Skip to main content

Advertisement

Log in

Obesity and Cardiovascular Risk Factors in Younger Breast Cancer Survivors: The Cancer and Menopause Study (CAMS)

Breast Cancer Research and Treatment Aims and scope Submit manuscript

Summary

Background.Breast cancer patients today can expect long-term survival; however, weight gain is a common problem after treatment and increases the risk for recurrence, cardiovascular disease and diabetes. The multi-ethnic cohort from the Cancer and Menopause Study, designed to examine the reproductive and late cardiovascular health effects of treatment in younger female breast cancer survivors (BCS), was used to describe the relationship of behavioral and treatment variables to body mass index (BMI), physical activity (PA), and cardiovascular risk factors.

Methods.Stage 0, I or II breast cancer survivors who were ≤50 years at diagnosis and 2–10 years disease-free survivors (mean 5.9±2.3 years) were recruited from two tumor registries to complete a mail survey that included information on demographics, health-related quality of life, reproductive health, cancer treatment, PA, weight and height. A sub-sample completed an office visit where fasting blood lipids, blood pressure (BP), height and weight were measured. Linear regression analysis was used to model the following outcomes: BMI, PA, blood lipids and BP.

Results.Current BMI was positively associated with higher BMI prior to diagnosis, unhappiness with body image and negatively associated with current total PA (model p<0.001). More work, home and leisure PA were all positively associated with greater physical functioning and higher energy levels (all models, p<0.001). Total and LDL cholesterol were positively associated with number of years since diagnosis and negatively associated with leisure PA (both models, p < 0.001), while systolic and diastolic BP were both positively associated with age, current use of BP medications and current BMI (models, p < 0.001). Conclusions.Obesity in these BCS is prevalent and associated with premorbid obesity and decreased current physical activity but not with adjuvant treatment. Given the negative health consequences of weight gain and obesity after breast cancer, continued study of the etiology of weight gain, and potential targets for weight gain prevention are required. Interventions that target PA may be important for weight maintenance in BCS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Cancer Society: Cancer Facts and Figures 2002, Atlanta, GA, 2002

  2. KC Chu RE Tarone LG Kessler LA Ries BF Hankey BA Miller E BK (1996) ArticleTitleRecent trends in U.S. breast cancer incidence, survival, and mortality rates J Natl Cancer Inst 88 1571–1579 Occurrence Handle8901855

    PubMed  Google Scholar 

  3. A Jemal LX Clegg E Ward LA Ries X Wu PM Jamison PA Wingo HL Howe RN Anderson E BK (2004) ArticleTitleAnnual Report to the Nation on the Status of Cancer, 1975–2001, with a Special Feature Regarding Survival Cancer 101 3–27 Occurrence Handle10.1002/cncr.20288 Occurrence Handle15221985

    Article  PubMed  Google Scholar 

  4. American Cancer Society: Cancer Facts & Figures for African Americans. 2003

  5. G Gatta R Capocaccia MP Coleman LA Gloeckler Ries T Hakulinen A Micheli M Sant A Verdecchia F Berrino (2000) ArticleTitleToward a comparison of survival in American and European cancer patients Cancer 89 893–900 Occurrence Handle10.1002/1097-0142(20000815)89:4<893::AID-CNCR24>3.0.CO;2-9 Occurrence Handle10951355

    Article  PubMed  Google Scholar 

  6. H Schnipper (2003) ArticleTitleLife after breast cancer J Clin Oncol 21 104S–107S Occurrence Handle10.1200/JCO.2003.01.189

    Article  Google Scholar 

  7. KH Dow BT Ferrell S Leigh (1996) ArticleTitleAn evaluation of the quality of life among long-term survivors of breast cancer Breast Cancer Res Treat 39 261–273 Occurrence Handle10.1007/BF01806154 Occurrence Handle8877006

    Article  PubMed  Google Scholar 

  8. PA Ganz JH Rowland K Desmond BE Meyerowitz GE Wyatt (1998) ArticleTitleLife after breast cancer: understanding women’s health-related quality of life and sexual functioning J Clin Oncol 16 501–514 Occurrence Handle9469334

