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Cancer Causes & Control

, Volume 27, Issue 2, pp 229–236 | Cite as

Body mass index and weight change in relation to triple-negative breast cancer survival

  • Ping-Ping Bao
  • Hui Cai
  • Peng Peng
  • Kai Gu
  • Yinghao Su
  • Xiao-Ou Shu
  • Ying ZhengEmail author
Original paper

Abstract

The aim of this study was to evaluate the influence of body mass index (BMI), weight change on triple-negative breast cancer (TNBC) prognosis in a population-based prospective cohort study. The current analysis included 518 participants diagnosed with TNBC in Shanghai Breast Cancer Survival Study. Weight at 1 year prior to cancer diagnosis, at diagnosis, and at 6, 18 and 36 months after cancer diagnosis and height at 6 months after cancer diagnosis were assessed. Disease-free survival (DFS) and overall survival (OS) were evaluated in relation to BMI and weight change using Cox proportional hazard models. Obesity (BMI ≥ 28.0 kg/m2) at 1-year pre-diagnosis was associated with higher risk of total mortality and recurrence/disease-specific mortality, with multivariate hazard ratios (HRs) of 1.79 (95 % CI 1.06–3.03) and 1.83 (95 % CI 1.05–3.21), respectively. The associations between BMI and TNBC prognosis attenuated over time from pre-diagnosis to post-diagnosis. Compared with stable weight (change within 5 %), weight loss ≥5 % at 18- or 36-month post-diagnosis was related with higher risk of total mortality and recurrence/disease-specific mortality. Respective multivariate HRs were 2.08 (95 % CI 1.25–3.46) and 1.42 (95 % CI 0.77–2.63) for OS, and 2.50 (95 % CI 1.45–4.30) and 2.17 (95 % CI 1.14–4.12) for DFS. However, the association of weight loss and OS/DFS attenuated after excluding patients whose weight was measured after recurrence. Weight gain ≥5 % at 18- or 36-month post-diagnosis was associated with a non-significant increased risk of death. The results showed that obesity pre-diagnosis and weight loss post-diagnosis was inversely associated with TNBC prognosis. Emphasis on maintaining stable weight after cancer diagnosis for TNBC patients may be considered.

Keywords

Triple-negative breast cancer Body mass index Weight change Survival outcomes Prognosis 

Notes

Acknowledgments

The authors thank Dr. Wei Lu and Dr. Fan Jin for her support in study implements and the participants and staff members of the SBCSS for making this study possible. The SBCSS was supported by Grants from the Department of Defense Breast Cancer Research Program (DAMD 17-02-1-0607 to X.-O. Shu) and the National Cancer Institute (R01 CA118229 to X.-O. Shu), and grants from the Shanghai Municipal Commission of Health and Family Planning (Grant No. 20134070 to P. P. Bao), as well as from the National Natural Science Foundation of China (Grant No. 81402734 to P. P. Bao).

