Annals of Oncology 15:875-884, 2004
© 2004 European Society for Medical Oncology
Original Paper |
Body mass index as a prognostic feature in operable breast cancer: the International Breast Cancer Study Group experience
Received 8 October 2003; revised 3 February 2004; accepted 4 February 2004Background:
Current information on the prognostic importance of body mass index (BMI) for patients with early breast cancer is based on a variety of equivocal reports. Few have data on BMI in relationship to systemic treatment.
Patients and methods:
Patients (6792) were randomized to International Breast Cancer Study Group trials from 1978 to 1993, studying chemotherapy and endocrine therapy. BMI was evaluated with eight other factors: menopausal status, nodal status, estrogen receptor status, progesterone receptor status, tumor size, vessel invasion, tumor grade and treatment. BMI was categorized as normal (
24.9), intermediate (25.0–29.9) or obese (
30.0).
Results:
Patients with normal BMI had significantly longer overall survival (OS) and disease-free survival (DFS) than patients with intermediate or obese BMI in pairwise comparisons adjusted for other factors. Subset analyses showed the same effect in pre- and perimenopausal patients and in those receiving chemotherapy alone. When assessed globally and adjusted for other factors, BMI significantly influenced OS (P = 0.03) but not DFS (P = 0.12).
Conclusions:
BMI is an independent prognostic factor for OS in patients with breast cancer, especially among pre-/perimenopausal patients treated with chemotherapy without endocrine therapy.
1 Department of Obstetrics and Gynecology; 2 Institute of Medical Oncology, Inselspital; 3 IBCSG Coordinating Center, Bern; 4 Kantonsspital, St Gallen; 5 Oncology Institute of Southern Switzerland, Lugano, Switzerland; 6 IBCSG Statistical Center, Dana-Farber Cancer Institute and Frontier Science and Technology Research Foundation, Boston, MA, USA; 7 The Cancer Council Australia and University of Sydney, Sydney; 8 Department of Surgery, The Royal Melbourne Hospital, Melbourne; 9 Department of Oncology, St Vincent’s Hospital, Melbourne, Australia; 10 West Swedish Breast Cancer Study Group, Sahlgrenska University Hospital, Göteborg; 11 Department of Surgery, SU/Moelndal’s Hospital, Moelndal, Sweden; 12 The Institute of Oncology, Ljubljana, Slovenia; 13 Madrid Breast Cancer Group, Madrid, Spain; 14 Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa; 15 Oncologia Medica-Spedali Civili, Brescia; 16 Centro di Riferimento Oncologico, Aviano; 17 European Institute of Oncology, Milan, Italy
Key words: body mass index, breast cancer, obesity, prognostic factor, survival
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C.-J. Kim, D.-H. Kang, and J.-W. Park A Meta-Analysis of Aerobic Exercise Interventions for Women With Breast Cancer West J Nurs Res, June 1, 2009; 31(4): 437 - 461. [Abstract] [PDF]
|
|
|
|
 |
|
 M. P. Cleary and M. E. Grossmann Obesity and Breast Cancer: The Estrogen Connection Endocrinology, June 1, 2009; 150(6): 2537 - 2542. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. W. Daniell Weight Loss After Breast Cancer Diagnosis May Not Improve Prognosis J. Clin. Oncol., February 10, 2009; 27(5): 829 - 830. [Full Text] [PDF]
|
|
|
|
 |
|
 N. K. Saxena, L. Taliaferro-Smith, B. B. Knight, D. Merlin, F. A. Anania, R. M. O'Regan, and D. Sharma Bidirectional Crosstalk between Leptin and Insulin-like Growth Factor-I Signaling Promotes Invasion and Migration of Breast Cancer Cells via Transactivation of Epidermal Growth Factor Receptor Cancer Res., December 1, 2008; 68(23): 9712 - 9722. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. K. Litton, A. M. Gonzalez-Angulo, C. L. Warneke, A. U. Buzdar, S.-W. Kau, M. Bondy, S. Mahabir, G. N. Hortobagyi, and A. M. Brewster Relationship Between Obesity and Pathologic Response to Neoadjuvant Chemotherapy Among Women With Operable Breast Cancer J. Clin. Oncol., September 1, 2008; 26(25): 4072 - 4077. