumors. The results were similar for body mass index, a measure of obesity in which weight is adjusted for height. CONCLUSION: Body weight at diagnosis and ER status are important predictors of breast cancer death in early-stage disease. SN - 0004-0010 UR - https://www.unboundmedicine.com/medline/citation/15381612/Body_weight_correlates_with_mortality_in_early_stage_breast_cancer_ L2 - https://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.139.9.954 DB - PRIME DP - Unbound Medicine ER -