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

Research output: Contribution to journalArticle

Standard

Harvard

APA

CBE

MLA

Vancouver

Author

RIS

TY - JOUR

T1 - Increasing preoperative body size in breast cancer patients between 2002 and 2016

T2 - Cancer Causes and Control

AU - Wisse, Agatha

AU - Tryggvadottir, Helga

AU - Simonsson, Maria

AU - Isaksson, Karolin

AU - Rose, Carsten

AU - Ingvar, Christian

AU - Jernström, Helena

PY - 2018/7

Y1 - 2018/7

N2 - 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.

AB - 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.

KW - Body mass index

KW - Breast cancer

KW - Breast volume

KW - Changes over time

KW - Prognosis

KW - Waist circumference

UR - http://www.scopus.com/inward/record.url?scp=85047404046&partnerID=8YFLogxK

U2 - 10.1007/s10552-018-1042-z

DO - 10.1007/s10552-018-1042-z

M3 - Article

VL - 29

SP - 643

EP - 656

JO - Cancer Causes and Control

JF - Cancer Causes and Control

SN - 1573-7225

IS - 7

ER -