Supportive Care in Cancer

, Volume 25, Issue 8, pp 2549–2558 | Cite as

Longitudinal patterns and associated factors of postdiagnosis weight changes in Korean breast cancer survivors with normal body mass index

  • Yul Ha Min
  • Jong Won LeeEmail author
  • Il Yong Chung
  • Sei Hyun Ahn
Original Article



This study aimed to describe longitudinal patterns of weight changes from diagnosis to within 5 years after diagnosis and investigate factors associated with short- and long-term weight changes among Korean breast cancer survivors with initially normal body mass index (BMI).


Body weights at diagnosis for 1546 breast cancer survivors were compared with those at 12, 24, 36, 48, and 60 months after diagnosis. Absolute weight change (kg) and relative weight changes (%) were analyzed. Logistic regression was used to identify factors associated with short-term (1 year) and long-term (5 years) weight changes.


A significant decrease in mean weight was predominant at 12 months postdiagnosis. In subgroup analysis, the younger age group showed significant weight gains after 36 months. The older age group and chemotherapy (CT) group showed significant weight losses after 24 months. About 40% of weight gainers and 60% of weight losers at 12 months returned to their initial weight by 60 months postdiagnosis. CT and lower educational levels were associated with short-term weight loss and gain, respectively. For long-term changes, age at diagnosis was the sole associated factor.


Korean breast cancer survivors treated with CT mainly experienced postdiagnosis weight loss rather than weight gain. Short-term weight change was independently associated with chemotherapy and educational level. However, long-term weight change was associated with age at diagnosis. Breast cancer survivors with normal BMI may be categorized according to the time-dependent risk for postdiagnosis weight change.


Breast cancer Weight change Longitudinal study Cancer survivorship 



This study was supported by a grant (2016-668) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea, and the Gachon University research fund of 2015 (GCU-2015-0049).

Compliance with ethical standards

The study was approved by the Institutional Review Board at Asan Medical Center (No. 2015-0924)

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

For this type of study, formal consent is not required.


