title: Impact of obesity on diagnosis and treatment of breast cancer.
abstract: In this population-based study, we evaluated the impact of obesity on presentation, diagnosis and treatment of breast cancer. Among all women diagnosed with invasive breast cancer in the canton Geneva (Switzerland) between 2003 and 2005, we identified those with information on body mass index (BMI) and categorized them into normal/underweight (BMI <25 kg/m(2)), overweight (BMI > or =-<30 kg/m(2)) and obese (BMI > or =30 kg/m(2)) women. Using multivariate logistic regression, we compared tumour, diagnosis and treatment characteristics between groups. Obese women presented significantly more often with stage III-IV disease (adjusted odds ratio [OR(adj)]: 1.8, 95% CI: 1.0-3.3). Tumours > or =1 cm and pN2-N3 lymph nodes were significantly more often impalpable in obese than in normal/underweight patients (OR(adj) 2.4, [1.1-5.3] and OR(adj) 5.1, [1.0-25.4], respectively). Obese women were less likely to have undergone ultrasound (OR(adj) 0.5, [0.3-0.9]) and MRI (OR(adj) 0.3, [0.1-0.6]) and were at increased risk of prolonged hospital stay (OR(adj) 4.7, [2.0-10.9]). This study finds important diagnostic and therapeutic differences between obese and lean women, which may impair survival of obese women with breast cancer. Specific strategies are needed to optimize the care of obese women with or at risk of breast cancer.
authors: Geneva Cancer Registry, Institute of Social and Preventive Medicine, Geneva University, 55 Boulevard de la Cluse, 1205, Geneva, Switzerland.
authors: Carole
authors: C
authors: Deglise
authors: Christine
authors: C
authors: Bouchardy
authors: Mafalda
authors: M
authors: Burri
authors: Massimo
authors: M
authors: Usel
authors: Isabelle
authors: I
authors: Neyroud-Caspar
authors: Georges
authors: G
authors: Vlastos
authors: Pierre Olivier
authors: PO
authors: Chappuis
authors: Michela
authors: M
authors: Ceschi
authors: Silvia
authors: S
authors: Ess
authors: Monica
authors: M
authors: Castiglione
authors: Elisabetta
authors: E
authors: Rapiti
authors: Helena Marieke
authors: HM
authors: Verkooijen
mesh_terms: D000368:Aged; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications*