Breast Cancer Research and Treatment

, Volume 16, Issue 3, pp 205–214 | Cite as

Body size and breast cancer prognosis: A critical review of the evidence

  • Pamela J. Goodwin
  • Norman F. Boyd


There is currently controversy about the effect of body size on the prognosis of patients with breast cancer. In order to clarify the prognostic importance of body size, and to determine whether the effect varies across subgroups of patients, a critical appraisal of the published literature was undertaken. Thirteen cohort studies and one case-control study were identified that examined the prognostic effect of body size. Methodologic standards were developed that reflected those features of study design considered most important in studies of prognosis in breast cancer, and were independently applied to each report by each of the authors.

When the effects of methodologic differences among the studies were controlled, a modest prognostic effect of body size was identified. This effect appeared to be greatest in postmenopausal women, in those with little or no involvement of axillary nodes, and to be independent of other prognostic factors.

Additional investigation is recommended to determine the prognostic effects of body size in postmenopausal women with axillary node negative breast cancer and in women receiving systemic adjuvant therapy, and to determine the pathophysiological basis for these effects. Intervention studies to determine the effects of altering body size may also be indicated.

Key words

body size breast cancer obesity prognosis Quetelet Index weight 


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  1. 1.
    Canadian Cancer Society: Canadian Cancer Statistics 1987. Toronto, Canada, 1987Google Scholar
  2. 2.
    Silverberg E, Lubera JA: Cancer statistics, 1988. CA — A Journal for Clinicians 38: 5–22, 1988Google Scholar
  3. 3.
    Henderson IC, Harris JR, Kinrie DW, Hellman S: Cancer of the breast. In: DeVita VT, Hellman S, Rosenberg SA (eds) Cancer: Principles and Practice of Oncology, 3rd Edition. J.B. Lippincott (Philadelphia), 1989, p 1230–1240Google Scholar
  4. 4.
    Abe R, Kumagi N, Kimura M, Hirosaki A, Nakamura T: Biological characteristics of breast cancer in obesity. Tokohu J Exp Med 120: 351–359, 1976Google Scholar
  5. 5.
    Feinstein AR: Clinical Epidemiology. The Architecture of Clinical Research. W.B. Saunders (Philadelphia), 1985, p 226Google Scholar
  6. 6.
    Donegan WL, Hartz AJ, Rimm AA: The association of body weight with recurrent cancer of the breast. Cancer 41: 1590–1594, 1978PubMedGoogle Scholar
  7. 7.
    Sohrabi A, Sandoz J, Spratt JS, Polk HC: Recurrence of breast cancer. Obesity, tumour size, and axillary lymph node metastases. JAMA 244: 264–265, 1980PubMedGoogle Scholar
  8. 8.
    Boyd NF, Campbell JAE, Germanson T, Thomson DB, Sutherland DJ, Meakin JW: Body weight and prognosis in breast cancer. JNCI 67: 785–789, 1981PubMedGoogle Scholar
  9. 9.
    Tartter PI, Papatestas AE, Ioannovich J, Mulvihill MN, Lesnick G, Aufses AH: Cholesterol and obesity as prognostic factors in breast cancer. Cancer 47: 2222–2227, 1981PubMedGoogle Scholar
  10. 10.
    Eberlein T, Simon R, Fisher S, Lippman ME: Height, weight, and risk of breast cancer relapse. Breast Cancer Res Treat 5: 81–86, 1985PubMedGoogle Scholar
  11. 11.
    Greenberg ER, Vessey MP, McPherson K, Doll R, Yeates D: Body size and survival in premenopausal breast cancer. Br J Cancer 51: 691–697, 1985PubMedGoogle Scholar
  12. 12.
    Gregario DE, Emrich LJ, Graham S, Marshall JR, Nemoto T: Dietary fat consumption and survival among women with breast cancer. JNCI 75: 37–41, 1985PubMedGoogle Scholar
  13. 13.
    Heasman KZ, Sutherland HJ, Campbell JA, Elhakim T, Boyd NF: Weight gain during adjuvant chemotherapy for breast cancer. Breast Cancer Res Treat 5: 195–200, 1985PubMedGoogle Scholar
  14. 14.
    Newman SC, Miller AB, Howe GR: A study of the effect of weight and dietary fat on breast cancer survival time. Am J Epidemiol 123: 767–774, 1986PubMedGoogle Scholar
  15. 15.
    Goodwin PJ, Panzarella T, Boyd NF: Weight gain in women with localized breast cancer — a descriptive study. Breast Cancer Res Treat 11: 59–66, 1988PubMedGoogle Scholar
  16. 16.
    Hebert JR, Augustine A, Barone J, Kabat GC, Kinne DW: Weight, height, and body mass index in the prognosis of breast cancer: Early results of a prospective study. Int J Cancer 42: 315–318, 1988PubMedGoogle Scholar
  17. 17.
    Suissa S, Pollak M, Spitzer WO, Margolese R. Body size and breast cancer prognosis: A statistical explanation of the discrepancies. Cancer Res 49: 3113–3116, 1989PubMedGoogle Scholar
  18. 18.
    Zumoff B, Gorzynski JG, Katz JL, Weiner H, Levin J, Holland J, Fukushima DK: Nonobesity at the time of mastectomy is highly predictive of 10-year disease-free survival in women with breast cancer. Anticancer Res 2: 59–62, 1982PubMedGoogle Scholar
  19. 19.
    Benn R: Some mathematical properties of weight-for-height indices used as measures of adiposity. Br J Prev Soc Med 25: 42–50, 1971PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • Pamela J. Goodwin
    • 1
  • Norman F. Boyd
    • 2
  1. 1.The Department of Medicine and the Samuel Lunenfeld Research Institute at Mount Sinai HospitalUniversityCanada
  2. 2.the Department of Medicine, Princess Margaret HospitalUniversity of TorontoCanada

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