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Field, S. Kosmider, M. Jefford, M. Michael, R. Jennens, M. Green, and P. Gibbs Chemotherapy Dosing Strategies in the Obese, Elderly, and Thin Patient: Results of a Nationwide Survey J. Oncol. Pract, May 1, 2008; 4(3): 108 - 113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. V. Barrett, J. Paul, A. Hay, P. A. Vasey, S. B. Kaye, R. M. Glasspool, and On behalf of the Scottish Gynaecological Cancer Tr Does body mass index affect progression-free or overall survival in patients with ovarian cancer? Results from SCOTROC I trial Ann. Onc., May 1, 2008; 19(5): 898 - 902. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Dawood, K. Broglio, A. M. Gonzalez-Angulo, S.-W. Kau, R. Islam, G. N. Hortobagyi, and M. Cristofanilli Prognostic Value of Body Mass Index in Locally Advanced Breast Cancer Clin. Cancer Res., March 15, 2008; 14(6): 1718 - 1725. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S.M. Buist, L. Ichikawa, M. N. Prout, M. U. Yood, T. S. Field, C. Owusu, A. M. Geiger, V. P. Quinn, F. Wei, and R. A. Silliman Receipt of Appropriate Primary Breast Cancer Therapy and Adjuvant Therapy Are Not Associated With Obesity in Older Women With Access to Health Care J. Clin. Oncol., August 10, 2007; 25(23): 3428 - 3436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. W. Reeves, K. Faulkner, F. Modugno, T. A. Hillier, D. C. Bauer, K. E. Ensrud, J. A. Cauley, and for the Study of Osteoporotic Fractures Research G Body Mass Index and Mortality among Older Breast Cancer Survivors in the Study of Osteoporotic Fractures Cancer Epidemiol. Biomarkers Prev., July 1, 2007; 16(7): 1468 - 1473. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. K. Saxena, P. M. Vertino, F. A. Anania, and D. Sharma Leptin-induced Growth Stimulation of Breast Cancer Cells Involves Recruitment of Histone Acetyltransferases and Mediator Complex to CYCLIN D1 Promoter via Activation of Stat3 J. Biol. Chem., May 4, 2007; 282(18): 13316 - 13325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Demirkan, A. Alacacioglu, and U. Yilmaz Relation of Body Mass Index (BMI) to Disease Free (DFS) and Distant Disease Free Survivals (DDFS) Among Turkish Women with Operable Breast Carcinoma Jpn. J. Clin. Oncol., April 1, 2007; 37(4): 256 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Hijiya, J. C. Panetta, Y. Zhou, E. P. Kyzer, S. C. Howard, S. Jeha, B. I. Razzouk, R. C. Ribeiro, J. E. Rubnitz, M. M. Hudson, et al. Body mass index does not influence pharmacokinetics or outcome of treatment in children with acute lymphoblastic leukemia Blood, December 15, 2006; 108(13): 3997 - 4002. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A M Lorincz and S Sukumar Molecular links between obesity and breast cancer. Endocr. Relat. Cancer, June 1, 2006; 13(2): 279 - 292. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-H. Tao, X.-O. Shu, Z. X. Ruan, Y.-T. Gao, and W. Zheng Association of Overweight with Breast Cancer Survival Am. J. Epidemiol., January 15, 2006; 163(2): 101 - 107. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Loi, R. L. Milne, M. L. Friedlander, M. R.E. McCredie, G. G. Giles, J. L. Hopper, and K.-A. Phillips Obesity and Outcomes in Premenopausal and Postmenopausal Breast Cancer Cancer Epidemiol. Biomarkers Prev., July 1, 2005; 14(7): 1686 - 1691. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Landgren, H. Andren, B. Nilsson, A. Ekbom, and M. Bjorkholm Risk profile and outcome in Hodgkin's lymphoma: is obesity beneficial? Ann. Onc., May 1, 2005; 16(5): 838 - 840. [Full Text] [PDF]
|
|
|
|
|
|
R. T. Chlebowski Obesity and Early-Stage Breast Cancer J. Clin. Oncol., March 1, 2005; 23(7): 1345 - 1347. [Full Text] [PDF]
|
|
|
|
|
|
K. Altundag, O. Altundag, P. Morandi, and M. Gunduz Obesity may decrease the amenorrhea associated with chemotherapy in premenopausal breast cancer patients Ann. Onc., February 1, 2005; 16(2): 333 - 333. [Full Text] [PDF]
|
|
|
|
|
|
R. T. Chlebowski, M. Pettinger, M. L. Stefanick, B. V. Howard, Y. Mossavar-Rahmani, and A. McTiernan Insulin, Physical Activity, and Caloric Intake in Postmenopausal Women: Breast Cancer Implications J. Clin. Oncol., November 15, 2004; 22(22): 4507 - 4513. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Dignam and E. P. Mamounas Obesity and breast cancer prognosis: an expanding body of evidence Ann. Onc., June 1, 2004; 15(6): 850 - 851. [Full Text] [PDF]
|
|