Skip to main content
Log in

Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Summary

Purpose

To examine whether weight gain after diagnosis of breast cancer affects the risk of breast cancer recurrence.

Patient and methods

Patients included 3215 women diagnosed with early stage breast cancer (Stage I >1 cm., II, and IIIA) who were enrolled either in an observational cohort of breast cancer survivors or were part of the comparison group of a dietary intervention trial to prevent breast cancer recurrence. We computed weight change from 1 year prior to diagnosis to study enrollment. Delayed entry Cox proportional hazards models were used to evaluate associations of categories of weight change with time to recurrence, controlling for known prognostic factors.

Results

Neither moderate (5–10%) nor large (> 10%) weight gain (HR 0.8, 95% CI, 0.6–1.1; HR 0.9, 95% CI, 0.7–1.2, respectively) after breast cancer diagnosis was associated with an increased risk of breast cancer recurrence in the early years post-diagnosis (median time of 73.7 months from diagnosis).

Conclusion

Our research provides evidence that weight gain commonly seen in the first several years following a breast cancer diagnosis does not increase a woman’s risk for breast cancer recurrence in the first 5–7 years post-diagnosis. However, this research does not address the effects of weight gain on overall survival or on the risk of other new cancers, other prognostic outcomes of concern to the breast cancer survivor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Reference

  1. Rock CL, Demark-Wahnefried W (2002): Can lifestyle modification increase survival in women diagnosed with breast cancer? J Nutr 132:3504S–3507S

    PubMed  CAS  Google Scholar 

  2. Rock CL, Demark-Wahnefried W (2002): Nutrition and survival after the diagnosis of breast cancer: a review of the evidence J Clin Oncol 20:3302–3306

    Article  PubMed  Google Scholar 

  3. Demark-Wahnefried W, Rock CL (2003): Nutrition-related issues for the breast cancer survivor Semin Oncol 30:789–798

    Article  PubMed  Google Scholar 

  4. Chlebowski RT, Aiello E, McTiernan A (2002): Weight loss in breast cancer patient management J Clin Oncol 20:1128–1143

    Article  PubMed  Google Scholar 

  5. Berclaz G, Li S, Price KN, Coates AS, Castiglione-Gertsch M, Rudenstam CM, Holmberg SB, Lindtner J, Erien D, Collins J, Snyder R, Thurlimann B, Fey MF, Mendiola C, Werner ID, Simoncini E, Crivellari D, Gelber RD, Goldhirsch A (2004): Body mass index as a prognostic feature in operable breast cancer: the International Breast Cancer Study Group experience Ann Oncol 15:875–884

    Article  PubMed  CAS  Google Scholar 

  6. Dignam JJ, Wieand K, Johnson KA, Fisher B, Xu L, Mamounas EP (2003): Obesity, tamoxifen use, and outcomes in women with estrogen receptor-positive early-stage breast cancer J Natl Cancer Inst 95:1467–1476

    PubMed  CAS  Google Scholar 

  7. McTiernan A, Rajan KB, Tworoger SS, Irwin M, Bernstein L, Baumgartner R, Gilliland F, Stanczyk FZ, Yasui Y, Ballard-Barbash R (2003): Adiposity and sex hormones in postmenopausal breast cancer survivors J Clin Oncol 21:1961–1966

    Article  PubMed  CAS  Google Scholar 

  8. Belfiore A, Frittitta L, Costantino A, Frasca F, Pandini G, Sciacca L, Goldfine ID, Vigneri R (1996): Insulin receptors in breast cancer Ann NY Acad Sci 784:173–188

    Article  PubMed  CAS  Google Scholar 

  9. Papa V, Belfiore A (1996): Insulin receptors in breast cancer: biological and clinical role J Endocrinol Invest 19:324–333

    PubMed  CAS  Google Scholar 

  10. Goodwin PJ, Ennis M, Pritchard KI, Trudeau ME, Koo J, Madarnas Y, Hartwick W, Hoffman B, Hood N (2002): Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study J Clin Oncol 20:42–51

    Article  PubMed  CAS  Google Scholar 

  11. Griggs JJ, Sorbero ME, Lyman GH (2005): Undertreatment of obese women receiving breast cancer chemotherapy Arch Intern Med 165:1267–1273

