Obesity at diagnosis of breast carcinoma influences duration of disease-free survival.
OBJECTIVE
To study disease-free survival at 10 years in relation to obesity at the time of diagnosis.


METHODS
A prospective study of consecutively treated patients with primary breast cancer.


METHODS
Memorial Sloan-Kettering Cancer Center, New York.


METHODS
Nine hundred twenty-three women treated by mastectomy and axillary dissection.


RESULTS
Women who were obese (25% or more over optimal weight for height) at the time of primary breast cancer treatment were at significantly greater risk for recurrence (42%) compared with nonobese patients (32%) 10 years after diagnosis (P less than 0.01). In multivariate analyses, obesity remained a statistically significant prognostic factor after controlling for measured tumor size, number of positive axillary lymph nodes, age at diagnosis, and adjuvant chemotherapy with a hazard ratio of 1.29 (95% CI, 1.0 to 1.67). When analyses were restricted to the 557 patients free of lymph node metastases, the hazard ratio of recurrence associated with obesity was 1.59 (CI, 1.06 to 2.39); 32% of obese patients developed recurrent disease compared with 19% of nonobese women.


CONCLUSIONS
Obesity at the time of diagnosis is a significant prognostic factor that may limit the reduction in breast cancer mortality attainable through detection at an early stage of disease. Because obesity and the risk for breast cancer increase with age, interventions that encourage weight control may influence breast cancer survival rates.
Senie
R T
RT
Centers for Disease Control, Atlanta, Georgia.
Rosen
P P
PP
Rhodes
P
P
Lesser
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ML
Kinne
D W
DW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications* / Q000401:mortality; D002277:Carcinoma / Q000150:complications* / Q000401:mortality / Q000556:secondary*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008408:Mastectomy; D008593:Menopause; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000401:mortality; D009765:Obesity / Q000150:complications*; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D015996:Survival Rate