Breast Cancer Research and Treatment

, Volume 140, Issue 1, pp 159–176 | Cite as

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

  • Ikuyo Imayama
  • Catherine M. Alfano
  • Marian L. Neuhouser
  • Stephanie M. George
  • Ashley Wilder Smith
  • Richard N. Baumgartner
  • Kathy B. Baumgartner
  • Leslie Bernstein
  • Ching-Yun Wang
  • Catherine Duggan
  • Rachel Ballard-Barbash
  • Anne McTiernan


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 Ptrend < 0.05). Future studies should examine whether interventions to maintain a healthy weight and reduce inflammation could alleviate cancer-related symptoms and improve HRQOL.


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

Supplementary material

10549_2013_2594_MOESM1_ESM.docx (70 kb)
Supplementary material 1 (DOCX 69 kb)


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ikuyo Imayama
    • 1
  • Catherine M. Alfano
    • 2
  • Marian L. Neuhouser
    • 1
    • 3
  • Stephanie M. George
    • 4
  • Ashley Wilder Smith
    • 5
  • Richard N. Baumgartner
    • 6
  • Kathy B. Baumgartner
    • 6
  • Leslie Bernstein
    • 7
  • Ching-Yun Wang
    • 1
    • 8
  • Catherine Duggan
    • 1
  • Rachel Ballard-Barbash
    • 4
  • Anne McTiernan
    • 1
    • 3
    • 9
  1. 1.Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.Office of Cancer SurvivorshipNational Cancer Institute/National Institutes of HealthBethesdaUSA
  3. 3.Department of Epidemiology, School of Public HealthUniversity of WashingtonSeattleUSA
  4. 4.Applied Research ProgramNational Cancer Institute/National Institutes of HealthBethesdaUSA
  5. 5.Outcomes Research BranchNational Cancer Institute/National Institutes of HealthBethesdaUSA
  6. 6.Department of Epidemiology and Population Health, School of Public Health and Information SciencesUniversity of LouisvilleLouisvilleUSA
  7. 7.Division of Cancer Etiology, Department of Population ScienceBeckman Research Institute of the City of HopeDuarteUSA
  8. 8.Department of Biostatistics, School of Public HealthUniversity of WashingtonSeattleUSA
  9. 9.Department of Medicine, School of MedicineUniversity of WashingtonSeattleUSA

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