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Obesity and subcutaneous fat patterning in relation to survival of postmenopausal breast cancer patients participating in the DOM-project

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Summary

The effect of obesity and fat distribution on survival of breast cancer patients was studied prospectively in 241 women with a natural menopause who participated in a breast cancer screening project, the DOM-project in Utrecht, The Netherlands. Mean follow-up time was 9.1 years and endpoint of interest was death from breast cancer. Fat distribution was assessed by contrasting groups of subscapular and triceps skinfold thickness.

No significant differences in survival time between more obese (Quetelet's index ≥ 26 kg/m2) and leaner (Quetelet's index < 26 kg/m2) patients or between patients with central fat distribution and patients with peripheral fat distribution were observed. Analyses were stratified by axillary node status, estrogen receptor status, and way of detection (by first screening or afterwards). Results of the stratified analyses were suggestive of a modifying effect of these factors.

The absence of an association between obesity and survival time might be explained by two counteracting mechanisms. On the one hand obesity might be related to impaired survival, due to a tumor growth promoting effect of extra-ovarian estrogens. On the other hand obesity might be related to improved survival in a screened population, because obese patients profit more from screening by earlier detection of tumors than leaner counterparts.

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Authors and Affiliations

  1. Department of Epidemiology, University of Utrecht, PO Box 80035, 3508 TA, Utrecht, The Netherlands

    Isolde den Tonkelaar, Frits de Waard & Jacques Fracheboud

  2. Department of Chronic Disease and Environmental Epidemiology, National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands

    Jacob C. Seidell

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  1. Isolde den Tonkelaar
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  2. Frits de Waard
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  3. Jacob C. Seidell
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  4. Jacques Fracheboud
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den Tonkelaar, I., de Waard, F., Seidell, J.C. et al. Obesity and subcutaneous fat patterning in relation to survival of postmenopausal breast cancer patients participating in the DOM-project. Breast Cancer Res Tr 34, 129–137 (1995). https://doi.org/10.1007/BF00665785

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