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Body Mass Index and Locoregional Recurrence in Women with Early-Stage Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Higher body mass index (BMI) has been associated with increased distant recurrence and decreased survival for women with breast cancer. However, the relationship between BMI and locoregional recurrence (LRR) has been less well studied and was therefore the subject of this investigation.

Methods

The study identified 878 women with early-stage invasive breast cancer who underwent breast-conservation therapy (BCT) between June 1997 and October 2007. Time from diagnosis to LRR was calculated using a competing risk analysis with contralateral breast cancer (CBC), distant metastases (DM), and death as the competing risks. Gray’s competing risks analysis, which included an interaction term between menopausal status and BMI, was used to identify significant risk factors for the development of LRR.

Results

After a median follow-up period of 10.8 years, LRR was diagnosed as a first event for 45 women. In a multivariable analysis, BMI was positively associated with LRR but only in premenopausal women. Specifically, when these women were compared with normal- and underweight women, both the overweight women (hazard ratio (HR), 2.97; 95 % confidence interval (CI) 1.04–8.46; p = 0.04) and the obese women (HR, 3.36; 95 % CI 1.07–10.63; p = 0.04) showed a higher risk of LRR. A similar association between BMI and disease-free survival was noted for premenopausal but not postmenopausal women.

Conclusion

For premenopausal women with invasive breast cancer who undergo BCT, BMI is an independent prognostic factor for LRR. If confirmed, these findings suggest that more aggressive treatment strategies may be warranted for these women.

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Acknowledgments

The authors report no specific funding supporting this research.

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Authors and Affiliations

  1. Harvard Radiation Oncology Program, Boston, MA, USA

    Laura E. G. Warren MD, EdM

  2. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Jennifer A. Ligibel MD

  3. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA

    Yu-Hui Chen MPH, MS

  4. Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA

    Linh Truong BSc & Jennifer R. Bellon MD

  5. Department of Biostatistics, Harvard T. H. Chan School of Public Health, and Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA

    Paul J. Catalano ScD

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  1. Laura E. G. Warren MD, EdM
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Correspondence to Jennifer R. Bellon MD.

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Warren, L.E.G., Ligibel, J.A., Chen, YH. et al. Body Mass Index and Locoregional Recurrence in Women with Early-Stage Breast Cancer. Ann Surg Oncol 23, 3870–3879 (2016). https://doi.org/10.1245/s10434-016-5437-3

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  • DOI: https://doi.org/10.1245/s10434-016-5437-3

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