  1. 1.
    Ewertz M, Jensen M-B, Gunnarsdóttir KÁ, Højris I, Jakobsen EH, Nielsen D, Stenbygaard LE, Tange UB, Cold S (2011) Effect of obesity on prognosis after early-stage breast cancer. J Clin Oncol 29:25–31CrossRefPubMedGoogle Scholar
  2. 2.
    Copson ER, Cutress RI, Maishman T, Eccles BK, Gerty S, Stanton L, Altman DG, Durcan L, Wong C, Simmonds PD et al (2015) Obesity and the outcome of young breast cancer patients in the UK: the POSH study. Ann Oncol 26:101–112CrossRefPubMedGoogle Scholar
  3. 3.
    Cecchini RS, Swain SM, Costantino JP, Rastogi P, Jeong J-H, Anderson SJ, Tang G, Geyer CE, Lembersky BC, Romond EH et al (2016) Body mass index at diagnosis and breast cancer survival prognosis in clinical trial populations from NRG oncology/NSABP B-30, B-31, B-34, and B-38. Cancer Epidemiol Biomark Prev 25:51–59CrossRefGoogle Scholar
  4. 4.
    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 123:627–635CrossRefPubMedGoogle Scholar
  5. 5.
    Niraula S, Ocana A, Ennis M, Goodwin PJ (2012) Body size and breast cancer prognosis in relation to hormone receptor and menopausal status: a meta-analysis. Breast Cancer Res Treat 134:769–781CrossRefPubMedGoogle Scholar
  6. 6.
    Playdon MC, Bracken MB, Sanft TB, Ligibel JA, Harrigan M, Irwin ML (2015) Weight gain after breast cancer diagnosis and all-cause mortality: systematic review and meta-analysis. JNCI-Natl Cancer Inst 107:15Google Scholar
  7. 7.
    Ahmed RL, Schmitz KH, Prizment AE, Folsom AR (2011) Risk factors for lymphedema in breast cancer survivors, the Iowa Women’s Health Study. Breast Cancer Res Treat 130:981–991CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Ridner SH, Dietrich MS, Stewart BR, Armer JM (2011) Body mass index and breast cancer treatment-related lymphedema. Support Care Cancer 19:853–857CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Andrykowski MA, Donovan KA, Laronga C, Jacobsen PB (2010) Prevalence, predictors, and characteristics of off-treatment fatigue in breast cancer survivors. Cancer 116:5740–5748CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Demark-Wahnefried W, Campbell KL, Hayes SC (2012) Weight management and its role in breast cancer rehabilitation. Cancer 118:2277–2287CrossRefPubMedGoogle Scholar
  11. 11.
    Howard-Anderson J, Ganz PA, Bower JE, Stanton AL (2012) Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. JNCI-Natl Cancer Inst 104:386–405CrossRefGoogle Scholar
  12. 12.
    Gu K, Chen X, Zheng Y, Chen Z, Zheng W, Lu W, Shu XO (2010) Weight change patterns among breast cancer survivors: results from the Shanghai breast cancer survival study. Cancer Cause Control 21:621–629CrossRefGoogle Scholar
  13. 13.
    Vance V, Mourtzakis M, McCargar L, Hanning R (2011) Weight gain in breast cancer survivors: prevalence, pattern and health consequences. Obes Rev 12:282–294CrossRefPubMedGoogle Scholar
  14. 14.
    Rock CL, Flatt SW, Newman V, Caan BJ, Haan MN, Stefanick ML, Faerber S, Pierce JP (1999) Factors associated with weight gain in women after diagnosis of breast cancer. Women’s Healthy Eating and Living Study Group. J Am Diet Assoc 99:1212–1221CrossRefPubMedGoogle Scholar
  15. 15.
    Schmitz KH, Neuhouser ML, Agurs-Collins T, Zanetti KA, Cadmus-Bertram L, Dean LT, Drake BF (2013) Impact of obesity on cancer survivorship and the potential relevance of race and ethnicity. JNCI-Natl Cancer Inst 105:1344–1354CrossRefGoogle Scholar
  16. 16.
    Irwin ML, McTiernan A, Baumgartner RN, Baumgartner KB, Bernstein L, Gilliland FD, Ballard-Barbash R (2005) Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. J Clin Oncol 23:774–782CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Heideman WH, Russell NS, Gundy C, Rookus MA, Voskuil DW (2009) The frequency, magnitude and timing of post-diagnosis body weight gain in Dutch breast cancer survivors. Eur J Cancer 45:119–126CrossRefPubMedGoogle Scholar
  18. 18.
    Han HS, Lee KW, Kim JH, Kim SW, Kim IA, Oh DY, Im SA, Bang SM, Lee JS (2009) Weight changes after adjuvant treatment in Korean women with early breast cancer. Breast Cancer Res Treat 114:147–153CrossRefPubMedGoogle Scholar
  19. 19.
    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 31:10CrossRefGoogle Scholar
  20. 20.
    Kim SH, Cho YU, Kim SJ (2013) Weight gain and its correlates among breast cancer survivors. Asian Nurs Res 7:161–167CrossRefGoogle Scholar
  21. 21.
    Shin SY, Lyu Y, Shin Y, Choi HJ, Park J, Kim WS, Lee JH (2013) Experience of de-identification system development for clinical research in tertiary hospital. Stud Health Technol Inform 192:1044PubMedGoogle Scholar
  22. 22.
    Caan BJ, Emond JA, Natarajan L, Castillo A, Gunderson EP, Habel L, Jones L, Newman VA, Rock CL, Slattery ML et al (2006) Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer. Breast Cancer Res Treat 99:47–57CrossRefPubMedGoogle Scholar
  23. 23.
    Caan BJ, Kwan ML, Shu XO, Pierce JP, Patterson RE, Nechuta SJ, Poole EM, Kroenke CH, Weltzien EK, Flatt SW et al (2012) Weight change and survival after breast cancer in the after breast cancer pooling project. Cancer Epidemiol Biomark Prev 21:1260–1271CrossRefGoogle Scholar
  24. 24.
    Saquib N, Flatt SW, Natarajan L, Thomson CA, Bardwell WA, Caan B, Rock CL, Pierce JP (2007) Weight gain and recovery of pre-cancer weight after breast cancer treatments: evidence from the Women’s Healthy Eating and Living (WHEL) study. Breast Cancer Res Treat 105:177–186CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.College of NursingGachon UniversityIncheonSouth Korea
  2. 2.Department of SurgeryUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulSouth Korea

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