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Pre-diagnosis body mass index and survival after breast cancer in the After Breast Cancer Pooling Project.
Breast Cancer Res Treat 2012; 132(2):729-39BC

Abstract

Obese and underweight women who develop breast cancer may have poorer survival compared with normal-weight women. However, the optimal weight for best prognosis is still under study. We conducted a prospective investigation of pre-diagnosis body mass index (BMI) and mortality among 14,948 breast cancer patients in the After Breast Cancer Pooling Project. Breast cancer patients diagnosed from 1990 to 2006 with AJCC Stage I-III breast tumors were drawn from four prospective cohorts. Hazard ratios (HR) and 95% confidence intervals (CI) representing the associations of BMI categories (World Health Organization international classifications) with recurrence and mortality were estimated using delayed entry Cox proportional hazards models. Obese (30 to < 35 kg/m(2)), severely obese (35 to < 40 kg/m(2)), and morbidly obese (≥ 40 kg/m(2)) were examined. After a mean follow-up of 7.8 years, 2,140 deaths and 2,065 recurrences were documented. Both underweight (HR = 1.59; 95% CI: 1.18, 2.13) and morbidly obese women (HR = 1.81; 95% CI: 1.42, 2.32) had the greatest risk of overall mortality compared with normal weight (18.5-24.9 kg/m(2)) women. Severe obesity (HR = 1.09; 95% CI: 0.88, 1.36) and obesity (HR = 1.11; 95% CI: 0.97, 1.27) were related to small non-significant increased risks. Overweight (25.0-29.9 kg/m(2)) was not associated with any excess risk compared with normal weight. Similar associations were found for breast cancer death and non-breast cancer death but not recurrence. Women who were underweight and morbidly obese before breast cancer diagnosis were at the greatest risk of all-cause mortality. Morbidly obese women were also at increased risk of death from breast cancer. These results suggest that degree of obesity confers differential risk on survival.

Authors+Show Affiliations

Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA. Marilyn.L.Kwan@kp.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

22187127

Citation

Kwan, Marilyn L., et al. "Pre-diagnosis Body Mass Index and Survival After Breast Cancer in the After Breast Cancer Pooling Project." Breast Cancer Research and Treatment, vol. 132, no. 2, 2012, pp. 729-39.
Kwan ML, Chen WY, Kroenke CH, et al. Pre-diagnosis body mass index and survival after breast cancer in the After Breast Cancer Pooling Project. Breast Cancer Res Treat. 2012;132(2):729-39.
Kwan, M. L., Chen, W. Y., Kroenke, C. H., Weltzien, E. K., Beasley, J. M., Nechuta, S. J., ... Caan, B. J. (2012). Pre-diagnosis body mass index and survival after breast cancer in the After Breast Cancer Pooling Project. Breast Cancer Research and Treatment, 132(2), pp. 729-39. doi:10.1007/s10549-011-1914-3.
Kwan ML, et al. Pre-diagnosis Body Mass Index and Survival After Breast Cancer in the After Breast Cancer Pooling Project. Breast Cancer Res Treat. 2012;132(2):729-39. PubMed PMID: 22187127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-diagnosis body mass index and survival after breast cancer in the After Breast Cancer Pooling Project. AU - Kwan,Marilyn L, AU - Chen,Wendy Y, AU - Kroenke,Candyce H, AU - Weltzien,Erin K, AU - Beasley,Jeannette M, AU - Nechuta,Sarah J, AU - Poole,Elizabeth M, AU - Lu,Wei, AU - Holmes,Michelle D, AU - Quesenberry,Charles P,Jr AU - Pierce,John P, AU - Shu,Xiao Ou, AU - Caan,Bette J, Y1 - 2011/12/21/ PY - 2011/12/01/received PY - 2011/12/03/accepted PY - 2011/12/22/entrez PY - 2011/12/22/pubmed PY - 2012/6/23/medline SP - 729 EP - 39 JF - Breast cancer research and treatment JO - Breast Cancer Res. Treat. VL - 132 IS - 2 N2 - Obese and underweight women who develop breast cancer may have poorer survival compared with normal-weight women. However, the optimal weight for best prognosis is still under study. We conducted a prospective investigation of pre-diagnosis body mass index (BMI) and mortality among 14,948 breast cancer patients in the After Breast Cancer Pooling Project. Breast cancer patients diagnosed from 1990 to 2006 with AJCC Stage I-III breast tumors were drawn from four prospective cohorts. Hazard ratios (HR) and 95% confidence intervals (CI) representing the associations of BMI categories (World Health Organization international classifications) with recurrence and mortality were estimated using delayed entry Cox proportional hazards models. Obese (30 to < 35 kg/m(2)), severely obese (35 to < 40 kg/m(2)), and morbidly obese (≥ 40 kg/m(2)) were examined. After a mean follow-up of 7.8 years, 2,140 deaths and 2,065 recurrences were documented. Both underweight (HR = 1.59; 95% CI: 1.18, 2.13) and morbidly obese women (HR = 1.81; 95% CI: 1.42, 2.32) had the greatest risk of overall mortality compared with normal weight (18.5-24.9 kg/m(2)) women. Severe obesity (HR = 1.09; 95% CI: 0.88, 1.36) and obesity (HR = 1.11; 95% CI: 0.97, 1.27) were related to small non-significant increased risks. Overweight (25.0-29.9 kg/m(2)) was not associated with any excess risk compared with normal weight. Similar associations were found for breast cancer death and non-breast cancer death but not recurrence. Women who were underweight and morbidly obese before breast cancer diagnosis were at the greatest risk of all-cause mortality. Morbidly obese women were also at increased risk of death from breast cancer. These results suggest that degree of obesity confers differential risk on survival. SN - 1573-7217 UR - https://www.unboundmedicine.com/medline/citation/22187127/Pre_diagnosis_body_mass_index_and_survival_after_breast_cancer_in_the_After_Breast_Cancer_Pooling_Project_ L2 - https://doi.org/10.1007/s10549-011-1914-3 DB - PRIME DP - Unbound Medicine ER -