Obesity is associated with a poorer prognosis in women with hormone receptor positive breast cancer

Objective: Whether moderate to severe obesity (body mass index (BMI) <= 30 to <40 kg/m(2)) contributes to breast cancer recurrence and mortality remains uncertain. Subjects and methods: 1199 women, recruited within 12 months of their diagnosis of kormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) invasive breast cancer completed an enrolment questionnaire and an annual follow-up questionnaire every 12 months for another 5 years. The impact of obesity on time to either local or distant recurrence or new breast cancer, or death due to breast cancer was determined by Cox regression. Women in the most extreme categories of BMI (<18.5 and >= 40) were excluded from the analysis. Results: Of the 1155 included women, mean age, 58.4 +/- 11.6 years, 53.8% had Stage 1 disease and 88.9% received oral adjuvant endocrine therapy (OAET) within 2 years of diagnosis. The likelihood of an event was significantly associated with moderate to severe obesity (HR = 1.71, 95%CI, 1.12-2.62, p = 0.014), disease beyond Stage 1 (HR = 2.87, 95% CI 1.73-4.75, p < 0.001), OAET (HR = 0.26, 95%CI 0.14-0.46, p < 0.001), mastectomy (HR = 3.28, 95%CI 1.98-5.44, p < 0.001) and radiotherapy (HR = 2.12, 95%0 1.24-3.63,p = 0.006). For Stage 1 disease, only moderate to severe obesity (HR3.23,95%CI 1.48-7.03, p = 0.003) and OAET use (HR 0.41, 95%CI 0.17-0.98,p = 0.046) were significantly associated with an event. Conclusion: Moderate to severe obesity is associated with a poorer invasive breast cancer prognosis; this is also true for women with Stage 1 disease, and is independent of age and treatment. (C) 2014 Elsevier Ireland Ltd. All rights reserved.