Epidemiology

Breast Cancer Research and Treatment

, Volume 140, Issue 1, pp 159-176

First online:

Weight, inflammation, cancer-related symptoms and health-related quality of life among breast cancer survivors

  • Ikuyo ImayamaAffiliated withPublic Health Sciences, Fred Hutchinson Cancer Research Center
  • , Catherine M. AlfanoAffiliated withOffice of Cancer Survivorship, National Cancer Institute/National Institutes of Health
  • , Marian L. NeuhouserAffiliated withPublic Health Sciences, Fred Hutchinson Cancer Research CenterDepartment of Epidemiology, School of Public Health, University of Washington
  • , Stephanie M. GeorgeAffiliated withApplied Research Program, National Cancer Institute/National Institutes of Health
  • , Ashley Wilder SmithAffiliated withOutcomes Research Branch, National Cancer Institute/National Institutes of Health
  • , Richard N. BaumgartnerAffiliated withDepartment of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville
  • , Kathy B. BaumgartnerAffiliated withDepartment of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville
  • , Leslie BernsteinAffiliated withDivision of Cancer Etiology, Department of Population Science, Beckman Research Institute of the City of Hope
  • , Ching-Yun WangAffiliated withPublic Health Sciences, Fred Hutchinson Cancer Research CenterDepartment of Biostatistics, School of Public Health, University of Washington
    • , Catherine DugganAffiliated withPublic Health Sciences, Fred Hutchinson Cancer Research Center
    • , Rachel Ballard-BarbashAffiliated withApplied Research Program, National Cancer Institute/National Institutes of Health
    • , Anne McTiernanAffiliated withPublic Health Sciences, Fred Hutchinson Cancer Research CenterDepartment of Epidemiology, School of Public Health, University of WashingtonDepartment of Medicine, School of Medicine, University of Washington Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Maintaining weight is important for better prognosis of breast cancer survivors. The associations between weight and cancer-related symptoms are not known. We examined associations among weight, weight change, inflammation, cancer-related symptoms, and health-related quality of life (HRQOL) in a cohort of stage 0-IIIA breast cancer survivors. Participants were recruited on average 6 months (2–12 months) after diagnosis. Height, weight, and C-reactive protein (CRP) were assessed at approximately 30 months post-diagnosis; cancer-related symptoms (chest wall and arm symptoms, vasomotor symptoms, urinary incontinence, vaginal symptoms, cognition/mood problems, sleep, sexual interest/function), and HRQOL (SF-36) were assessed at approximately 40 months post-diagnosis. Weight was measured at baseline in a subset. Data on 661 participants were evaluable for body mass index (BMI); 483 were evaluable for weight change. We assessed associations between BMI (<25.0, 25.0–29.9, ≥30.0 kg/m2), post-diagnosis weight change (lost ≥5 %, weight change <5 %, gained ≥5 %), and CRP (tertile) with cancer-related symptoms and HRQOL using analysis of covariance. Higher symptoms scores indicate more frequent or severe symptoms. Higher HRQOL scores indicate better HRQOL. Compared with those with BMI <25 kg/m2, women with BMI ≥30 kg/m2 had the following scores: increased for arm symptoms (+25.0 %), urinary incontinence (+40.0 %), tendency to nap (+18.9 %), and poorer physical functioning (−15.6 %, all p < 0.05). Obese women had lower scores in trouble falling asleep (−9.9 %; p < 0.05). Compared with weight change <5 %, participants with ≥5 % weight gain had lower scores in physical functioning (−7.2 %), role-physical (−15.5 %) and vitality (−11.2 %), and those with weight loss ≥5 % had lower chest wall (−33.0 %) and arm symptom scores (−35.5 %, all p < 0.05). Increasing CRP tertile was associated with worse scores for chest wall symptoms, urinary incontinence, physical functioning, role-physical, vitality and physical component summary scores (all P trend < 0.05). Future studies should examine whether interventions to maintain a healthy weight and reduce inflammation could alleviate cancer-related symptoms and improve HRQOL.

Keywords

Breast cancer survivors Body weight Inflammation Cancer-related symptoms Quality of life