    PubMed  Google Scholar 

  9. JE Bower PA Ganz K Desmond JH Rowland BE Meyerowitz TR Belin (2000) ArticleTitleFatigue in breast cancer survivors: occurrence, correlates, and impact of quality of life J Clin Oncol 18 743–753 Occurrence Handle10673515

    PubMed  Google Scholar 

  10. PA Ganz L Kwan AL Stanton JL Krupnick JH Rowland BE Meyerowitz J Bower TR Belin (2004) ArticleTitleQuality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial JNCI 96 376–387 Occurrence Handle14996859

    PubMed  Google Scholar 

  11. PA Ganz GA Greendale L Petersen B Kahn JE Bower (2003) ArticleTitleBreast cancer in younger women: reproductive and late health effects of treatment J Clin Oncol 21 4184–4193 Occurrence Handle10.1200/JCO.2003.04.196 Occurrence Handle14615446

    Article  PubMed  Google Scholar 

  12. PJ Goodwin M Ennis KI Pritchard ME Trudeau N Hood (1999) ArticleTitleRisk of menopause during the first year after breast cancer diagnosis J Clin Oncol 17 2365–2370 Occurrence Handle10561298

    PubMed  Google Scholar 

  13. PJ Goodwin M Ennis KI Pritchard D McCready J Koo S Sidlofsky M Trudeau N Hood S Redwood (1999) ArticleTitleAdjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis J Clin Oncol 17 120–129 Occurrence Handle10458225

    PubMed  Google Scholar 

  14. W Demark-Wahnefried B Peterson E Winer L Marks N Aziz PJ Marcom K Blackwell B Rimer (2001) ArticleTitleChanges in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy J Clin Oncol 19 2381–2389 Occurrence Handle11331316

    PubMed  Google Scholar 

  15. W Demark-Wahnefried V Hars MR Conaway K Havlin BK Rimer G McElveen EP Winer (1997) ArticleTitleReduced rates of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy Am J Clin Nutr 65 1495–1501 Occurrence Handle9129482

    PubMed  Google Scholar 

  16. PJ Goodwin N Boyd (1990) ArticleTitle Body size and breast cancer prognosis: a critical review of the evidence Breast Cancer Res Treat 16 205–214 Occurrence Handle10.1007/BF01806329 Occurrence Handle2085672

    Article  PubMed  Google Scholar 

  17. CL Rock W Demark-Wahnefried (2002) ArticleTitleNutrition and survival after the diagnosis of breast cancer: a review of the evidence J Clin Epidemiol 20 3302–3316

    Google Scholar 

  18. RT Senie PP Rosen P Rhodes ML Lesser DW Kinne (1992) ArticleTitleObesity at diagnosis of breast carcinoma influences duration of disease-free survival Ann Intern Med 116 26–32 Occurrence Handle1727092

    PubMed  Google Scholar 

  19. J Bastarrachea GN Hortobagyi TL Smith S-WC Kau AU Buzdar (1993) ArticleTitleObesity is an adverse prognostic factor for patients receiving adjuvant chemotherapy for breast cancer Ann Intern Med 119 18–25

    Google Scholar 

  20. PJ Goodwin M Esplen K Butler J Winocur K Pritchard S Brazel J Gao A Miller (1998) ArticleTitleMultidisciplinary weight management in locoregional breast cancer: results of a Phase II study Breast Cancer Res Treat 48 53–64 Occurrence Handle10.1023/A:1005942017626 Occurrence Handle9541189

    Article  PubMed  Google Scholar 

  21. JR Daling KE Malone DR Doody LG Johnson JR Gralow PL Porter (2001) ArticleTitleRelation of body mass index to tumor markers and survival among young women with invasive ductal breast carcinoma Cancer 92 720–729 Occurrence Handle10.1002/1097-0142(20010815)92:4<720::AID-CNCR1375>3.0.CO;2-T Occurrence Handle11550140

