Postdiagnosis Change in Bodyweight and Survival After Breast Cancer Diagnosis

被引:90
作者
Bradshaw, Patrick T. [1 ]
Ibrahim, Joseph G. [2 ]
Stevens, June [1 ,3 ]
Cleveland, Rebecca [3 ]
Abrahamson, Page E. [1 ]
Satia, Jessie A. [1 ,3 ]
Teitelbaum, Susan L. [4 ]
Neugut, Alfred I. [5 ,6 ]
Gammon, Marilie D. [1 ]
机构
[1] Univ N Carolina, Dept Epidemiol, Sch Publ Hlth, Chapel Hill, NC 27599 USA
[2] Univ N Carolina, Dept Biostat, Sch Publ Hlth, Chapel Hill, NC 27599 USA
[3] Univ N Carolina, Sch Med, Dept Radiol, Chapel Hill, NC 27514 USA
[4] Mt Sinai Sch Med, Dept Community & Prevent Med, New York, NY USA
[5] Columbia Univ Coll Phys & Surg, Dept Med, New York, NY 10032 USA
[6] Columbia Univ, Dept Epidemiol, Mailman Sch Publ Hlth, New York, NY USA
关键词
BODY-MASS INDEX; WEIGHT-GAIN; ADJUVANT CHEMOTHERAPY; WOMEN; NUTRITION; INSULIN; RISK; FAT;
D O I
10.1097/EDE.0b013e31824596a1
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Weight gain after diagnosis is common among women with breast cancer, yet results have been inconsistent among the few studies examining its effects on survival. Methods: We examined the effects of weight gain on mortality among a cohort of 1436 women diagnosed with a first primary breast cancer in 1996-1997, on Long Island, NY. Subjects were interviewed soon after diagnosis and again after approximately 5 years. Weight was assessed at each decade of adult life; 1 year before, at, and 1 year after diagnosis; and at the time of follow-up. Mortality through the end of 2005 was assessed using the National Death Index. Proportional hazards regression was used while using a selection model to account for missing data. Results: Compared with women who maintained their prediagnosis weight (+/- 5%), those who gained more than 10% after diagnosis had worse survival (hazard ratio [HR] = 2.67; [95% credible interval = 1.37-5.05]). The effect was more pronounced during the first 2 years after diagnosis (>5% gain: all-cause mortality in the first 2 years, HR = 5.87 [0.89-47.8] vs. after 2 years, 1.49 [0.85-2.57]); among women overweight before diagnosis (overweight women: all-cause HR = 1.91 [0.91-3.88] vs. ideal-weight women, 1.39 [0.62-3.01]); and for women who had gained at least 3 kg in adulthood before diagnosis (>= 3-kg gain before diagnosis: 1.80 [0.99-3.26 vs. <3 kg gain before diagnosis: 1.07 [0.30-3.37]. Conclusions: These results highlight the importance of weight maintenance for women after breast cancer diagnosis.
引用
收藏
页码:320 / 327
页数:8
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