title: Weight gain and recovery of pre-cancer weight after breast cancer treatments: evidence from the women's healthy eating and living (WHEL) study.
abstract: OBJECTIVE
  To examine predictors of weight gain following breast cancer diagnosis and subsequent return to pre-cancer weight.
  
  
  OBJECTIVE
  To determine (1) the associations of anti-neoplastic chemotherapy and/or, Tamoxifen((R)) 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.
  
  
  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((R)) was not (OR = 1.03, 95% CI = 0.71, 1.51). Tamoxifen((R)) 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.
  
  
  CONCLUSIONS
  Chemotherapy was associated with clinically meaningful weight gain, and a return to initial weight following weight gain was unlikely.
authors.affiliation: Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, 9500 Gilman Drive, San Diego, La Jolla, CA 92093-0901, USA.
authors.forename: Nazmus
authors.initials: N
authors.lastname: Saquib
authors.forename: Shirley W
authors.initials: SW
authors.lastname: Flatt
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Thomson
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Bardwell
authors.forename: Bette
authors.initials: B
authors.lastname: Caan
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Rock
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001835:Body Weight; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011795:Surveys and Questionnaires; D017741:Survivors; D013997:Time Factors; D015430:Weight Gain; D016387:Women's Health