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Weight Matters in Locally Advanced Breast Cancer
By Janet Mandelstam
How overweight you are may affect your prognosis if you are diagnosed with an advanced or aggressive breast cancer.
The higher a woman’s body mass index (BMI—a calculation of a person’s total body fat percentage, based on height and weight) at the time of diagnosis, the worse her prognosis if her cancer has spread to nearby tissue or lymph nodes or if she has inflammatory breast cancer (IBC), according to a new study from The University of Texas M.D. Anderson Cancer Center.
Researchers reviewed outcomes for 606 patients who were treated for those advanced or aggressive cancers. Massimo Cristofanilli, M.D., the study’s senior author, says the center began this research “because the vast majority of our newly diagnosed inflammatory breast cancer patients were overweight or obese, and IBC is associated with a poor prognosis.”
The study measured both overall survival rates and survival without a recurrence for patients whose BMI scores indicated they were normal or underweight, overweight or obese. All had received similar chemotherapy treatments. Patients with locally advanced cancer were measured together, then separately from women with IBC. Overall, and for women with each type of cancer, results were significantly worse for overweight and obese patients. For example, among those with locally advanced breast cancer, the 10-year survival rate was 42.4 percent for obese women, 44.1 percent for overweight women, and 57.3 percent for women whose BMI was normal or who were underweight.
Cristofanilli notes that more research is necessary before BMI can be used routinely to predict outcomes. Meanwhile, he urges oncologists who treat overweight and obese patients with these cancers to follow up aggressively after initial treatment, such as by doing physical exams and imaging procedures like mammography and MRI more frequently.
Can patients who lose weight after diagnosis alter their prognosis? “Probably,” Cristofanilli says, “but we haven’t studied that yet.” Doctors at M.D. Anderson are exploring a program that would motivate overweight and obese patients to adopt an exercise program and a healthy diet. “We hope this report will serve as a wake-up call,” he says. While Cristofanilli recognizes that it can be hard for overweight women to adjust their eating habits during chemotherapy, he stresses that lifestyle changes are important.
The study was published in the March 15, 2008, issue of Clinical Cancer Research.
