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Pre-diagnosis body mass index, post-diagnosis weight change, and prognosis among women with early stage breast cancer
Caan BJ et al. – Obesity before breast cancer diagnosis is associated with increased risk of recurrence and poorer survival; weight gain after diagnosis did not confer additional risk; body weight pre-diagnosis may be strongest predictor of an adverse breast cancer prognosis

Methods

  • Study of the association between body mass index (BMI) at diagnosis, weight change post-diagnosis, and breast cancer prognosis in a prospective cohort study of 1,692 breast cancer survivors
  • Calculation of weight change and BMI based on questionnaires for pre-diagnosis weight, weight at study entry, and height

Results
  • At 7-yr follow-up, 207 recurrences, 99 deaths due to breast cancer, and 162 deaths due to any cause
  • Obesity 1 yr pre-diagnosis was associated with an increased risk of death from any cause and possibly increased risk of death from breast cancer
  • Weight gain up to 4 yrs after diagnosis was not associated with an increased risk of recurrence or death from any cause; moderate weight loss (5–10%) did not decrease risk of these outcomes
  • Women with larger weight losses (≥10%) between pre-diagnosis and study entry had an increased risk of recurrence and death due to any cause vs weight-stable pts
  • This elevated risk was more pronounced among women obese before diagnosis (BMI ≥30 kg/m2) or with ER- or PR- tumors
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