Weight gain and recovery of pre-cancer weight after breast cancer treatments: Evidence from the women's healthy eating and living (WHEL) study

Nazmus Saquib, Shirley W. Flatt, Loki Natarajan, Cynthia Thomson, Wayne A. Bardwell, Bette Caan, Cheryl L. Rock, John P. Pierce

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

Purpose: To examine predictors of weight gain following breast cancer diagnosis and subsequent return to pre-cancer weight. Objectives: To determine (1) the associations of anti-neoplastic chemotherapy and/or, Tamoxifen® therapy on weight change following breast cancer diagnosis, (2) whether chemotherapy modified the effect of specific demographic and tumor characteristics on weight gain, (3) the proportion and characteristics of women who gained significant weight on chemotherapy and returned to their pre-cancer weight during follow-up. Subjects and methods: Participants were 3088 breast cancer survivors, aged 27-74 years. Weight was measured at baseline and years 1 through 6; pre-cancer weight was self-reported. Cancer stage and treatment modalities were obtained by medical record review; demographic and physical activity data were obtained from questionnaires. Weight gain of ≥5% body weight following cancer diagnosis was considered significant. Results: Chemotherapy was significantly associated with weight gain (OR = 1.65, 95% CI = 1.12, 2.43) and Tamoxifen® was not (OR = 1.03, 95% CI = 0.71, 1.51). Tamoxifen® did not modify the effect of either chemotherapy or its different regimens on weight gain. Both types (anthracycline: OR = 1.63, p-value = 0.01, non-anthracycline: OR = 1.79, p = 0.003) and all regimens of chemotherapy (AC: OR = 1.55, p-value = 0.01, CAF: OR = 1.83, p = 0.003, CMF: OR = 1.76, p = 0.004) were associated with weight gain but the associations were not different from one another. Only 10% of participants returned to their pre-cancer diagnosis weight at the follow-up visits; the degree of initial gain (p for trend <0.0001) predicted that return. Conclusion: Chemotherapy was associated with clinically meaningful weight gain, and a return to initial weight following weight gain was unlikely.

Original languageEnglish (US)
Pages (from-to)177-186
Number of pages10
JournalBreast Cancer Research and Treatment
Volume105
Issue number2
DOIs
StatePublished - Oct 2007

Fingerprint

Weight Gain
Breast Neoplasms
Weights and Measures
Drug Therapy
Neoplasms
Tamoxifen
Therapeutics
Demography
Healthy Diet
Anthracyclines
Medical Records
Survivors
Body Weight
Exercise

Keywords

  • Adriamycin
  • Anthracycline
  • Body weight
  • Chemotherapy
  • Cohort studies
  • Cyclophosphamide
  • Fluorouracil
  • Methotrexate
  • Tamoxifen
  • Women

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Weight gain and recovery of pre-cancer weight after breast cancer treatments : Evidence from the women's healthy eating and living (WHEL) study. / Saquib, Nazmus; Flatt, Shirley W.; Natarajan, Loki; Thomson, Cynthia; Bardwell, Wayne A.; Caan, Bette; Rock, Cheryl L.; Pierce, John P.

In: Breast Cancer Research and Treatment, Vol. 105, No. 2, 10.2007, p. 177-186.

Research output: Contribution to journalArticle

Saquib, Nazmus ; Flatt, Shirley W. ; Natarajan, Loki ; Thomson, Cynthia ; Bardwell, Wayne A. ; Caan, Bette ; Rock, Cheryl L. ; Pierce, John P. / Weight gain and recovery of pre-cancer weight after breast cancer treatments : Evidence from the women's healthy eating and living (WHEL) study. In: Breast Cancer Research and Treatment. 2007 ; Vol. 105, No. 2. pp. 177-186.
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abstract = "Purpose: To examine predictors of weight gain following breast cancer diagnosis and subsequent return to pre-cancer weight. Objectives: To determine (1) the associations of anti-neoplastic chemotherapy and/or, Tamoxifen{\circledR} therapy on weight change following breast cancer diagnosis, (2) whether chemotherapy modified the effect of specific demographic and tumor characteristics on weight gain, (3) the proportion and characteristics of women who gained significant weight on chemotherapy and returned to their pre-cancer weight during follow-up. Subjects and methods: Participants were 3088 breast cancer survivors, aged 27-74 years. Weight was measured at baseline and years 1 through 6; pre-cancer weight was self-reported. Cancer stage and treatment modalities were obtained by medical record review; demographic and physical activity data were obtained from questionnaires. Weight gain of ≥5{\%} body weight following cancer diagnosis was considered significant. Results: Chemotherapy was significantly associated with weight gain (OR = 1.65, 95{\%} CI = 1.12, 2.43) and Tamoxifen{\circledR} was not (OR = 1.03, 95{\%} CI = 0.71, 1.51). Tamoxifen{\circledR} did not modify the effect of either chemotherapy or its different regimens on weight gain. Both types (anthracycline: OR = 1.63, p-value = 0.01, non-anthracycline: OR = 1.79, p = 0.003) and all regimens of chemotherapy (AC: OR = 1.55, p-value = 0.01, CAF: OR = 1.83, p = 0.003, CMF: OR = 1.76, p = 0.004) were associated with weight gain but the associations were not different from one another. Only 10{\%} of participants returned to their pre-cancer diagnosis weight at the follow-up visits; the degree of initial gain (p for trend <0.0001) predicted that return. Conclusion: Chemotherapy was associated with clinically meaningful weight gain, and a return to initial weight following weight gain was unlikely.",
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AU - Saquib, Nazmus

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AU - Natarajan, Loki

AU - Thomson, Cynthia

AU - Bardwell, Wayne A.

AU - Caan, Bette

AU - Rock, Cheryl L.

AU - Pierce, John P.

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N2 - Purpose: To examine predictors of weight gain following breast cancer diagnosis and subsequent return to pre-cancer weight. Objectives: To determine (1) the associations of anti-neoplastic chemotherapy and/or, Tamoxifen® therapy on weight change following breast cancer diagnosis, (2) whether chemotherapy modified the effect of specific demographic and tumor characteristics on weight gain, (3) the proportion and characteristics of women who gained significant weight on chemotherapy and returned to their pre-cancer weight during follow-up. Subjects and methods: Participants were 3088 breast cancer survivors, aged 27-74 years. Weight was measured at baseline and years 1 through 6; pre-cancer weight was self-reported. Cancer stage and treatment modalities were obtained by medical record review; demographic and physical activity data were obtained from questionnaires. Weight gain of ≥5% body weight following cancer diagnosis was considered significant. Results: Chemotherapy was significantly associated with weight gain (OR = 1.65, 95% CI = 1.12, 2.43) and Tamoxifen® was not (OR = 1.03, 95% CI = 0.71, 1.51). Tamoxifen® did not modify the effect of either chemotherapy or its different regimens on weight gain. Both types (anthracycline: OR = 1.63, p-value = 0.01, non-anthracycline: OR = 1.79, p = 0.003) and all regimens of chemotherapy (AC: OR = 1.55, p-value = 0.01, CAF: OR = 1.83, p = 0.003, CMF: OR = 1.76, p = 0.004) were associated with weight gain but the associations were not different from one another. Only 10% of participants returned to their pre-cancer diagnosis weight at the follow-up visits; the degree of initial gain (p for trend <0.0001) predicted that return. Conclusion: Chemotherapy was associated with clinically meaningful weight gain, and a return to initial weight following weight gain was unlikely.

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