    Article  PubMed  Google Scholar 

  12. Madarnas Y, Sawka CA, Franssen E, Bjarnason GA (2001): Are medical oncologists biased in their treatment of the large woman with breast cancer? Breast Cancer Res Treat 66:123–133

    Article  PubMed  CAS  Google Scholar 

  13. Hall HI, Coates RJ, Uhler RJ, Brinton LA, Gammon MD, Brogan D, Potischman N, Malone KE, Swanson CA (1999): Stage of breast cancer in relation to body mass index and bra cup size Int J Cancer 82:23–27

    Article  PubMed  CAS  Google Scholar 

  14. Cui Y, Whiteman MK, Flaws JA, Langenberg P, Tkaczuk KH, Bush TL, (2002): Body mass and stage of breast cancer at diagnosis Int J Cancer 98:279–283

    Article  PubMed  CAS  Google Scholar 

  15. Demark-Wahnefried W, Rimer BK, Winer EP (1997): Weight gain in women diagnosed with breast cancer J Am Diet Assoc 97:519–526, 529

    Article  PubMed  CAS  Google Scholar 

  16. Demark-Wahnefried W, Peterson BL, Winer EP, Marks L, Aziz N, Marcom PK, Blackwell K, Rimer BK, (2001): Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy J Clin Oncol 19:2381–2389

    PubMed  CAS  Google Scholar 

  17. Lankester KJ, Phillips JE, Lawton PA (2002): Weight gain during adjuvant and neoadjuvant chemotherapy for breast cancer: an audit of 100 women receiving FEC or CMF chemotherapy Clin Oncol (R Coll Radiol) 14:64–67

    CAS  Google Scholar 

  18. Camoriano J, Loprinzi C, Ingle J, Therneau T, Krook J, Veeder M (1990): Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer J Clin Oncol 8:1327–1334

    PubMed  CAS  Google Scholar 

  19. Levine E, Raczynski J, Carpenter J (1991): Weight gain with breast cancer adjuvant treatment Cancer 67:1954–1959

    Article  PubMed  CAS  Google Scholar 

  20. Heasman K, Sutherland H, Campbell J, Elhakim T, Boyd N (1985): Weight gain during adjuvant chemotherapy for breast cancer Cancer Res Treat 5:195–200

    Article  CAS  Google Scholar 

  21. Bonomi P, Bunting N, Fishman D et al. (1984) Weight gain during adjuvant chemotherapy or hormonochemotherapy for stage II breast cancer evaluated in relation to disease-free survival (DFS) Breast Cancer Res Treat 4:339

    Google Scholar 

  22. Chlebowski RT, Weiner JM, Reynolds R, Luce J, Bulcavage L, Bateman JR (1986): Long-term survival following relapse after 5-FU but not CMF adjuvant breast cancer therapy Breast Cancer Res Treat 7:23–30

    Article  PubMed  CAS  Google Scholar 

  23. Goodwin P, Panzarella T, Boyd N (1988): Weight gain in women with localized breast cancer – a descriptive study Breast Cancer Res Treat 11:59–66

    Article  PubMed  CAS  Google Scholar 

  24. Kroenke CH, Chen WY, Rosner B, Holmes MD (2005): Weight, weight gain, and survival after breast cancer diagnosis J Clin Oncol 23:1370–1378

    Article  PubMed  Google Scholar 

  25. Pierce JP, Faerber S, Wright FA, Rock CL, Newman V, Flatt SW, Kealey S, Jones VE, Caan BJ, Gold EB, Haan M, Hollenbach KA, Jones L, Marshall JR, Ritenbaugh C, Stefanick ML, Thomson C, Wasserman L, Natarajan L, Thomas RG, Gilpin EA (2002): A randomized trial of the effect of a plant-based dietary pattern on additional breast cancer events and survival: the Women’s Healthy Eating and Living (WHEL) Study Control Clin Trials 23:728–756

    Article  PubMed  Google Scholar 

  26. Caan B, Sternfeld B, Gunderson E, Cates A, Quesenberry C, Slattery ML: Life After Cancer Epidemiology (LACE) Study: a cohort of early stage breast cancer survivors. Cancer Causes Control 16(5): 545–546, 2005

