Increasing preoperative body size in breast cancer patients between 2002 and 2016: implications for prognosis

Research output: Contribution to journalArticle


Overweight and obesity are increasing worldwide, but the extent in breast cancer patients is unknown. The two aims were to study secular trends in preoperative body mass index (BMI), waist circumference, and breast volume and their impacts on clinical outcome. BMI, waist circumference, and breast volume were measured preoperatively in 24–99-year-old primary breast cancer patients (n = 640) in Sweden 2002–2016. The measurements were analyzed alone and combined in relation to recurrence and overall survival (OS). BMI, waist circumference, and breast volume increased 2002–2016 (ptrends < 0.0001). Of these, a breast volume ≥ 850 mL was associated with the strongest recurrence-risk (adjusted hazard ratio [adjHR] 1.67; 95% CI 1.17–2.39), especially combined with waist circumference ≥ 80 cm (adjHR 2.07; 95% CI 1.25–3.44), while BMI ≥ 25 kg/m2 or large waist circumference conferred almost a twofold risk for death (both Log-Rank p ≤ 0.0001). Chemotherapy seemed to counteract the negative impact of a high BMI or large waist circumference on OS. Large breast volume was the strongest predictor for recurrence in all treatment groups. In conclusion, preoperative BMI, waist circumference, and breast volume increased between 2002 and 2016. Larger body size negatively impacted breast cancer-free interval and OS. If confirmed, body measurements may help select patients requiring more individualized treatment.


External organisations
  • Skåne University Hospital
  • Lund University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology


  • Body mass index, Breast cancer, Breast volume, Changes over time, Prognosis, Waist circumference
Original languageEnglish
Pages (from-to)643-656
JournalCancer Causes and Control
Issue number7
Early online date2018 May 26
Publication statusPublished - 2018 Jul
Publication categoryResearch