    Article  PubMed  Google Scholar 

  22. RT Chlebowski E Aiello A McTiernan (2002) ArticleTitleWeight loss in breast cancer patient management J Clin Oncol 20 1128–1143 Occurrence Handle10.1200/JCO.20.4.1128 Occurrence Handle11844838

    Article  PubMed  Google Scholar 

  23. JJ Dignam K Wieand KA Johnson B Fisher L Xu EP Mamounas (2003) ArticleTitleObesity, tamoxifen use, and outcomes in women with estrogen receptor-positive early-stage breast cancer J Natl Cancer Inst 95 1467–1476 Occurrence Handle14519753

    PubMed  Google Scholar 

  24. JE Manson PJ Skerrett P Greenland TB VanItallie (2004) ArticleTitleThe escalating pandemics of obesity and sedentary lifestyle: a call to action for clinicians Arch Intern Med 164 249–258 Occurrence Handle10.1001/archinte.164.3.249 Occurrence Handle14769621

    Article  PubMed  Google Scholar 

  25. L Mosca LJ Appel EJ Benjamin K Berra N Chandra-Strobos RP Fabunmi D Grady CK Haan SN Hayes DR Judelson NL Keenan P McBride S Oparil P Ouyang MC Oz ME Mendelsohn RC Pasternak VW Pinn RM Robertson K Schenk-Gustafsson CA Sila SC Smith G Sopko AL Taylor BW Walsh NK Wenger CL Williams (2004) ArticleTitleEvidence-based guidelines for cardiovascular disease prevention in women Circulation 109 672–693 Occurrence Handle10.1161/01.CIR.0000114834.85476.81 Occurrence Handle14761900

    Article  PubMed  Google Scholar 

  26. C Schairer PJ Mink L Carroll SS Devesa (2004) ArticleTitleProbabilities of death from breast cancer and other causes among female breast cancer patients JNCI 96 1311–1321 Occurrence Handle15339969

    PubMed  Google Scholar 

  27. A Pakilit B Kahn L Petersen L Abraham GA Greendale PA Ganz (2001) ArticleTitleMaking effective use of tumor registries for cancer survivorship research Cancer 92 1305–1314 Occurrence Handle10.1002/1097-0142(20010901)92:5<1305::AID-CNCR1452>3.0.CO;2-M Occurrence Handle11571747

    Article  PubMed  Google Scholar 

  28. C Crandall L Petersen PA Ganz GA Greendale (2004) ArticleTitleAssociation of breast cancer and its therapy with menopause-related symptoms Menopause 11 519–530 Occurrence Handle10.1097/01.GME.0000117061.40493.AB Occurrence Handle15356404

    Article  PubMed  Google Scholar 

  29. C Crandall L Petersen PA Ganz GA Greendale (2004) ArticleTitleBone mineral density and adjuvant therapy in breast cancer survivors Breast Cancer Res Treat 88 257–261 Occurrence Handle10.1007/s10549-004-0804-3 Occurrence Handle15609128

    Article  PubMed  Google Scholar 

  30. PA Ganz K Desmond B Leedham JH Rowland BE Meyerowitz TR Belin (2002) ArticleTitleQuality of life in long-term, disease-free survivors of breast cancer: a follow-up study J Natl Cancer Inst 94 39–49 Occurrence Handle11773281

    PubMed  Google Scholar 

  31. CA Schag PA Ganz L Polinsky C Fred K Hirji L Petersen (1993) ArticleTitleCharacteristics of women at risk for psychological distress in the year after breast cancer J Clin Oncol 11 783–793 Occurrence Handle8478672

    PubMed  Google Scholar 

  32. PA Ganz R Day JE Jr. Ware C Redmond B Fisher (1995) ArticleTitleBase-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial J Natl Cancer Inst 87 1372–1382 Occurrence Handle7658498

    PubMed  Google Scholar 

  33. R Day PA Ganz J Costantino WM Cronin DL Wickerham B Fisher (1999) ArticleTitleHealth-related quality of life and tamoxifen in breast cancer prevention: a report from the National Surgical Breast and Bowel Project P-1 Study J Clin Oncol 17 2659–2669 Occurrence Handle10561339