    Google Scholar 

  27. Thernau TM, Grambsh PM (2000): Modeling Survival Data: Extending the Cox Model, Statistics for Biology and Health. Springer-Verlag, New York

    Google Scholar 

  28. Cox DR, Oakes D: Analysis of Survival Data: Monographs in Statistics and Applied Probability. Chapman & Hall, 21, 1994

  29. Weaver T, Kushi L, McGovern P, Potter J, Rich S, King R, Whitbeck J, Greenstein J, Sellers T (1996): Validation study of self-reported measures of fat distribution Int J Obes Relat Metab Disord 20:644–650

    PubMed  CAS  Google Scholar 

  30. Spencer EA, Appleby PN, Davey GK, Key TJ (2002): Validity of self-reported height and weight in 4808 EPIC-Oxford participants Public Health Nutr 5:561–565

    Article  PubMed  Google Scholar 

  31. Thomson CA, Flatt SW, Rock CL, Ritenbaugh C, Newman V, Pierce JP (2002): Increased fruit, vegetable and fiber intake and lower fat intake reported among women previously treated for invasive breast cancer J Am Diet Assoc 102:801–808

    Article  PubMed  Google Scholar 

  32. Goodwin PJ, Ennis M, Pritchard KI, Trudeau M, Hood N, (1999): Risk of menopause during the first year after breast cancer diagnosis J Clin Oncol 17:2365–2370

    PubMed  CAS  Google Scholar 

  33. Rock C, Flatt S, Newman V, Caan B, Haan M, Stefanick M, Faerber S, Pierce J (1999): Factors associated with weight gain in women after diagnosis of breast cancer J Am Diet Assoc 99:1212–1218

    Article  PubMed  CAS  Google Scholar 

  34. Lahmann PH, Hoffmann K, Allen N, van Gils CH, Khaw KT, Tehard B, Berrino F, Tjonneland A, Bigaard J, Olsen A, Overvad K, Clavel-Chapelon F, Nagel G, Boeing H, Trichopoulos D, Economou G, Bellos G, Palli D, Tumino R, Panico S, Sacerdote C, Krogh V, Peeters PH, Bueno-de-Mesquita HB, Lund E, Ardanaz E, Amiano P, Pera G, Quiros JR, Martinez C, Tormo MJ, Wirfalt E, Berglund G, Hallmans G, Key TJ, Reeves G, Bingham S, Norat T, Biessy C, Kaaks R, Riboli E (2004): Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer And Nutrition (EPIC) Int J Cancer 111:762–771

    Article  PubMed  CAS  Google Scholar 

  35. Hunter DJ, Willett WC (1996): Nutrition and breast cancer Cancer Causes Control 7:56–68

    Article  PubMed  CAS  Google Scholar 

  36. Weiderpass E, Braaten T, Magnusson C, Kumle M, Vainio H, Lund E, Adami HO (2004): A prospective study of body size in different periods of life and risk of premenopausal breast cancer Cancer Epidemiol Biomarkers Prev 13:1121–1127

    PubMed  Google Scholar 

Download references

Acknowledgements

Supported by NCI Grant CA 080027 and CA 106764; Kaiser Foundation Research Institute, Oakland, Ca., NCI Grant CA69375; University of California, San Diego, General Clinical Research Center NIH Grant M01-RR00827; University of California, San Francisco, General Clinical Research Center NIH Grant M01-RR00079; Stanford University General Clinical Research Center NIH Grant M01-RR00070; and the Walton Family Foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bette J. Caan.

Additional information

For the Life After Cancer Epidemiology (LACE) Study group (Bette J. Caan, Adrienne Castillo, Erica P. Gunderson, Laurel Habel, Martha L. Slattery, Barbara Sternfeld),

For the Women’s Healthy Eating and Living (WHEL) Study Group (Jennifer A. Emond, Loki Natarajan, Lovell Jones, Vicky A. Newman, Cheryl L. Rock, Marcia L. Stefanick, Cynthia A. Thomson, John P. Pierce)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Caan, B.J., Emond, J.A., Natarajan, L. et al. Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer. Breast Cancer Res Treat 99, 47–57 (2006). https://doi.org/10.1007/s10549-006-9179-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-006-9179-y

Keywords

Navigation