title: Body mass index and weight change in relation to triple-negative breast cancer survival.
abstract: The aim of this study was to evaluate the influence of body mass index (BMI), weight change on triple-negative breast cancer (TNBC) prognosis in a population-based prospective cohort study. The current analysis included 518 participants diagnosed with TNBC in Shanghai Breast Cancer Survival Study. Weight at 1 year prior to cancer diagnosis, at diagnosis, and at 6, 18 and 36 months after cancer diagnosis and height at 6 months after cancer diagnosis were assessed. Disease-free survival (DFS) and overall survival (OS) were evaluated in relation to BMI and weight change using Cox proportional hazard models. Obesity (BMI ≥ 28.0 kg/m(2)) at 1-year pre-diagnosis was associated with higher risk of total mortality and recurrence/disease-specific mortality, with multivariate hazard ratios (HRs) of 1.79 (95 % CI 1.06-3.03) and 1.83 (95 % CI 1.05-3.21), respectively. The associations between BMI and TNBC prognosis attenuated over time from pre-diagnosis to post-diagnosis. Compared with stable weight (change within 5 %), weight loss ≥5 % at 18- or 36-month post-diagnosis was related with higher risk of total mortality and recurrence/disease-specific mortality. Respective multivariate HRs were 2.08 (95 % CI 1.25-3.46) and 1.42 (95 % CI 0.77-2.63) for OS, and 2.50 (95 % CI 1.45-4.30) and 2.17 (95 % CI 1.14-4.12) for DFS. However, the association of weight loss and OS/DFS attenuated after excluding patients whose weight was measured after recurrence. Weight gain ≥5 % at 18- or 36-month post-diagnosis was associated with a non-significant increased risk of death. The results showed that obesity pre-diagnosis and weight loss post-diagnosis was inversely associated with TNBC prognosis. Emphasis on maintaining stable weight after cancer diagnosis for TNBC patients may be considered.
authors.affiliation: Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhong Shan Road (W), Shanghai, 200336, China.
authors.forename: Ping-Ping
authors.initials: PP
authors.lastname: Bao
authors.affiliation: Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, 37203, USA.
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.affiliation: Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhong Shan Road (W), Shanghai, 200336, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Peng
authors.affiliation: Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhong Shan Road (W), Shanghai, 200336, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Gu
authors.affiliation: Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, 37203, USA.
authors.forename: Yinghao
authors.initials: Y
authors.lastname: Su
authors.affiliation: Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, TN, 37203, USA.
authors.forename: Xiao-Ou
authors.initials: XO
authors.lastname: Shu
authors.affiliation: Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhong Shan Road (W), Shanghai, 200336, China. zhengying@scdc.sh.cn.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D064726:Triple Negative Breast Neoplasms / Q000453:epidemiology / Q000401:mortality*; D015430:Weight Gain; D015431:Weight Loss
keywords: Body mass index; Prognosis; Survival outcomes; Triple-negative breast cancer; Weight change