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

References

  1. 1.
    Conroy SM, Maskarinec G, Wilkens LR, White KK, Henderson BE, Kolonel LN (2011) Obesity and breast cancer survival in ethnically diverse postmenopausal women: the Multiethnic Cohort Study. Breast Cancer Res Treat 129:565–574PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Protani M, Coory M, Martin JH (2010) Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 123:627–635PubMedCrossRefGoogle Scholar
  3. 3.
    Jiralerspong S, Kim ES, Dong W, Feng L, Hortobagyi GN, Giordano SH (2013) Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients. Ann Oncol 24:2506–2514PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Kwan ML, Chen WY, Kroenke CH et al (2012) Pre-diagnosis body mass index and survival after breast cancer in the After Breast Cancer Pooling Project. Breast Cancer Res Treat 132:729–739PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Azrad M, Demark-Wahnefried W (2014) The association between adiposity and breast cancer recurrence and survival: a review of the recent literature. Curr Nutr Rep 3:9–15PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Chan DS, Vieira AR, Aune D et al (2014) Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol 25:1901–1914PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Boyle P (2012) Triple-negative breast cancer: epidemiological considerations and recommendations. Ann Oncol 23(Suppl 6):vi7–vi12PubMedCrossRefGoogle Scholar
  8. 8.
    Ademuyiwa FO, Groman A, O’Connor T, Ambrosone C, Watroba N, Edge SB (2011) Impact of body mass index on clinical outcomes in triple-negative breast cancer. Cancer 117:4132–4140PubMedCrossRefGoogle Scholar
  9. 9.
    Sparano JA, Wang M, Zhao F et al (2012) Obesity at diagnosis is associated with inferior outcomes in hormone receptor-positive operable breast cancer. Cancer 118:5937–5946PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Mowad R, Chu QD, Li BD, Burton GV, Ampil FL, Kim RH (2013) Does obesity have an effect on outcomes in triple-negative breast cancer? J Surg Res 184:253–259PubMedCrossRefGoogle Scholar
  11. 11.
    Tait S, Pacheco JM, Gao F, Bumb C, Ellis MJ, Ma CX (2014) Body mass index, diabetes, and triple-negative breast cancer prognosis. Breast Cancer Res Treat 146:189–197PubMedCrossRefGoogle Scholar
  12. 12.
    Dawood S, Lei X, Litton JK, Buchholz TA, Hortobagyi GN, Gonzalez-Angulo AM (2012) Impact of body mass index on survival outcome among women with early stage triple-negative breast cancer. Clin Breast Cancer 12:364–372PubMedCrossRefGoogle Scholar
  13. 13.
    Pajares B, Pollan M, Martin M et al (2013) Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes: a pooled analysis. Breast Cancer Res 15:R105PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Turkoz FP, Solak M, Petekkaya I et al (2013) The prognostic impact of obesity on molecular subtypes of breast cancer in premenopausal women. J BUON 18:335–341PubMedGoogle Scholar
  15. 15.
    Makari-Judson G, Braun B, Jerry DJ, Mertens WC (2014) Weight gain following breast cancer diagnosis: implication and proposed mechanisms. World J Clin Oncol 5:272–282PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Nichols HB, Trentham-Dietz A, Egan KM et al (2009) Body mass index before and after breast cancer diagnosis: associations with all-cause, breast cancer, and cardiovascular disease mortality. Cancer Epidemiol Biomarkers Prev 18:1403–1409PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Thivat E, Therondel S, Lapirot O et al (2010) Weight change during chemotherapy changes the prognosis in non metastatic breast cancer for the worse. BMC Cancer 10:648PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Bradshaw PT, Ibrahim JG, Stevens J et al (2012) Postdiagnosis change in bodyweight and survival after breast cancer diagnosis. Epidemiology 23:320–327PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Chen X, Lu W, Zheng W et al (2010) Obesity and weight change in relation to breast cancer survival. Breast Cancer Res Treat 122:823–833PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Caan BJ, Kwan ML, Shu XO et al (2012) Weight change and survival after breast cancer in the after breast cancer pooling project. Cancer Epidemiol Biomarkers Prev 21:1260–1271PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Jeon YW, Lim ST, Choi HJ, Suh YJ (2014) Weight change and its impact on prognosis after adjuvant TAC (docetaxel–doxorubicin–cyclophosphamide) chemotherapy in Korean women with node-positive breast cancer. Med Oncol 31:849PubMedCrossRefGoogle Scholar
  22. 22.
    Caan BJ, Kwan ML, Hartzell G et al (2008) Pre-diagnosis body mass index, post-diagnosis weight change, and prognosis among women with early stage breast cancer. Cancer Causes Control 19:1319–1328PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Shu XO, Zheng Y, Cai H et al (2009) Soy food intake and breast cancer survival. JAMA 302:2437–2443PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Epplein M, Zheng Y, Zheng W et al (2011) Quality of life after breast cancer diagnosis and survival. J Clin Oncol 29:406–412PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Su Y, Zheng Y, Zheng W et al (2011) Distinct distribution and prognostic significance of molecular subtypes of breast cancer in Chinese women: a population-based cohort study. BMC Cancer 11:292PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Matthews CE, Shu XO, Yang G et al (2003) Reproducibility and validity of the Shanghai Women’s Health Study physical activity questionnaire. Am J Epidemiol 158:1114–1122PubMedCrossRefGoogle Scholar
  27. 27.
    Grunau GL, Sheps S, Goldner EM, Ratner PA (2006) Specific comorbidity risk adjustment was a better predictor of 5-year acute myocardial infarction mortality than general methods. J Clin Epidemiol 59:274–280PubMedCrossRefGoogle Scholar
  28. 28.
    Korn EL, Graubard BI, Midthune D (1997) Time-to-event analysis of longitudinal follow-up of a survey: choice of the time-scale. Am J Epidemiol 145:72–80PubMedCrossRefGoogle Scholar
  29. 29.
    Rock CL, Demark-Wahnefried W (2002) Nutrition and survival after the diagnosis of breast cancer: a review of the evidence. J Clin Oncol 20:3302–3316PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Demark-Wahnefried W, Campbell KL, Hayes SC (2012) Weight management and its role in breast cancer rehabilitation. Cancer 118:2277–2287PubMedCrossRefGoogle Scholar
  31. 31.
    Cole SW (2009) Chronic inflammation and breast cancer recurrence. J Clin Oncol 27:3418–3419PubMedCrossRefGoogle Scholar
  32. 32.
    Oh SW, Park CY, Lee ES et al (2011) Adipokines, insulin resistance, metabolic syndrome, and breast cancer recurrence: a cohort study. Breast Cancer Res 13:R34PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Dodson S, Baracos VE, Jatoi A et al (2011) Muscle wasting in cancer cachexia: clinical implications, diagnosis, and emerging treatment strategies. Annu Rev Med 62:265–279PubMedCrossRefGoogle Scholar
  34. 34.
    Zauderer M, Patil S, Hurria A (2009) Feasibility and toxicity of dose-dense adjuvant chemotherapy in older women with breast cancer. Breast Cancer Res Treat 117:205–210PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Ping-Ping Bao
    • 1
  • Hui Cai
    • 2
  • Peng Peng
    • 1
  • Kai Gu
    • 1
  • Yinghao Su
    • 2
  • Xiao-Ou Shu
    • 2
  • Ying Zheng
    • 1
    Email author
  1. 1.Shanghai Municipal Center for Disease Control and PreventionShanghaiChina
  2. 2.Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of MedicineVanderbilt UniversityNashvilleUSA

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