Body Mass Index at Diagnosis and Breast Cancer Survival Prognosis in Clinical Trial Populations from NRG Oncology/NSABP B-30, B-31, B-34, and B-38.

MedStar author(s):
Citation: Cancer Epidemiology, Biomarkers & Prevention. 25(1):51-9, 2016 Jan.PMID: 26545405Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Randomized Controlled TrialSubject headings: *Body Mass Index | *Breast Neoplasms/mo [Mortality] | Biomarkers, Tumor/me [Metabolism] | Breast Neoplasms/di [Diagnosis] | Breast Neoplasms/dt [Drug Therapy] | Breast Neoplasms/me [Metabolism] | Female | Follow-Up Studies | Humans | Immunoenzyme Techniques | Middle Aged | Neoplasm Staging | Prognosis | Receptor, ErbB-2/me [Metabolism] | Receptors, Estrogen/me [Metabolism] | Survival RateYear: 2016Local holdings: Available online from MWHC library: Nov 1991 - present (after 1 year)ISSN:
  • 1055-9965
Name of journal: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive OncologyAbstract: BACKGROUND: Body mass index (BMI) has been associated with breast cancer outcomes. However, few studies used clinical trial settings where treatments and outcomes are consistently evaluated and documented. There are also limited data assessing how patient/disease characteristics and treatment may alter the BMI-breast cancer association.CONCLUSIONS: In our investigation, we did not find a consistent relationship between BMI at diagnosis and breast cancer recurrence or death.IMPACT: This work demonstrates that the heterogeneity of breast cancer between different breast cancer populations and the different therapies used to treat them may modify any association that exists between BMI and breast cancer outcome.Copyright ©2015 American Association for Cancer Research.METHODS: We evaluated 15,538 breast cancer participants from four NSABP protocols. B-34 studied early-stage breast cancer patients (N = 3,311); B-30 and B-38 included node-positive breast cancer patients (N = 5,265 and 4,860); and B-31 studied node-positive and HER2-positive breast cancer patients (N = 2,102). We used Cox proportional hazards regression to calculate adjusted hazards ratios (HR) for risk of death and recurrence, and conducted separate analyses by estrogen receptor (ER) status and treatment group.RESULTS: In B-30, increased BMI was significantly related to survival. Compared with BMI < 25, HRs were 1.04 for BMI 25 to 29.9 and 1.18 for BMI > 30 (P = 0.02). Separate analyses indicated the significant relationship was only in ER-positive disease (P = 0.002) and the subgroup treated with doxorubicin/cyclophosphamide (P = 0.005). There were no significant trends across BMI for the other three trials. Similar results were found for recurrence. Increased BMI was significantly related to recurrence in B-30 (P = 0.03); and the significant relationship was only in ER-positive breast cancers (P = 0.001). Recurrence was also significant among ER-positive disease in B-38 (P = 0.03).All authors: Anderson SJ, Cecchini RS, Costantino JP, Geyer CE Jr, Jeong JH, Lembersky BC, Paterson AH, Rastogi P, Romond EH, Swain SM, Tang G, Wolmark NFiscal year: 2016Digital Object Identifier: Date added to catalog: 2017-03-06
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 26545405 Available 26545405

Available online from MWHC library: Nov 1991 - present (after 1 year)

BACKGROUND: Body mass index (BMI) has been associated with breast cancer outcomes. However, few studies used clinical trial settings where treatments and outcomes are consistently evaluated and documented. There are also limited data assessing how patient/disease characteristics and treatment may alter the BMI-breast cancer association.

CONCLUSIONS: In our investigation, we did not find a consistent relationship between BMI at diagnosis and breast cancer recurrence or death.

IMPACT: This work demonstrates that the heterogeneity of breast cancer between different breast cancer populations and the different therapies used to treat them may modify any association that exists between BMI and breast cancer outcome.Copyright ©2015 American Association for Cancer Research.

METHODS: We evaluated 15,538 breast cancer participants from four NSABP protocols. B-34 studied early-stage breast cancer patients (N = 3,311); B-30 and B-38 included node-positive breast cancer patients (N = 5,265 and 4,860); and B-31 studied node-positive and HER2-positive breast cancer patients (N = 2,102). We used Cox proportional hazards regression to calculate adjusted hazards ratios (HR) for risk of death and recurrence, and conducted separate analyses by estrogen receptor (ER) status and treatment group.

RESULTS: In B-30, increased BMI was significantly related to survival. Compared with BMI < 25, HRs were 1.04 for BMI 25 to 29.9 and 1.18 for BMI > 30 (P = 0.02). Separate analyses indicated the significant relationship was only in ER-positive disease (P = 0.002) and the subgroup treated with doxorubicin/cyclophosphamide (P = 0.005). There were no significant trends across BMI for the other three trials. Similar results were found for recurrence. Increased BMI was significantly related to recurrence in B-30 (P = 0.03); and the significant relationship was only in ER-positive breast cancers (P = 0.001). Recurrence was also significant among ER-positive disease in B-38 (P = 0.03).

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