    PubMed  Google Scholar 

  34. JE Jr. Ware (1993) SF-36 Health Survey. Manual and Interpretation Guide The Health Institute, New England Medical Center Boston, MA

    Google Scholar 

  35. RD Hays CD Sherbourne RM Mazel (1993) ArticleTitleThe RAND 36-Item Health Survey 1.0 Health Econ 2 217–227 Occurrence Handle8275167

    PubMed  Google Scholar 

  36. LS Radloff (1977) ArticleTitleThe CES-D Scale: A self-report depression scale for research in the general population Appl Psychol Measure 1 385–401

    Google Scholar 

  37. GA Greendale L Bodin-Dunn S Ingles R Haile E Barrett-Connor (1996) ArticleTitleLeisure, home, and occupational physical activity and cardiovascular risk factors in postmenopausal women Arch Intern Med 156 418–424 Occurrence Handle10.1001/archinte.156.4.418 Occurrence Handle8607727

    Article  PubMed  Google Scholar 

  38. CN Bairey Merz M Olson S McGorray DL Pakstis K Zell CR Rickens SF Kelsey V Bittner BL Sharaf G Sopko (2000) ArticleTitlePhysical activity and functional capacity measurement in women: a report from the NHLBI-sponsored WISE Study J Women’s Health Gender-based Med 9 769–777 Occurrence Handle10.1089/15246090050147745

    Article  Google Scholar 

  39. TR Wessel CB Arant MB Olson BD Johnson SE Reis BL Sharaf LJ Shaw E Handberg G Sopko SF Kelsey CJ Pepine CN Bairey Merz (2004) ArticleTitleRelationship of physical fitness vs body mass index with coronary heart disease and cardiovascular events in women JAMA 292 1179–1187 Occurrence Handle10.1001/jama.292.10.1179 Occurrence Handle15353530

    Article  PubMed  Google Scholar 

  40. A Bryman D Cramer (2001) Quantitative Data Analysis with SPSS Release 10 for Windows Routledge London

    Google Scholar 

  41. AA Hedley CL Ogden CL Johnson MD Carroll LR Curtin KM Flegal (2004) ArticleTitlePrevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002 JAMA 291 2847–2850 Occurrence Handle10.1001/jama.291.23.2847 Occurrence Handle15199035

    Article  PubMed  Google Scholar 

  42. U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute: Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults, NIH Publication No. 01–3305. U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, 2004

  43. ME Lean TS Han CE Morrison (1995) ArticleTitleWaist circumference as a measure for indicating need for weight management BMJ 311 58–64

    Google Scholar 

  44. InstitutionalAuthorNameNational Institutes of Health: (2000) The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults NIH Bethesda, MD

    Google Scholar 

  45. National Institutes of Health, National Institute of Diabetes & Digestive & Kidney Diseases: Statistics Related to Overweight and Obesity. 2004, NIH, NIDDK, 2004

  46. BH Lin CL Huang SA French (2004) ArticleTitleFactors associated with women’s and children’s body mass indices by income status Int J Obes Relat Metab Disord 28 536–542 Occurrence Handle10.1038/sj.ijo.0802604 Occurrence Handle14770199

    Article  PubMed  Google Scholar 

  47. CL Ogden MD Carroll KM Flegal (2003) ArticleTitleEpidemiologic trends in overweight and obesity Endocrinol Metab Clin North Am 32 IssueIDvii 741–760 Occurrence Handle10.1016/S0889-8529(03)00074-4 Occurrence Handle14711060

    Article  PubMed  Google Scholar 

  48. RW Jeffrey SA French (1996) ArticleTitleSocioeconomic status and weight control practices among 20–45 year old women Am J Public Health 86 1005–1010 Occurrence Handle8669502

    PubMed  Google Scholar 

  49. W Demark-Wahnefried BK Rimer EP Winer (1997) ArticleTitleWeight gain in women diagnosed with breast cancer J Am Diet Assoc 97 519–529 Occurrence Handle10.1016/S0002-8223(97)00133-8 Occurrence Handle9145091

