title: Association of Locoregional Control With High Body Mass Index in Women Undergoing Breast Conservation Therapy for Early-Stage Breast Cancer.
abstract: Obesity, as measured by the body mass index (BMI), is a risk factor for distant recurrence and decreased survival in breast cancer. We sought to determine whether the BMI correlated with local recurrence and reduced survival in a cohort of predominantly obese women treated with breast conservation therapy.
  
  
  
  From 1998 to 2010, 154 women with early-stage invasive breast cancer and 39 patients with ductal carcinoma in situ underwent prone whole breast irradiation. Cox proportional hazards regression, Kaplan-Meier methods with the log-rank test, and multivariate analysis were used to explore the association of the outcomes with the BMI.
  
  
  
  The median patient age was 60 years, and the median follow-up duration was 73 months. The median BMI was 33.2 kg/m(2); 91% of the patients were overweight (BMI ≥25 kg/m(2)) and 69% of the patients were clinically obese (BMI ≥30 kg/m(2)). The BMI was significantly associated with the locoregional recurrence-free interval for patients with invasive cancer and ductal carcinoma in situ (hazard ratio [HR], 1.09; P=.047). Also, a trend was seen for increased locoregional recurrence with a higher BMI (P=.09) for patients with invasive disease, which was significant when examining the outcomes with a BMI stratified by the median value of 33.2 kg/m(2) (P=.008). A greater BMI was also significantly associated with decreased distant recurrence-free interval (HR, 1.09; P=.011) and overall survival (HR, 1.09; P=.004); this association remained on multivariate analysis (distant recurrence-free interval, P=.034; overall survival, P=.0007).
  
  
  
  These data suggest that the BMI might affect the rate of locoregional recurrence in breast cancer patients. A higher BMI predicted a worse distant recurrence-free interval and overall survival. The present investigation adds to the increasing evidence that BMI is an important prognostic factor in early-stage breast cancer treated with breast conservation therapy.
authors: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Carmen
authors: C
authors: Bergom
authors: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Tracy
authors: T
authors: Kelly
authors: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Meena
authors: M
authors: Bedi
authors: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Hina
authors: H
authors: Saeed
authors: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Phillip
authors: P
authors: Prior
authors: Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Lisa E
authors: LE
authors: Rein
authors: Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Aniko
authors: A
authors: Szabo
authors: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: J Frank
authors: JF
authors: Wilson
authors: Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors: Adam D
authors: AD
authors: Currey
authors: Department of Radiation Oncology, James Cancer Hospital, Ohio State University Comprehensive Cancer Center, Columbus, Ohio. Electronic address: Julia.White@osumc.edu.
authors: Julia
authors: J
authors: White
mesh_terms: D015992:Body Mass Index; D001943:Breast Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D003131:Combined Modality Therapy / Q000401:mortality / Q000706:statistics & numerical data; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000401:mortality* / Q000706:statistics & numerical data; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control*; D009367:Neoplasm Staging; D009765:Obesity / Q000401:mortality* / Q000532:radiotherapy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014922:Wisconsin / Q000453:epidemiology