Weight gain after breast cancer diagnosis worsens survival

Women who gain weight after their breast cancer diagnosis face a higher risk of breast cancer death, according to a report in the March 1st Journal of Clinical Oncology.

“The majority of women who undergo treatment for a breast cancer diagnosis gain weight subsequent to treatment, and this may adversely impact survival,” Dr. Candyce H. Kroenke from Harvard Medical School, Boston, told Reuters Health. “Physicians may wish to work with women to develop a plan that can help them to maintain weight after breast cancer diagnosis and treatment.”Dr. Kroenke and colleagues evaluated the impact of weight gain on breast cancer survival in 5204 women with breast cancer from the Nurses’ Health Study.Body weight before breast cancer diagnosis was significantly associated with breast cancer death and all-cause mortality, but not recurrence, especially among premenopausal women and women who had never smoked, the authors report.Weight gain after diagnosis was associated with an increased risk of recurrence, breast cancer death, and total mortality, the report indicates, but only among women who had never smoked.The association of weight gain and breast cancer mortality was evident only among women whose weights were normal at baseline, the researchers note, and not among women who were overweight at the time of their diagnoses.”The relationship between weight, weight gain, and breast cancer survival may be more complex than originally considered,” the investigators suggest.”The fact that so many women gain weight after diagnosis (60% or more depending on the study) suggest that women undergoing treatment encounter particular difficulties and barriers in attempting to maintain a healthy weight,” Dr. Kroenke said.”For example, treatment with chemotherapy has been linked to weight gain. I am hopeful and optimistic that new treatments developed in the future will have fewer negative side effects.””Evidence from observational studies and retrospective analyses of randomized trials is now sufficient to support clinical trials of life-style interventions with an anticipated improvement in survival comparable to that seen for many current systemic adjuvant treatments,” writes Dr. Rowan T. Chlebowski from Los Angeles Biomedical Research Institute, Torrance, California in a related editorial.”An important follow-up to this study would be to explore how weight loss influences survival,” Dr. Kroenke said. “I have been working to develop a study about particular aspects of diet that might help women to maintain weight after a breast cancer diagnosis.””There is good evidence to suggest that a healthy diet and physical activity, which may help women to maintain healthy weight, may also improve survival after diagnosis,” Dr. Kroenke added.(Source: J Clin Oncol 2005;23:1345-1347,1370-1378: Reuters Health: Will Boggs, MD: Oncolink: April 2005.)