    Article  PubMed  Google Scholar 

  50. MC Hjortland PM McNamara WB Kannel (1976) ArticleTitleSome atherogenic concomitants of menopause: the Framingham Study Am J Epidemiol 103 304–311 Occurrence Handle1258858

    PubMed  Google Scholar 

  51. SL Crawford VA Casey NE Avis SM McKinlay (2000) ArticleTitleA longitudinal study of weight and menopause transition: results from the Massachusetts Women’s Health Study Menopause 7 96–104 Occurrence Handle10746891

    PubMed  Google Scholar 

  52. C Bjorkeland L Lissner S Andersson L Lapidus C Bengtsson (1996) ArticleTitleReproductive history in relation to relative weight and fat distribution Int J Obes 20 213–219

    Google Scholar 

  53. FC Dimeo R Stieglitz U Novelli-Fischer S Fetscher J Keul (1999) ArticleTitleEffects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy Cancer 85 2273–2277 Occurrence Handle10.1002/(SICI)1097-0142(19990515)85:10<2273::AID-CNCR24>3.0.CO;2-B Occurrence Handle10326708

    Article  PubMed  Google Scholar 

  54. C Friedenreich (2001) ArticleTitlePhysical activity and cancer prevention: from observational to intervention research Cancer Epidemiol Biomark Prev 10 287–301

    Google Scholar 

  55. G Berglund C Bolund T Fornander LE Rutqvist PO Sjoden (1991) ArticleTitleLate effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients Eur J Cancer 27 1075–1081 Occurrence Handle1683557

    PubMed  Google Scholar 

  56. ML Winningham LM Nail M Barton Burke L Brophy B Cimprich L Jones S Pickard-Holley V Rhodes B St Pierre S Beck (1994) ArticleTitleFatigue and the cancer experience: the state of the knowledge Oncol Nurse Forum 21 23–36

    Google Scholar 

  57. YL Michael I Kawachi LF Berkman MD Holmes GA Colditz (2000) ArticleTitleThe persistent impact of breast carcinoma on functional health status Cancer 89 2176–2186 Occurrence Handle10.1002/1097-0142(20001201)89:11<2176::AID-CNCR5>3.0.CO;2-6 Occurrence Handle11147587

    Article  PubMed  Google Scholar 

  58. ML Irwin D Crumley A McTiernan L Bernstein R Baumgartner FD Gilliland A Kriska R Ballard-Barbash (2003) ArticleTitlePhysical activity levels before and after a diagnosis of breast carcinoma. The Health, Eating, Activity and Lifestyle (HEAL) Study Cancer 97 1746–1757 Occurrence Handle10.1002/cncr.11227 Occurrence Handle12655532

    Article  PubMed  Google Scholar 

  59. GS Perry TE Byers AH Mokdad MK Serdula DF Williamson (1995) ArticleTitleThe validity of self-reports of past body weights by U.S. adults Epidemiology 6 1–6 Occurrence Handle7888438

    PubMed  Google Scholar 

  60. MF Kuczmarski RJ Kuczmarski M Najjar (2001) ArticleTitleEffects of age on validity of self-reported height, weight, and body mass index: Findings from the third National Health and Nutrition Examination Survey, 1988–1994 J Am Diet Assoc 101 28–34 Occurrence Handle10.1016/S0002-8223(01)00008-6 Occurrence Handle11209581

    Article  PubMed  Google Scholar 

  61. L Jalkanen J Tuomilehto A Tanskanen P Puska (1987) ArticleTitleAccuracy of self-reported body weight compared to measured body weight A population survey. Scand J Soc Med 15 191–198

    Google Scholar 

  62. InstitutionalAuthorNameExpert Panel on Detection Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) ArticleTitleExecutive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) JAMA 285 3486–3497

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Patricia A. Ganz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Herman, D.R., Ganz, P.A., Petersen, L. et al. Obesity and Cardiovascular Risk Factors in Younger Breast Cancer Survivors: The Cancer and Menopause Study (CAMS). Breast Cancer Res Treat 93, 13–23 (2005). https://doi.org/10.1007/s10549-005-2418-9

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-005-2418-9

Keywords

Navigation